What is a chemical peel?

A chemical peel uses a chemical solution to improve the skin's health or appearance by removing the damaged outer layers. It can:

• Correct uneven skin color (pigmentation)

• Remove precancer skin growths

• Soften acne or treat scars caused by acne

• Treat wrinkles caused by sun damage and scarring

• Treat skin blemishes common with age and heredity

Chemical peels can be done on the face, neck, chest, hands, arms, and legs. Chemical peels won't treat deep lines, change pore size, or remove deep scars. 

Possible complications from chemical peels

Possible complications from chemical peels may include:

• Change in skin color. For certain skin types, there is a risk of skin color change due to irritation. The change can be short-term or long-lasting. Taking birth control pills, being pregnant, or having a family history of brownish discoloration on the face (melasma) may raise your risk of developing the abnormal pigmentation.

• Scarring. Chemical peels can cause scarring. More aggressive peels are more likely to create scars.

• Infection. Infections after chemical peels are uncommon but may sometimes happen.

• Cold sores and fever blisters. People who tend to get cold sores or herpes simplex infections may have cold sores or fever blisters after a chemical peel. Medicine may be prescribed to prevent an outbreak.

Most complications after a chemical peel happen when post-treatment instructions are not followed correctly. Be careful to follow all instructions from your healthcare provider. A chemical peel is most often done for cosmetic reasons to improve appearance and self-confidence. It may be done with a facelift or other cosmetic procedures. But a chemical peel is not a substitute for a facelift. It doesn't prevent or slow the aging process. Be sure to tell your healthcare provider about medicines you are taking, a history of cold sores, and any abnormal scarring tendencies.

What substances are used for chemical peels?

Chemical peels may use alpha hydroxy acids, trichloroacetic acid, and phenol. The exact formula used may be adjusted for each person.

Alpha hydroxy acids (AHAs)

These include glycolic, lactic, and fruit acids. They are the mildest of the peel formulas. They create light peels that can often provide smoother, brighter-looking skin. AHA peels may be used to do the following:

• Reduce fine wrinkles

• Treat dry areas

• Reduce uneven pigmentation

• Help control acne

• Smooth rough, dry skin

• Improve texture of sun-damaged skin

AHAs are sometimes used together with a mild beta hydroxy acid (BHA). Salicylic acid is a BHA often used for hyperpigmentation and discoloration from acne scarring. 

AHA peels may cause the following:

• Stinging

• Redness

• Irritation

• Crusting, flaking, or scaling

• Dryness

Generally, no anesthesia is needed for AHA peels. That’s because they cause only a slight stinging feeling when applied.

Protecting your skin from the sun is important following AHA peels.

Trichloroacetic acid (TCA)

TCA is used for stronger peels. It can be used in many concentrations and is used to

• Smooth fine surface wrinkles

• Remove superficial blemishes

• Correct pigment problems

TCA can be used on the neck or other body areas. It may need pretreatment with tretinoin or AHA creams. This procedure is preferable for people with darker skin.

Anesthesia is not often required for TCA peels because the chemical solution acts as an anesthetic. But you may be given medicine (a sedative) to help you relax before and during the procedure. Two or more TCA peels may be needed over several months to get the desired result. But mild TCA peels may be done more often. The results of a TCA peel are often less dramatic than a phenol peel and they don't last as long.

Avoid sun exposure for a few months after a TCA peel. The procedure also may cause some unintended color changes in your skin.

Phenol

Phenol is the strongest of the chemical solutions and produces a deep peel. Phenol peels have become less popular as laser technology has improved. A phenol peel is mainly used to do the following:

• Correct blotches caused by sun exposure, birth control pills, or aging

• Smooth out coarse wrinkles

• Remove precancer growths

Phenol:

• Should be used on your face only. Scarring may result if used on the neck or other body areas.

• Is not advised for people with darker skin

• May pose a risk for people with heart problems

• May permanently remove facial freckles

• May cause permanent skin lightening

• May leave lines

• May be more painful and require anesthesia 

• Often requires skin to be pretreated for up to 8 weeks with retinoic acid

Recovery may be slow, and complete healing may take several months.

After a phenol peel, new skin may lose its ability to produce pigment. The skin will be lighter and will always have to be protected from the sun.

About the procedure

The procedure involves a chemical solution that is applied to the skin for several minutes until it is washed off or neutralized. The solution causes a layer of skin to separate and peel off. The healing process may take anywhere from 1 day to 3 weeks, depending on the type and strength of the peel. The new skin underneath is usually smoother, less wrinkled, and more even in color than the old skin. No matter the type of peel, the skin will always have to be protected from the sun.