What is Chemical Peel?

Chemical peel is a method for removing the superficial layer of the skin. One or more peeling chemicals are applied to the skin resulting in destruction of the superficial part of the skin. This allows a new layer of skin lining to develop. This procedure allows the removal of the superficial lining of the skin. It may help to remove black/white heads of pimples, superficial scars and superficial benign skin growths.

Chemical peels should only be carried out by trained individuals. Complications from chemical peels may be irreversible.

Type of Chemical Peels

1. Glycolic Acid Peel (AHA peel)
2. Trichloroacetic Acid Peel (TCA peel)
3. Jessner's Peel

What is a Glycolic Acid Peel?

Glycolic acid is a group of naturally occurring substances often called "fruit acids". When applied to the skin it destroys the "glue" that holds dead cells on the surface of the skin. This allows the dead cells to slough off, leaving behind a smoother skin surface.

A high concentration of glycolic acid remove up to the upper layer of the skin (called the epidermis) exposing the lower layer of undamaged skin. It is generally used for mild skin scars and comedones.

TCA and Jessner's Peels

These peels use chemicals that are more toxic than glycolic acids to the skin. These peels cause destruction to the deeper layer of the skin, thus permitting the underlying new skin to resurface. It is generally used for treating deeper scars and skin growths.

What are the medical indications for chemical peels treatment?

1. Minimize fine and coarse skin lines which resulted from sun damage (chronic sun exposure).
2. Treatment of acne (pimples) especially those with blackheads and whiteheads.
3. Mild/superficial acne scars.
4. Some pigmentary disorders.

What can I expect during and after a chemical peel?

When the chemical peel agent is applied to the skin you may feel a burning sensation for a few minutes. If TCA and Jessner's peels are applied on the skin, the skin will turn white and then pink.

For AHA peels there may be a transient pink discoloration which quickly returns to "normal" color. Occasionally very slight flaking in a few localized areas is seen for 1-2 days. Do not expect the skin to really peel.

For TCA and Jessner's peels, the skin may turn brown, feel dry, flake and peel for a few days.

You can have chemical peels done as an outpatient. For AHA peels you can return to work after the procedure without having to miss any time from work.

What must I do after a peel?

1. Wash your face as usual but use a gentler cleanser.
2. You may be asked to use a moisturizing cream prescribed to you by your doctor.
3. Do not apply any skin medication or glycolic acid product during the entire time of healing or the skin will become irritated.
4. Avoid sun exposure. Use a sun block beginning on the day after you have done the peel.
5. Do not peel, prick, scrape or scratch the skin at any time.

How many treatment sessions do I need?

To get best results peels have to be repeated. Most patients require 2-4 peels at 2-4 weeks intervals.

What are the possible complications of chemical peels and what to do if complications develop?

1. For the AHA peels crusted scabs may be seen if not treated appropriately. This could become infected and possibly lead to a scar. Contact the doctor's office if any crusted scabs form.
2. The skin should look and feel completely normal within 3 or 4 days (for AHA peels). If not contact your doctor.
3. Persistent pain developing after the peel. This may be reactivation of cold sores. See your doctor immediately.
4. See your doctor if blisters appear.
5. Skin infections are uncommon complications. These are seen as painful red areas often with scabs.
6. Allergic reactions to medication are seen as persistent, itchy and painful rash.
7. Scars.
8. Persistent areas of increased/decreased pigmentation.

All complications are rare, prompt recognition and treatment is necessary to prevent scars.