While dermal fillers can erase lines and wrinkles, one of the keys to looking younger lies in how healthy our skin looks. Chemical peeling is one of the oldest beauty secrets in the book. Chemical peels involve the application of a chemical solution to the surface of the skin to produce the careful removal of its outer layers. The amount of skin removed will depend on the type of chemical used, the strength of this product and how long it is left on the skin.
Chemical peels come in different strengths ranging from superficial peels, which have minimal downtime and can be done in your lunch hour, to deep peels which can give dramatic results but which involve a longer recovery time and more serious side effects. You will usually require a course of treatments with superficial peels but they can also be a great way to give your skin a boost before a special occasion. Although they are most commonly used on the face, chemical peels can also rejuvenate the skin on the back of the hands and the décolleté, which can give away your age as much as your face.
Almost everyone can benefit from a chemical peel. Peels can improve the look of your skin dramatically and can leave you looking younger and healthier.
If you have any of the following concerns, you could be a candidate for a peel:
- Dry skin
- Oily skin
- Acne scarring
- Lines and wrinkles
- Sun damage
- Dull or lifeless skin
If you have a history of poor skin healing and keloid scarring you may not be suitable for a peel, especially a stronger, deeper peel where scarring is a risk. If you have any type of infection on your face you may be best advised to wait until it clears up before having a peel. People with acne who have been using isotretinoin within the last 12 months are not suitable. People with dark skin types such as Asian or Afro-Caribbean skin are more at risk from hypopigmentation (loss of pigmentation in the skin) following a peel and may not be suitable for medium or deep peels. Anyone with heart problems should not have a Phenol peel.
The best way to discover if a peel is right for you is to have a consultation with an aesthetic practitioner who can assess your skin and talk to you about your concerns before advising what type of peel may best suit your needs.
There are virtually no risks associated with light or superficial peels. As they only mildly exfoliate the skin you should not get any negative side effects. On rare occasions some people develop hyperpigmentation (brown marks on the skin) but this can be avoided by ensuring you wear sun protection, even when it is not sunny outside.
There are some risks associated with medium depth peels. You will usually get patches of brown and white skin on your face after treatment but this should only be temporary. You are at risk of developing hyperpigmentation after having a medium depth peel, especially if you do not wear a sunscreen every time you go outside. You can also get a red appearance to your skin, which lasts for several months. This should not be a permanent side effect. There is a rare chance of scarring after a medium peel, so make sure you avoid picking or scratching.
There are a number of risks associated with deep peels, the most common of which is hypopigmentation (loss of pigment in the skin). This can be permanent and is particularly bad if you have a darker skin type, as it will be very noticeable. As with all peels you are also at risk of hyperpigmentation so make sure you religiously apply sunscreen with a high SPF. Scarring is another risk and can be permanent. Deep peels are very traumatic on the skin and can be quite dangerous so it is vital you go to a highly experienced surgeon or doctor to have your treatment.
How your treatment is performed will depend on the type of peel you are having.
Typically, with a superficial peel your skin will be cleansed and the peeling solution will be applied. In some cases, this is removed after a few minutes and in others you may leave the clinic with it on and remove it at home later. During the peel you should feel nothing more than a slight tingling or stinging sensation. With many superficial peels you won’t feel anything. The treatment is really quick and easy and can take as little as 10 minutes.
With Medium depth peels the skin is also thoroughly cleansed before the peeling solution is applied. In some cases, a fan is used to cool the face. The peel will then be neutralized and removed. As this is a medium depth peel expect the treatment to be more uncomfortable than a light peel. You may feel some stinging, burning and irritation.
With deep peels like Phenol peels, a local anesthetic will be used to numb the face first. You may also be given a sedative. Deep peels are often performed in conjunction with a face-lift or other surgical procedures when you are under general anesthetic. Deep peels can be quite dangerous and can cause an irregular heart beat so you will be kept on a heart monitor. If you are having your whole face done, then the peel will be applied to one side first and then removed after about 30 minutes before the other side is done. When the peel is applied to your skin it turns white. When the peel has been removed Vaseline or waterproof tape may be applied to help it work more effectively. As you are under anesthetic you should not feel pain during the treatment.
Before you have a chemical peel you will need to have a consultation with a qualified aesthetic practitioner. This will be your opportunity to discuss your skin concerns so they can decide what type and depth of peel will be best suited to you.
A medical history will usually be taken to make sure there are no reasons you should be having the treatment. You will then be asked to sign a consent form. Make sure you read this and all the associated information you are given carefully.
You should avoid exfoliating your face, sun bathing or using tanning beds and changing your normal skincare regime, unless instructed to do so by your practitioner. It is important to remember that with certain types of peel you will have to prepare your skin beforehand. This will involve using homecare products for about two weeks before treatment. Make sure you stick to the routine given to you by your practitioner as this will enhance your results and make the treatment itself less irritating.
With a superficial peel you may get a little bit of pinkness and some mild skin peeling for a couple of days but will be able to resume normal activities straight away.
With medium depth peels there is a longer recovery period, usually a week to 10 days, although your skin can be pink for a few months. You will also get more peeling with a medium depth peel and may want to stay inside for a few days. Your face might be quite sore and swollen and feel tight after treatment. You can take painkillers to control this and use an antibiotic ointment to reduce the risk of infection. You must avoid scratching or picking off any peeling skin as you may cause your skin to bleed and be left with scars.
Recovery from a deep peel can take a couple of weeks. Some people feel quite ill after having a deep peel so you are advised to get someone to pick you up and drive you home. You are likely to experience pain and discomfort after the treatment, as your face will be tender and swollen and feel almost sun burnt. You should take recommended painkillers to manage this. You will get quite severe peeling, which can look fairly horrific and be incredibly itchy. This is usually at its worst a couple of days after treatment. You must avoid scratching or picking any scabs or bits of peeling skin as this can result in scarring. It can take up to two weeks before you start to look normal again. Redness can take even longer to disappear and may last three or four months.
With all chemical peels you should avoid sunbathing afterwards and make sure you wear a sunscreen when you go out, even if it is not sunny, as you may develop brown marks on your skin known as hyperpigmentation.
Chemical peeling involves applying a chemical solution to the skin to remove its outer layers. How much skin they remove and how deep they penetrate will depend on the type of peel used, its strength and how long it is left on. There are three types of peel: superficial, medium and deep. These have varying percentages of active ingredients and different PH levels. The percentage of a peel just indicates how much of the peeling agent is contained in the peel so a 15% glycolic acid peel has less glycolic acid than a 50% glycolic acid peel. It is a common misconception that if a peel has a high percentage it means it cannot be done in a beauty salon however although this is not true, there is a difference between peels you can have at the beauticians and those you can have in a medi-spa or clinic. What really matters when it comes to peels is their PH level. This indicates how deep the peel will penetrate into your skin and how much irritation you will get. The thing to remember is; the lower the PH, the deeper the peel. Anything with a PH of less than 2.5 should be done by a doctor or nurse and if it has a PH of 1 only a doctor or surgeon. Beauty therapists cannot legally do anything lower than a 2.5. Peels with a PH of 3 are what you would usually find in a beauty salon.
Superficial or light peels are the gentlest type of peels available and one of the true ‘lunchtime’ aesthetic procedures. They only remove the top layer of the skin, known as the epidermis, and can give your skin and instantly brighter look as well as a smoother, more even texture. They can be used to minimise fine lines and wrinkles, sun damage, mild acne scarring, age spots and dry or flaking skin. They are usually made from alpha hydroxy or beta hydroxy acids, known as AHAs and BHAs and include glycolic acid, lactic acid and salicylic acid. Nowadays it is also common to use fruit enzymes and acids from natural sources such as pumpkins, cranberries and pineapples. There are now advanced peeling systems, which offer the kind of results you would expect from a medium depth peel but with the side effects of a superficial peel. These types of peels use active ingredients to penetrate and deliver anti-oxidants and vitamins deep into the skin encouraging the new cells to grow stronger and healthier. A course of between six and 10 treatments is usually recommended to achieve the best results. Superficial peels do not hurt, you only feel a slight tingling or stinging sensation, and have virtually no recovery time. You can be a little bit pink afterwards and may get some mild flaking of the skin but this can be disguised with make-up. With a superficial peel you would be able to return to work or go out straight afterwards and no one would know you had had the treatment done.
Medium Depth Peels
Medium depth peels give more dramatic results than superficial peels. Usually derived from TCA (trichloroacetic acid), they penetrate deeper in to the skin and can be used to treat sun damage, pigmentation and wrinkles. The downside of medium peels is that you will have a longer recovery and more side effects. You may also feel more discomfort during the treatment than you would with a superficial peel including burning and stinging, which can last for 30 minutes to an hour after treatment. You may want to hide yourself away for a few days following a medium peel as your face can become swollen, pink and itchy following treatment and you will get more ‘peeling’ of the skin than you would with a superficial peel. You can also get patches of brown and white skin on your face during the healing process and in rare cases you can get scarring from medium depth peels. Generally, recovery takes around a week but your skin can be a little bit pink for up to six weeks afterwards.
Deep peels are the strongest type of chemical peel available and can achieve amazing results for sun damage, scarring and deep lines and wrinkles but be prepared to look quite scary after your treatment. They usually use carbolic acid (Phenol peels) or high strength TCA to penetrate the deeper layers, or dermal layers, of the skin. However, this type of peel is painful and can take months to fully recover from. Your skin will be very red and feel almost like it is sun burnt after the procedure. Although you will heal in one to three weeks the redness can still be visible for months after the treatment but the results of the peel are long lasting. Be warned you could also feel quite unwell after a Phenol peel and may need to be sedated during the treatment. The side effects of deep peels can look quite horrific. Your whole face will be swollen for a couple of days and will then scab. You will also get a lot of peeling and your skin may be quite itchy. For some people it can take up to two weeks before they want to go out in public. The most common problem associated with deep peels is patches of white or bleached looking skin, known as hypopigmentation, which can be permanent. There is also a risk of scarring. Because of the risks associated with Phenol peels it is incredibly important you find an experienced dermatologist or plastic surgeon to carry out the treatment.
Glycolic acid is the most common peeling agent. It comes in different strengths (30% – 90%) and different pH levels (levels of acidity) which will determine how deep it penetrates and how much peeling you get. It can be used to treat fine lines and wrinkles, sun damage, improvement of skin texture, skin brightening.
Salicylic acid is unique amongst the hydroxy acids in that it can penetrate deeper into the oil glands causing exfoliation even in the oily areas of the face and scalp, making it ideal for treating acne and oily skin.
Lactic acid occurs naturally in human skin and is also found in milk. It is less irritating than other AHAs and has a natural moisturising effect on the skin. It is ideal for skin brightening. It can be used to treat pigmentation, dry or dehydrated skin, sensitive skin, rosacea.
Fruit enzymes can also be used as peeling agents. Commonly used fruit enzymes come from fruits such as papaya, pineapple, pumpkin and cranberry. They are anti-bacterial, promote cell renewal and can digest oil from spots (sebum) and dead skin. They can be used to treat acne, rosacea, dehydrated skin, hyper reactive and sensitive skin.
Tartaric acid comes from grapes and is a less irritating alternative to glycolic acid for a milder exfoliation of the skin. It can also help increase hydration. It can be used to treat acne, photo damage, rosacea, superficial pigmentation, eczema.
Malic acid comes from apples and pears and like tartaric acid is a weaker AHA than glycolic acid. It can be used to treat acne, photo damage, rosacea, superficial pigmentation, eczema. Citric acid comes from lemons and oranges and works in the same way as tartaric and malic acids. It can be used to treat acne, photo damage, rosacea, superficial pigmentation, eczema.
TCA or trichloroacetic acid is a stronger acid than glycolic. It penetrates deeper into the skin and is usually used for medium depth or deep peels although it can be used at a lower concentration in combination with other acids for a milder peel. It can be used to treat skin tightening, fine lines and wrinkles, acne scars, large pores, hyperpigmentation.
Carbolic acid is found in Phenol peels and is the strongest type of peeling agent available. It is used for very deep peels. It can be used to treat deep lines and wrinkles, scarring, severe sun damage.
Meet the experts featured
on our global TV Series
Dr. Dilip Madnani
Dr. Marina Peredo
Dr. Jayson Oates
Dr. Lauren Bramley
Dr. Catherine Stone
Dr. Nicole Yap
Dr. Sean Kelishadi
Dr. William Mooney
Dr. Dilip Madnani