7 Questions To Ask Before Getting A Professional Chemical Peel
A good chemical peel can totally reset your skin — helping brighten pigmentation and dullness, reduce the appearance of large pores and fine lines, and improve tone and texture. They can also cause quite a bit of, well, peeling and leave skin feeling raw for some time afterwards. The good news? There are different kinds of peels that treat different layers of the skin, which means a dermatologist can tailor a treatment to directly address your skin concerns and skin type. So, what are the questions to ask? Ahead, top dermatologists speak to the most important intel to have pre-peel.
1. What is a chemical peel?
If you’ve ever used a chemical exfoliator (think: a glycolic acid toner or a lactic acid serum), then you’ve used ingredients similar to those in a peel. A medical-grade chemical peel, however, exposes the ingredients we use at home to be quite weak in comparison to what happens when they’re applied professionally. “Chemical peels refer to a type of topical resurfacing in which a chemical exfoliant is applied to the skin to induce controlled skin injury at a certain depth, leading to subsequent skin regrowth,” explains Marisa Garshick, MD, New York City-based, board certified dermatologist.
2. What are the different types of chemical peels?
There are three categories of professional chemical peels:
“These terms describe how deeply the peels penetrate into the skin,” says Sejal Shah, MD, a board certified dermatologist in NYC. Superficial peels penetrate only the epidermis (a.k.a. the outermost layer of skin); medium-depth peels affect the entire epidermis and a portion of the papillary dermis (upper to mid-dermis); and deep peels aim to penetrate to the level of the mid-reticular dermis (deeper part of the dermis).
3. What ingredients are found in chemical peels?
The depth, however, isn’t the only differentiating factor among peels. There’s also the ingredients — or cocktail of ingredients — used. As Dr. Garshick explains, superficial chemical peels often contain:
- Alpha hydroxy acids (like glycolic, lactic, and mandelic)
- Trichloroacetic acid (TCA)
- Beta hydroxy acids (read: salicylic acid)
Superficial glycolic peels may have a concentration of anywhere from 20 to 50 percent. Lactic acid peels fall in the 20 to 30 percent range. TCA can be used to produce deeper results, but, at superficial strength, it’ll be found at 10 to 20 percent. Needless to say, those percentages increase as you wish to increase the intensity of the peel. “Medium to deep peels penetrate to the mid to deep dermis,” Dr. Garshick explains. The most common? TCA peels at 35 to 50 percent, “which may also be used in combination with other ingredients such as Jessner's solution or glycolic acid,” she adds. (Note: Jessner’s solution includes salicylic acid, resorcinol, lactic acid, and ethanol.)
4. Who is (and isn’t) a good candidate for a chemical peel?
Superficial chemical peels are generally considered safe and effective for most skin types. Medium and deep peels require a bit more caution. If you’re dealing with photo damage, actinic keratoses (i.e. rough patches that can be considered precancerous), sun spots, fine lines, wrinkles, and discoloration, Dr. Garshick says you may be a good candidate for a medium-deep peel. Medium strength peels can also be good for patients looking to smooth acne scars.
But it’s important to consider your medical history. If you have a history of keloids or hypertrophic scars, have used certain acne treatments in the past year, have very sensitive or easily irritated skin, you may not be a good candidate, Dr. Shah notes. Finally, patients with darker skin tones must be more cautious, as deeper peels pose risks for post-inflammatory pigmentation.
5. Is there downtime after a chemical peel?
After a superficial chemical peel, you can expect to see about a week of flaking, but it shouldn’t impact your daily routine too much. When it comes to more potent peels, Dr. Shah says to expect up to a week of downtime after a medium chemical peel and up to two weeks after certain deeper peels. You’ll likely experience physical skin peeling for five to seven days and the skin may be pink or red. “While the worst of that will subside within one to two weeks, some may experience some residual erythema (or pinkness of the skin) for up to three to four weeks,” Dr. Garshick notes. “Some individuals may also experience some swelling in the first one to two days.”
6. What kind of results can be expected from a chemical peel?
That said, if you can handle a week or two of downtime — the results of a medium and deep chemical peel can be impressive. Positive outcomes can include “improvements in fine lines, wrinkles, texture, hyperpigmentation, sun damage, acne, dullness, and overall skin complexion,” Dr. Shah says. Even at the more superficial end of the spectrum, you can expect to see some improvement in skin brightness, tone, and texture.
7. What kind of post-peel care is involved?
In the case of superficial chemical peels, a temporary change to your skincare routine (think: laying off sensitizing products like retinol for a few days) may be suggested post-peel. Deeper peels will require more care, and your provider will likely provide thorough instructions. “Immediately after the peel, ice soaked gauze may be applied to the skin or you may be provided with a fan to help keep the skin feeling cool,” Dr. Garshick shares, adding that a thin layer of petrolatum (read: Vaseline) or wound-healing cream is often applied. It is especially important to avoid the sun and use strict sun protection. She likes EltaMD UV Replenish to minimize post-inflammatory discoloration and protect the new, fresh layer of skin.
Regardless of what kind of peel you choose, Dr. Shah has some key behavioral suggestions for your post-peel care routine:
- Don’t Touch: “Avoid touching, picking, rubbing, or peeling the sloughing skin,” she says.
- Keep It Clean: Use a gentle cleanser to keep the skin as clean as possible.
- Moisturize: You can even apply and reapply throughout the day if skin feels dry or tight. “Sometimes I will even recommend a mild hydrocortisone,” Dr. Shah adds.
- Be Gentle: Skip exfoliation (chemical and physical) while your skin heels.
- Stay Protected: For good measure, we’ll remind you one more time — be extra diligent with your SPF application.
Don’t be shy about asking your provider for their pre- and post-peel skincare tips to ensure you maximize your results.
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