Chemical peel, also known as chemexfoliation or derma-peeling, is a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin, which causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin also is temporarily more sensitive to the sun.
What Conditions Do a Chemical Peel Treat?
Chemical peels are performed on the face, neck, or hands. They can be used to:
- Reduce fine lines under the eyes and around the mouth
- Treat wrinkles caused by sun damage, aging and family history
- Improve the appearance of mild scarring
- Treat certain types of acne
- Reduce age spots, freckles and dark patches due to pregnancy or taking birth control pills (melasma)
- Improve the look and feel of skin that is dull in texture and color
Areas of sun damage, which may contain pre-cancerous keratoses that appear as scaly spots, may improve after chemical peeling. Following treatment, new pre-cancerous lesions are less likely to appear.
However, sags, bulges, and more severe wrinkles do not respond well to chemical peels. They may require other kinds of cosmetic surgical procedures, such as laser resurfacing, a facelift, brow lift, eyelid lift, or soft tissue filler (collagen or fat). A dermatologic surgeon can help determine the most appropriate type of treatment for each individual case.
Who Is a Good Candidate For a Chemical Peel?
Generally, fair-skinned and light-haired patients are better candidates for chemical peels. Darker skin types may also have good results, depending upon the type of problem being treated. However, the risk of an uneven skin tone after the procedure is increased.
How Are Chemical Peels Performed?
A chemical peel can be performed in a doctor's office or in a surgery center as an outpatient procedure.
The skin is thoroughly cleansed with an agent that removes excess oils and the eyes and hair are protected. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol), are applied to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.
Preparing for a Chemical Peel
Prior to the chemical peel, your doctor may ask you to stop taking certain drugs and prepare your skin with topical preconditioning medications such as Retin-A, Renova, or glycolic acid. After the chemical peel, it's important to use a broad-spectrum sunscreen every day.
If you have been prescribed oral antibiotics or an oral antiviral medicine, you should begin taking those as directed. Typically, the oral antibiotics are prescribed depending on the depth of the chemical peel.
Remember to ask your doctor if you need to have someone drive you home.
What to Expect During a Chemical Peel
During a chemical peel, most patients experience a burning sensation that lasts about five to ten minutes, followed by a stinging sensation. Cool compresses may be applied to help alleviate this stinging. A deeper peel may require pain medication during or after the procedure.
What To Expect After the Chemical Peel
Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness, followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved.
Medium-depth and deep peeling may result in swelling, as well as the presence of water blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to twelve months, if necessary.
You will work with your dermatologist to determine the depth of your peel. This joint decision can vary, depending upon the condition of your skin and the objectives of treatment.
After treatment, some peels may require bandages to be placed on part or all of the skin that is treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment.
It is important to avoid exposure to the sun for several months after a chemical peel since the new skin is fragile and more susceptible to complications. Your doctor will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling.
What Are the Possible Complications of Chemical Peels?
In certain skin types, there is a risk of developing a temporary or permanent color change in the skin after a chemical peel. Taking birth control pills, subsequent pregnancy, or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.
Although low, there is a risk of scarring in certain areas of the face, and certain individuals may be more prone to scarring. If scarring does occur, it can usually be treated with good results.
There is a small risk of reactivation of cold sores in patients with a history of herpes outbreaks. This problem is treated with medication as prescribed by the doctor. Your doctor may also choose to give you medication before or immediately after the peel in order to prevent a herpes outbreak.
Prior to treatment, it is important for a patient to inform the physician of any past history of keloids (scar tissue overgrowth created at the site of a skin injury) or unusual scarring tendencies, as well as any history of X-rays treatments to the face or recurring cold sores.
WebMD Medical Reference
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Mayo Clinic: "Chemical peel."
American Society for Dermatological Surgery: "Chemical Peels Information."
American Academy of Dermatology: "Chemical Peeling."
Reviewed by Norman Levine, MD on July 11, 2012