Chemical Peels are also known as: Fruit Acid Peel, Skin Peel, Facial Peel, AHA Peel, Glycolic Acid and Lactic Acid.
A chemical peel involves a chemical solution being applied to the skin causing the dead skin to slough off and eventually peel. The regenerated and resurfaced skin is smoother, with better texture and less lines than the old skin. A chemical peel works by inducing a controlled wound to the skin, removing the top layers of the skin causing collagen remodelling. Peels can be used to treat sun damage, wrinkles, fine lines, texture irregularities, skin pigmentation and the general appearance of the skin.
Chemical peels range from the least invasive to the most invasive. This relates to their strength, which will determine how deep they will peel. The least invasive peels also have the least risks and complications, but the most invasive peels, have the greatest potential to improve the skin.
Types of chemical peels
Glycolic and lactic acid peels (Aspect Dr)
These are great for exfoliation and removing the top layers of skin and stimulating collagen. Treatment is mild and recovery is quick.
Salicylic Acid is the usual ingredient in a BHA peel. These peels are best for acne prone and oilier skin types, because they are oil soluble and penetrate well in these skin types.
Retinoic acid peels
Tretinoin is the active ingredient in Retin-A. It is a retinoid, which is related to vitamin A.
These peels are suitable for those with sun damage who want younger skin
This is a combination of AHA and BHA and resorcinol. Great for acne and oily skin
If you are trying to improve oily, acne-prone skin, then the most suitable peels will be the BHA (salicylic acid) and Jessner’s (which includes a BHA) peels. Salicylic acid peels and Jessner’s peels (which also contains salicylic acid) are oil soluble, so they can penetrate deeper into pores and remove oil and sebum and are also anti-inflammatory (which is very important when treating the inflammation associated with acne).
If you have darker skin, then you will have to be wary of deeper treatments as you are at higher risk of PIH (Post Inflammatory Pigmentation)
If you are trying to improve pigmentation or sun damage, alpha-hydroxy acid peels, and Jessner’s peels are suitable.
If you are aiming for exfoliation, AHA and BHA are suitable
Typically, the face is treated with chemical peels but other areas that can potentially be treated include the backs of hands and décolletage areas.
It is advised to prep for a peel or series of peels. If the patient has a history of or is at risk of Post-Inflammatory Pigmentation (PIH), or has a history or melasma/chloasma, then prepping with a prescription skin lightening cream/gel combined with Vitamin A is advised.
The patient will be advised with what to prep the skin during the initial consultation. It may include AHA, salicylic acid, tretinoin or other retinoids. Sun avoidance is always advised.
Patients with PIH will have a strict protocol for after care to reduce the incidence or pigmentation after a peel.
Some peels have zero downtime and others take up to 7 days to peel. It is advised that the patient has the treatment 2 weeks prior to any important social engagement
Risks associated with peels
- Post Inflammatory Pigmentation (PIH): More likely to occur in those with darker skin tones
- Redness: Will often occur in those patients who have a tendency towards redness, can be prolonged
- Acne: Emollients used after the peel on the skin can trigger a breakout. May need to be treated with antibiotics
- Milia: Very small, superficial cysts may occur after the peel. These are easily treated
- Herpes infection: this needs to be treated with anti-viral medication asap to avoid scarring
- Bacterial Infection: Uncommon, requires antibiotics. Could lead to scarring
- Scarring or loss of pigment or textural changes: Very uncommon, mostly associated with deeper peels
- Allergies: Uncommon, can occur with Jessner’s peel
- Demarcation lines: can occur where the peeled skin meets the unpeeled skin. This is usually only associated with deeper peels
- Facial capillaries: Especially in those who are prone to them
- No peels while pregnant and breastfeeding
- With a history of herpes, antiviral medication may be prescribed preventatively
- History of Roaccutane use: No peels until 6 months after the Roaccutane was stopped
- Immunocompromised (e.g. HIV) patients should avoid chemical peels
- Patients with a history of keloid scarring should avoid anything deeper than very superficial peels.
Jessners Peel (Compounded)
Key Ingredients of the Reveal Peel
- Glycolic Acid: Great exfoliator, revealing new regenerated and resurfaced skin underneath
- Lactic Acid: Great for fine lines, pigmentation and sun spots
- Citric Acid: For skin brightening
- Salicylic Acid: A great exfoliator
It is for those who need exfoliation to treat fine lines, pigmentation and sun spots. It can be used to slough off the outer layer of dead skin cells revealing smoother and younger and fresher skin.
Upon application you will normally experience a strong tingling sensation and the skin may appear pink and tight immediately after application. Some peels have zero downtime, while others take up to 7 days to peel. Having a chemical peel on a regular basis is an important aspect of a good skin regime.