Chemical peels are very common in dermatological practice. Here in this article, the common and frequently asked questions about chemical peeling are discussed.
Chemical peeling refers to the application of a chemical agent to the skin to cause a controlled chemical burn. It should be deep enough to cause exfoliation of skin layers and superficial enough to allow regeneration with subsequent resurfacing and remodeling of collagen and elastic fibers. A chemical peel works like a snake shedding its skin. So several layers of damaged skin cells are shed, and a new fresh layer of skin is formed, which has a more even texture and color. They are used to improve the appearance of the skin or the texture of the skin.
Chemical peeling is often used to treat melasma, freckles, fine lines under the eye and around the mouth, and mild to moderate photodamage.
Mild superficial scarring and certain types of acne can also be treated with a chemical peel.
In addition, skin that is dull in texture and color may be improved with chemical peeling.
Uneven skin tone.
For chemical peeling, the most commonly used chemicals are
Trichloroacetic acid (TCA).
Alpha-hydroxy acid - Glycolic acid (AHA-GCA).
There are various types of chemical peels available, which includes:
Superficial peels penetrate only the outermost layer of the skin. Mild acids like alpha-hydroxy acid are used to gently exfoliate the skin.
Medium types of peels are known to be more effective in removing dead and damaged skin cells. Trichloroacetic or Glycolic acid is used to reach the middle layers of the skin.
As the name suggests, it deeply penetrates the middle layer of the skin to exfoliate the dead skin cells. Most often, Phenol or Trichloroacetic acid is used.
Tell your doctor if you have a prior history of scarring, cold sores, or any other medical illnesses. Mention all the drugs you are taking. Sometimes the doctor may ask you to stop certain drugs before the procedure.
After collecting a thorough medical history, the doctor may examine the skin type to determine the type of chemical peel that can be used.
Sometimes antiviral medication may be recommended before and after the treatment to prevent infections.
Retinoid creams like Retin-A may be suggested for better healing.
Prolonged unprotected sun exposure should be avoided as it can cause permanent irregular pigmentation in the treated areas.
Your face is cleaned, and your eyes and hair are protected with gauze, tape, or goggles.
In this procedure, a brush, cotton ball, gauze, or sponge is used to apply the chemical solution. You may experience a slight burning or stinging sensation on your skin. The treated skin starts to whiten. And the doctor will use a neutralizing solution to remove the chemical solution from the skin. Superficial peels require seven days to heal.
During a medium peeling, procedure chemical solution containing Trichloroacetic acid is applied using a cotton-tipped applicator. And a few minutes of cold compresses are given to soothe the treated skin. In this, no neutralizing solution is used. The patient may feel a stinging or burning sensation for 20 minutes. The treated skin starts to whiten. Medium peeling takes 7 to 14 days to heal.
During a deep peeling procedure, intravenous fluids (IV) will be administered, and heart rate will be monitored. Then the doctor will apply phenol using a cotton-tipped applicator. But the exposure to phenol should be limited, so the doctor applies it in portions at 15-minute intervals. The full procedure takes around 90 minutes. Deep peeling takes around 14 to 21 days to heal.
After care for superficial peel:
Restriction of emollients to the treated skin for 24 to 48 hours.
Tretinoin should not be applied for the first 3 to 7 days.
Sun avoidance is mandatory.
Sunscreen use may have to be temporarily discontinued for 3 to 7 days after a superficial peel if stinging occurs on application.
Peeling skin should not be picked, or scarring could result. The skin should be allowed to come off naturally.
The frequency of follow-up after the chemical peeling depends on the depth and severity of the condition. The skin will be sensitive after a chemical peel, so it is essential to avoid sun exposure.
Chemical peeling can be combined with other procedures to improve the texture and contour of the skin. Procedures like laser treatment and injectable filling agents can be combined with chemical peels.
Pitted scars will not respond to peeling, nor will deep scars with severe atrophy.
Chemical peels cannot tighten loose skin.
Chemical peels cannot remove the broken blood vessels on the face.
And chemical peels cannot always totally remove hyperpigmentation in dark-skinned people.
The day-to-day activities can be resumed immediately after the treatment. Intense exercise and excessive sweating should be avoided during the treatment.
Some of the common side effects of chemical peeling include:
These side effects are commonly reported and are temporary. But there are also some serious or severe side effects reported following chemical peels, which include:
Changes in skin color. There can be either darkening or lightening of the skin color, particularly in people with darker skin.
There can be permanent scarring.
The chemical phenol used in deep peeling can damage the heart muscle, kidney, and liver.
Patients having active herpes, unrealistic expectation, open cuts, a tendency for keloid formation, and patients undertaking Isotretinoin therapy are not suitable for chemical peeling. So it is wise to analyze if chemical peeling will suit you before going for the procedure.
Last reviewed at:
12 May 2022 - 4 min read
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