What’s a Chemical Peel?
A chemical peel is an application of acids that remove the outer layers of the skin. It’s used to reduce the appearance of fine wrinkles, scars, scaly areas, acne, or other problems with the skin. A chemical peel cannot remove deep scars or wrinkles, but just smoothes out the skin to help it appear more vibrant. Different types of acids can be used for a light, medium, or deep chemical peel, depending on the extent and type of the damage to your skin.
If you’re choosing a chemical peel, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that a chemical peel is right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of having a chemical peel at Chemical Peel: Risks and Benefits.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the doctor who will perform your procedure if you decide to proceed.
How it’s done
For a light chemical peel, you don’t need any anesthetic or sedative. With a medium chemical peel, you may feel significant discomfort, so you may be offered a sedative to help you relax; this is not always necessary. A deep chemical peel can be painful, so it’s usually done under local anesthesia (injections of a numbing medicine, similar to Novocain) along with a sedative. Deep chemical peels were formerly done under general anesthesia, and there are still some providers who prefer this approach.
After you’ve received any necessary anesthetic and/or sedative, then the chemical peel solution will be applied to your face. For a light chemical peel, it’s a solution of alphahydroxy and betahydroxy acids; for a medium chemical peel, it’s trichloroacetic acid, sometimes along with glycolic acid; for a deep chemical peel, it’s a chemical called phenol. The acids are left on for only a few minutes. Then they’re neutralized with water or saline, and washed off. The timing is precisely controlled, to prevent skin damage and scarring from the chemical peel. After the acids are washed off, an ointment may be applied to the skin to help with the healing process.
Preparing for the procedure
Choosing your doctor
While cosmetic dermatology procedures may be offered at spas and beauty salons, they’re actually technical procedures that should be performed by qualified medical professionals. Your provider should have the degree MD (Medical Doctor), or should be an RN (Registered Nurse) or PA (Physician’s Assistant) who is under the direct supervision of an MD. Ideally, this doctor should be trained and board-certified in either plastic surgery or dermatology.
When you go to a doctor’s clinic for a chemical peel, be aware that the doctor whose name is on the clinic may not be directly involved in your treatment; you may never even meet him or her. Sometimes, the doctor doesn’t even stay at the clinic during the day! For safety reasons, it’s best to have an MD on-site who has examined you personally. This is because while the risks from these procedures are small, adverse reactions can and do happen, so you want someone present who can deal with problems if they do arise. When you call to schedule an appointment, ask who will be performing the procedure and whether a qualified physician will be present in the clinic during the procedure.
For more help in your search for a cosmetic dermatologist, visit our How to Find the Best Cosmetic Dermatologist page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for the procedure
A deep chemical peel often requires pretreatment prior to the procedure. This involves rubbing a solution of retinoic acid (derived from vitamin A) on the face one or more times per day, for up to eight weeks before the chemical peel is done. Retinoic acid thins the upper layer of skin, so that the phenol can penetrate the skin more evenly and deeply. For light and medium chemical peels, pretreatment is usually not necessary.
Your skin will look red and flaky after your chemical peel, and may sting or feel irritated. With a light or medium chemical peel, this is usually not very dramatic, and you can return to normal activities within a couple of days. However, you’ll need to be very diligent about avoiding the sun as much as possible and using sunscreen whenever you’re in the sun at all, because your new skin will be very sensitive to sun exposure.
With a deep chemical peel, the redness and irritation will be fairly severe, and there will also be crusting and peeling of the skin. It will take two weeks for your skin to heal enough for you to wear makeup, so you will probably want to plan for at least this much time off from work and important social activities. The redness may last for months. You’ll need to be diligent about sun protection for the rest of your life, because the new skin may not have the ability to fully pigment itself (meaning to tan, to protect itself from the sun).