Treatment Overview

A chemical peel is a treatment to improve the look of the skin. This process destroys the top layers of the skin in a controlled way so that new skin can grow in its place.

There are different types of chemical peels. Deeper peels give more noticeable results. But they also have higher risks and have a longer healing time than light or medium peels.

Before the peel

Your doctor can help you decide what depth of peel and what type of chemical is best for you. This decision is based on your skin type, which areas you want peeled, and what kind of results you want.

You will be given instructions on how to prepare your skin before the peel.

How a peel is done

• You may be given pain medicine before having the treatment.
• Your skin will be thoroughly cleaned.
• A chemical solution will be brushed onto your skin for several minutes before being removed. (You may feel a little stinging while the chemical is on your skin.)
• Water or a cool compress will be used to end the chemical reaction.
• Ointment and a dressing will be applied to your skin.

Depending on how large an area is being treated, the entire process may take 60 to 90 minutes.

What To Expect

The time it takes to heal after a chemical peel depends on what kind of peel was done and how deep it was. Proper care of the skin after the peel is very important. This care can speed healing, help results last longer, prevent infection, and avoid color changes in the treated area caused by sun exposure. Proper skin care after a peel is very similar to the care used to prepare for a peel. It most often involves:

• Cleaning the skin often. You will use water or a special wash that your surgeon tells you to use.
• Changing the dressing or ointment on the wound (for medium and deep peels).
• Moisturizing the skin daily.
• Avoiding any sun exposure until peeling has stopped and sunscreen can be used. After peeling has stopped, sunscreen should be used every day. New skin is more likely to be damaged by the sun.

Light peels

Light peels often cause some stinging, redness, skin flaking, and irritation. Most people can go back to their normal activities right away. The skin heals quickly after a light peel. The skin may turn pink. In most cases, there is only a small amount of peeling.

Medium peels

A medium peel often causes redness, stinging, and skin flaking for about a week. The skin may turn reddish brown with symptoms like a deep sunburn. Keeping your skin well moisturized will help during the peeling process. Most people can go back to their normal activities in about a week.

Deep peels

A deep peel causes a deeper burn of the skin, with peeling, crusting, redness, and discomfort for several days or more. Skin grows back about 10 to 14 days after a deep peel. The skin stays very red for 3 weeks, and up to 2 months for some people. Most people take about 2 weeks off from work. Complete healing of the skin may take several months.

Why It Is Done

• Light peels are used to improve the look of pigment changes in the skin, acne scars, mild sun damage, or fine wrinkles in all skin types. They can be done on the face and on other parts of the body. A light peel may also be used to prepare the skin for a deeper peel.
• Medium peels are used to treat mild to moderate wrinkles, long-term sun damage, pigment changes, and precancerous lesions of the skin (usually caused by sun exposure). Medium peels are used most often on the face.
• Deep peels are used to treat severe wrinkles, long-term sun damage, pronounced pigment changes, and lesions and growths on the skin. They are done only on the face. Deep peels are not done on darker skin types, because they bleach the skin.

Chemical peels are sometimes done with dermabrasion or laser resurfacing for a more dramatic overall effect.

How Well It Works

The results of a chemical peel depend in part on the depth of the peel.

• A light peel may slightly reduce sun damage and signs of aging, but it doesn't remove them. The results may not appear for some time. And when they do appear, you may only see small changes. You may need to repeat peels to get the results you want.
• A medium peel can work very well to even out pigment differences and reduce fine wrinkles and signs of sun damage. You may need to get a second peel after 3 to 6 months to produce the best result.
• A single deep peel removes wrinkles and may tighten the skin. The effects are often quite noticeable. In general, a person can't repeat deep peels.

Your skin type, your skin care before and after the peel, the doctor's level of experience, and your lifestyle after treatment can also affect the results. Some types of skin problems respond better to a chemical peel than others. People with lighter skin who limit their sun exposure after the treatment tend to have better results than those who have darker skin and those who keep spending lots of time in the sun.

Before you decide to have a chemical peel, talk to your doctor about the kind of results you can expect.

Changes in the color and texture of the skin caused by aging and sun exposure may still get worse after a chemical peel. Chemical peels are not a permanent solution for these problems.

Risks

In general, the deeper the peel, the greater the risk of side effects and problems. Chemical peels can cause:

• Redness. Expect some redness of the skin after a chemical peel. With deeper peels or with certain skin types, redness can be severe. It may fade within a few weeks, or it may last several months.
• Color changes in the skin. Treated areas may be darker or lighter than the skin around them.
• Crusting and scaling.
• Swelling, mainly around the eyes.
• Scarring.
• Allergic reaction to the chemical.
• Infection. People who have a history of herpes outbreaks seem to be more likely to have an outbreak after a chemical peel.
• Increased sensitivity to sunlight.

Special concerns with deep peels

In rare cases, deep peels using phenol can cause more severe problems during the treatment, including heart, liver, or kidney failure.