What Are Chemical Peels?
Simply put, chemical peels are acids that are applied to the skin, are left on for approximately 3-5 minutes and then removed. They can be one or a combination of the following:
- Amino fruit acid
- Glycolic acid
- Jessner’s Peel (a mixture of lactic acid, salicylic acid, and resorcinol)
- Lactic acid
- Polyhydroxy acid
- Pyruvic acid
- Salicylic acid
- Trichloracetic acid (TCA)
They can be done at a frequency of once every two or three weeks and can be completed by an esthetician or by a doctor. In the case of an esthetician, a strength of up to 30% will be applied whereas doctors can go higher, up to 70%.
The result of the acid causes the skin to peel, even blister, and will heal in a few days’ time. The purpose of the peel is to trigger the skin cells to regenerate more quickly and thus improve the texture of the skin and help to prevent dead skin from clogging pores.
The classification of the peel is constructed on the type of acid and the concentration levels; no one acid appears to have better results over another. When a client receives a peel, they can choose from three levels, that of superficial, medium, or a deep peel.
For those who choose to receive a peel due to acne, they will receive either a superficial peel or a medium peel to help treat scars. Deep peels are usually reserved for those who have scars only.
There is nothing to say that those who are taking medication for their acne cannot also receive chemical treatment on their skin. Often, if a patient chooses to receive a peel the results are not enough and a prescribed medication is also necessary for the desired results. That said, it is always best to consult your healthcare provider before receiving any treatment.
Self-Medication of Acids
A lower-strength acid that can be purchased at a drug store or from a pharmacist can be used as an “at home” treatment. This over-the-counter treatment, typically around 10% strength, can be used more frequently than a professional chemical treatment and may result in a slower, but more controllable, form of exfoliating the top layer of the skin.
The cost of this and possible side effects will be drastically reduced by trying this method of self-medicated treatment. The product can safely be applied to the skin 2-3 times per week, depending on the individual.
Who Can Benefit from a Chemical Peel?
Due to the fact that a peel can sometimes cause hyperpigmentation (darkening of the skin) or the reverse effect, hypopigmentation (a lightening of the skin) typically, those who have a lighter skin tone won’t be bothered as much by darker tones created as a result of the peel.
Although not a common occurrence, a deep peel can result in raised, permanent scarring in those who have darker skin, known as keloid or a keloidal scar. Those with darker skin are often advised to use a superficial treatment as they are deemed to be safer.
It is always best then to talk with an experienced individual, whether a dermatologist, esthetician, or doctor, before receiving a chemical peel, especially one from medium to deep. An individual with a darker skin pigmentation should feel safe using an over-the-counter method of treatment.
How to Know Which Chemical Peel is Right for You
To know which chemical peel, or acid, works best for you, it is important to know what each of the advertised acids can do for the skin, let’s review:
Alpha-Hydroxy Acid (AHA)
This acid can be found in many over-the-counter chemical peels, their purpose is to loosen the structure which holds the skin cells onto the surface of the skin.
Beta-Hydroxy Acids (BHA)
This acid is believed to help exfoliate the skin and reverse the effects of photoaging, that of wrinkles or discolored skin; it also helps to loosen dead skin cells. Specifically, salicylic acid is the only beta-hydroxy used in a chemical peel. When a sebum (oily substance) breaks down due to propanoic acid, or acne bacteria, it is also a beta-hydroxy acid.
The most common acid used in a chemical peel, over-the-counter treatments will come in 10% strength levels whereas a medical treatment will have a strength of up to 30%. It is often used to not only treat acne but also to remove brown spotting on the skin. If you suffer from tight, dry skin, then this is the better acid treatment to use, whereas those who have oily, loose skin should use a different acid treatment.
This lesser-used acid helps to break up the oily and waxy surface that exist on the surface of plants, therefore serves no purpose for human skin. If a product advertises this acid, avoid its use.
The same acid that originates in milk can be used to treat brown spotting on the skin. If you suffer from oily and tight skin, you may choose to try this acidic treatment.
This particular acid is frequently used on those with dark pigmentation in their skin and can serve the purpose of a peel as well as an anti-inflammatory. When used, the concentration is never above 3%.
Using an Acne Chemical Peel
When a chemical peel is used, immediately you will notice a color change in your skin. If you also use retinol, tretinoin tropical, Retin-A, or another product on your skin that contains alpha-hydroxy or beta-hydroxy already, restrict the use of your peel to once a week.
Your skin will become irritated if you choose to combine the use of a peel and a scrub, so it is best to stick with one. If a peel is your choice of treatment, and that alone, you can use a peel every second day, but keep an eye on any irritation or redness.
For those with darker pigments in their skin, select an acid treatment that contains BHA and avoid AHA. It is also advised to begin with a low concentration of the acid and apply on a hidden spot first to determine the reaction of your skin. Any reaction and you may have to try a scrub or skin lightener in lieu of the peel.
If your acne has disappeared and you would like to treat dark spots you can try a peel and a lightener. Hydroquinone, a skin lightener is best for fair skin, those of Asian or African descent will want to avoid it as it can cause discoloration of the skin that is permanent.
In order to be safe, try a lightener of the following varieties: arbutin, azelaic acid, or even Kojic acid and be sure to rotate the use of the selected acid to prevent changes that cannot be reversed.
Types of Chemical Peels
Superficial Peel – To Treat Mild Acne
The purpose of a superficial peel is to shed the outer layer of skin cells. The acid in the peel also helps to provide anti-inflammatory properties which can also aid in lowering the oil secretions from the skin.
Typically, the acid that is used in this type of peel is either derived from AHA or BHA and the strength is lower than what would be used in a stronger peel. Glycolic acid, which is a type of alpha hydroxy or salicylic acid, are the two most common acids used. The level of concentration is that of 30% and the treatment can be received from an esthetician or a doctor.
Moderate Peel – To Treat Acne and Light Scarring
In the case of a moderate peel, trichloroacetic acid (TCA) with a strength of between 35-50% is used. The concentration level allows for the peel to penetrate deeper into the skin. When the layers of the skin peel, particularly at a deeper level, the production of collagen and elastin are increased thus giving the skin more elasticity.
To prevent complications that can sometimes occur from a higher strength of 50% with this acid, the skin can be prepped using a different method and a lower concentration of the TCA will then be used.
Methods can be either through the freezing of the skin beforehand with CO2 and acetone, followed by a peel of 20-35% TCA.
A second method can be done through the use of Jessner’s solution, a mixture of lactic acid, salicylic acid, and resorcinol, which helps to exfoliate the skin, penetrate it, and breakdown hardened skin, respectively. After this prepping has been completed, a peel of 70% glycolic acid can be then applied.
Deep Peel – For Scarring Treatment
When an individual has suffered from acne, and as a result, their skin has become scarred, a deeper peel may be in order. In this case, a stronger concentration of acid will be used and may only be conducted by a trained dermatologist.
The peel uses phenol and can be combined with croton oil at a concentration level of 88%. The proteins in the skin are broken down and the collagen is stimulated to help regenerate the skin.