How does a chemical peel work?

Chemical solutions are carefully applied to your skin to improve the texture by removing damaged outer layers. The chemicals used are phenol, trichloroacetic acid and alphahydroxy acids. Each one has a different purpose. The formula used by your doctor will be adjusted to meet your particular needs.

Light chemical peel

Subtle improvements at first, but that healthy glow will increase with more treatments

If you have uneven pigment, dryness, acne or fine wrinkling, a light chemical peel might be the right choice. This kind of peel removes just the outer layer of skin (epidermis) in a light exfoliation and results in a healthier glow. Your healthcare provider will use a combination of alphahydroxy acids and beta hydroxy acids, such as glycolic acid, lactic acid, salicylic acid and maleic acid. All of these chemicals are the mildest choices. You can repeat these treatments weekly for up to six weeks to achieve your desired results.

Here’s how it works:
  • Your face will be cleansed.
  • The chemical solution is brushed onto your skin and left for up to 10 minutes. You may feel some mild stinging.
  • The chemical peel is then washed off and neutralized.

Return once a month to maintain your vibrant new look.

Medium chemical peel

Your skin will be noticeably smoother and fresher-looking

Acne scars, deeper wrinkles and uneven skin color can all be treated with a medium chemical peel. The chemicals used for this type of peel will remove skin cells from both the outer layer of skin (epidermis) and upper part of your middle layer of skin (dermis). Your healthcare provider will use trichloroacetic acid, sometimes used in combination with glycolic acid.

Here’s how it works:
  • Your face will be cleansed.
  • The chemical solution is brushed onto your skin and left for just a few minutes. You may feel some burning or stinging.
  • The treated area may turn a whitish grey color.
  • The chemicals are neutralized with cool saline compresses.
  • Your skin may turn red or brown in the days just after the peel. It may take up to six weeks for your skin to look normal.

You may repeat a medium chemical peel every 6 to 12 months to maintain your glowing new skin.

Deep chemical peel

Results are dramatic, but recovery takes the longest

chemical peel

If you have deeper facial wrinkles, skin that’s damaged by the sun, scars, areas that appear blotchy or even pre-cancerous growths, deep facial chemical peels might be the right choice for you. Your physician will use the strongest chemical called phenol to penetrate down to the lower dermal layer of your skin. For this type of peel, you may need a local anesthetic and a sedative to manage any discomfort.

Here’s How it Works:

A deep chemical peel usually involves some sort of pretreatment for up to 8 weeks. This will prepare your skin for the peel and speed the healing process. Pretreatment may include use of Retin A – a prescription medication that’s derived from vitamin A. This works to thin out the skin’s surface layer, allowing the chemical solution to penetrate more evenly and deeply. If you can’t tolerate Retin A as a pre-treatment, your doctor may prescribe another medication.

  • A local anesthetic will be injected to freeze your face along with giving you a sedative to relax.
  • Your face will be cleansed.
  • Phenol is brushed onto the area and allowed to remain for at least 30 minutes and up to two hours.The chemical is neutralized with water.
  • After allowing your skin to rest for an hour, a thick coat of petroleum jelly is smoothed over your skin, covering the crust which develops. The petroleum jelly must stay in place for up to two days. Sometimes your healthcare provider will opt to cover your skin with strips of adhesive tape with openings for your eyes and mouth, rather than the layer of petroleum jelly. Your doctor will choose this approach if you have severe wrinkling.

chemical peel

Managing your discomfort: Deep chemical facial peels will result in peeling, redness and discomfort for several days. Your doctor will provide painkillers to keep you comfortable. Although the swelling is likely to disappear in about two weeks, your skin may be red for up to three months.

One treatment with a deep chemical peel will produce long-lasting and dramatic results whi

chemical peel You should understand that all chemical peels will carry some risks and uncertainties. It’s usually a very safe procedure when performed by a qualified and experienced plastic surgeon. It happens infrequently, but you could develop an infection or scarring from chemical peels.

For people with certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Birth control pills, getting pregnant, or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

If you have suffered from cold sores (herpes) in the past, there is a small risk of reactivation. Be sure to tell your doctor because she may prescribe medication before and immediately after a chemical peel to avoid an outbreak.

Inform your physician is you have a history of keloids (scar tissue overgrowth) or any unusual scarring tendencies.

Other considerations for each type of peel include:

Light chemical peel

You are likely to experience some redness, stinging, skin crusting and irritation from a light chemical peel. After repeated treatments these side effects will likely subside. Other risks include:

  • Hyper pigmentation. Your new skin may have too much pigment which will turn to brown blotches in sunlight. Avoid this by always using a high-factor sunscreen.
  • Infection

Medium chemical peel

chemical peel

When trichloroacetic acid is used in a medium chemical peel, you’ll experience some redness, stinging and skin crusting just like a light chemical peel. And although these chemicals won’t bleach your skin, you may see some color changes. You’re advised to avoid the sun for several months to protect that fresh new layer of skin. Other risks include:

  • Hyperpigmentation – when too much pigment occurs, causing brown blotches – may result even if you use sunscreen.
  • Redness, which occurs in everyone after the peel, may last longer than a few months for some people.
  • Permanent scarring is another, infrequent, risk.

Deep chemical peel

The chemical used for this kind of peel, phenol, can lighten the skin that’s treated. Your skin tone may be a determining factor as to whether or not this is an appropriate treatment for you. With this kind of peel, your new skin often loses its ability to make pigment, meaning a tan. You will always need to protect your skin from the sun. Phenol also can pose a special risk for people with heart disease. Be sure to tell your surgeon about any heart problems and include it in your medical history. Other risks include:

  • A red face which can last three to four months.
  • Cysts or white spots may appear with a deep peel and they can last up to several weeks.
  • Scarring is an infrequent risk.
  • Some areas of your skin may lose pigment permanently.
  • Hyperpigmentation – when too much pigment occurs, causing brown blotches – may result even if you use sunscreen.

A deep chemical peel requires that you have an adequate recovery time. You may return to work and some of your normal activities two weeks after treatment. At that point, your skin will be healed enough for you to wear makeup.

Now that you know what a facial chemical peel can do for your skin, it’s important to understand what they cannot do, such as:

  • Treat deep facial lines
  • Tighten loose or sagging skin
  • Stimulate collagen production
  • Remove broken capillaries
  • Change pore size
  • Remove deep scars

You may not be a good candidate for chemical peeling if you have:

  • A history of skin scarring
  • Abnormal pigmentation
  • Afro-Caribbean or Asian skin
  • Facial warts
  • Red hair and pale freckled skin
  • Used certain acne treatments within the last year

Choose a qualified plastic surgeon

asps logo

To find a qualified plastic surgeon who performs this procedure, visit the online referral service of the American Society of Plastic Surgeons (ASPS). ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. All ASPS physician members are certified by the American Board of Plastic Surgery (ABPS) or the Royal College of Physicians and Surgeons of Canada.

Caution: In some states, no medical degree is required to perform a chemical peel. In fact, many states have laws that allow non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply. It’s vital to find a physician who has adequate training and experience in skin resurfacing to avoid complications and achieve the best results.

Cost is always a consideration in elective procedures or treatment. The cost for a chemical peel may vary based on the expertise and qualifications of the person performing the treatment, type of chemical peel performed, time and effort the procedure or treatment requires as well as geographic office location. In 2009, the American Society of Plastic Surgeons estimated national surgeons’ average fees were $764 for a chemical peel. Many plastic surgeons offer patient financing plans, so be sure to ask. Additional fees may include:

  • Surgical facility costs
  • Anesthesia fees
  • Prescriptions for medication
  • Be sure to ask your surgeon about all costs involved in your procedure

Your satisfaction involves more than a fee

When choosing a plastic surgeon for a chemical peel, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the procedure.

Most health insurance does not cover cosmetic surgery or its complications.

  • Are you certified by the American Board of Plastic Surgery?
  • Were you specifically trained in the field of plastic surgery?
  • Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for a chemical peel?
  • What will be expected of me to get the best results?
  • Who will perform the chemical peel?
  • Have they been specifically trained in this procedure?
  • Where and how will you perform my procedure or treatment?
  • How long of a recovery period can I expect?
  • What are the risks and possible complications associated with my procedure?
  • How can I expect to look over time?
  • Do you have before-and-after photos I can look at for this procedure?
  • What results are reasonable for me?