chemical peel

What is a facial chemical peel

A chemical peel also called chemexfoliation or derma peeling, is a skin-resurfacing cosmetic procedure in which a chemical solution is brushed to the skin to remove dead skin cells and stimulate the growth of new skin cells. The skin that grows back after a chemical peel is smoother and younger looking. The aim of chemical peel procedure is to improve the appearance of your facial skin – for example, by reducing age spots and evening out skin tone. A chemical peel can diminish many signs of aging on the face as well as the hands, neck, and chest.

Chemical peels also treat some skin conditions. Dermatologists use chemical peels to treat some types of acne and conditions that discolor the skin.

Dermatologists use chemical peels to treat:

  • Acne (some types).
  • Age spots.
  • Discoloration (blotchy complexion, uneven skin tone).
  • Dull complexion.
  • Fine lines (especially under the eyes and around the mouth).
  • Freckles.
  • Melasma.
  • Rough-feeling skin.
  • Sun-damage skin.

A chemical peel may be performed in the doctor’s surgery or day-care facility. Chemical peels are considered a cosmetic treatment. Insurance does not cover the cost of cosmetic treatments.

Chemical peels are used to treat wrinkles, skin discoloration and scars — typically on the face. A chemical peel can be done alone or in combination with other cosmetic procedures.

Chemical peels can be done at different depths — light, medium or deep — depending on your desired results. Each type of chemical peel uses a different chemical solution. Deeper chemical peels produce more-dramatic results, but also involve longer recovery times.

A chemical peel can be used to treat various skin problems. Depending on the issues you’re addressing with the procedure, you’ll choose a chemical peel in one of three depths:

  • Light chemical peel. A light (superficial) chemical peel removes the outer layer of skin (epidermis). It can be used to treat fine wrinkles, acne, uneven skin tone and dryness. You might have a light chemical peel as often as every two to five weeks — depending on your desired results.
  • Medium chemical peel. This type of chemical peel removes skin cells from the epidermis and from portions of the upper part of your middle layer of skin (dermis). A medium chemical peel can treat wrinkles, acne scars and uneven skin tone. You might repeat a medium chemical peel after three to nine months to maintain results.
  • Deep chemical peel. A deep chemical peel removes skin cells from the epidermis and from portions of the mid to lower layer of your dermis. Your doctor might recommend a deep chemical peel if you have deeper wrinkles, scars or precancerous growths. A deep chemical peel can only be performed once.

Superficial and medium chemical peels are usually safe, provided they’re administered correctly. Deeper chemical peels are more risky. Deep chemical peels are now rarely performed and have been largely replaced by laser ablation.

Chemical peels can be expensive and have their limitations. The effects of a superficial or medium chemical peel aren’t permanent. The effects of a deeper chemical peel are long-lasting, but this is much more expensive, painful and risky.

Take time to find a reputable practitioner who is properly qualified and practices in a clean, safe and appropriate environment. Ask the practitioner what you should do if something were to go wrong.

The practitioner carrying out the procedure should advise how you can reduce your risk of side effects and complications.

A chemical peel is typically done in an office-based procedure room or outpatient surgical facility. Before the procedure, your doctor will clean your face and might cover your eyes with ointment, gauze, tape or goggles. He or she might also protect your hair.

Pain relief isn’t typically needed for a light chemical peel. If you’re having a medium chemical peel, you might have the option of taking a sedative and a painkiller.

If you’re having a deep chemical peel, your doctor will likely numb your skin with a local anesthetic and give you a sedative or use regional anesthesia — which numbs a certain part of your body.

As it heals, your skin would also be more sensitive to the sun, so you need to use sunscreen for at least a month after treatment.

Chemical Peel Warning

The results you see after getting a chemical peel depend largely on the skill of the person performing the peel. To protect your health and get the results you seek, you should see a dermatologist or dermatologic surgeon. These doctors have in-depth knowledge of the skin.

What to do if you have problems

If you’re not happy with the results or are experiencing problems, take up the matter with your practitioner through the clinic where you were treated.

If there are any complications that require medical attention, it is best that you go back to the practitioner who treated you. If this is not possible, you can go to your doctor or local accident and emergency department.

Is there downtime after a chemical peel?

After a medium or deep chemical peel, you will have downtime. A deep chemical peel requires recuperation at home for 2 to 3 weeks.

When will I see the results after a chemical face peel?

Once your skin heals, you will see the results. Healing time ranges from 1 day for a refreshing or lunchtime chemical peel to 14 days or longer for a deep chemical peel. To get the results you seek from a refreshing chemical peel or lunchtime chemical peel, you may need to have 3 to 5 peels.

How long will the chemical peel results last?

Most results are not permanent because your skin continues to age. If you have lots of sun-damaged skin or precancerous skin growths called actinic keratosis, you will likely continue to see new spots and growths on your skin.

How many treatments are needed?

Superficial peels are typically performed between 3 to 6 times, spaced every two weeks or so apart.

Most people are pleased with the result from a single medium-depth peel.

When is it safe to have another chemical peel?

To maintain results, you can repeat mild and medium chemical peels. Your dermatologist can tell you how often you can have a repeat treatment. A person can have only one deep chemical peel.

What is the safety record for chemical peels?

Dermatologists have been performing chemical peels for more than 50 years, with an excellent safety record.

Even people who have skin of color can safely have a chemical peel — but they should see a dermatologist who has expertise using chemical peels to treat darker skin tones. Without this knowledge, people who have skin of color (i.e., African American, Asian, Latino) can develop permanent pigment problems.

Can a chemical peel be combined with other procedures?

A chemical peel may be combined with other procedures to improve contour and texture of skin. Procedures such as laser treatment, injectable filling agents and muscle relaxants are often combined with chemical peels. Laser ablation may be performed to treat more heavily wrinkled areas or for pitted scarring. Filling agent injections may be required to touch up wrinkles and scars.

Chemical peel benefits

Chemical peels can improve and smooth the texture of facial skin by removing damaged outer layers and can be helpful in treating dull facial texture and color, fine wrinkles around the eyes and mouth, uneven pigmentation (solar lentigines, or “sun spots”), melasma, mild acne, and even precancerous lesions (i.e., actinic keratoses).

Whether you receive a chemical peel to diminish signs of aging or treat a skin condition, you can see:

  • Fewer lines and wrinkles.
  • More even skin color.
  • Brighter complexion.
  • Smoother skin.

A light chemical peel can improve skin texture and tone, as well as decrease the appearance of fine wrinkles. The results will be subtle at first, but will increase with repeated treatments. After a light chemical peel, avoid sun exposure until new skin completely covers the treated area.

If you have a medium chemical peel, treated skin will be noticeably smoother after the procedure. Your doctor will recommend avoiding sun exposure for several months.

After a deep chemical peel, you’ll see a dramatic improvement in the look and feel of treated areas. You’ll need to protect your skin from the sun permanently to prevent changes in skin color.

Keep in mind that chemical peel results might not be permanent. As you age you’ll continue to acquire lines by squinting and smiling. New sun damage also can reverse your results and cause changes in your skin color.

What chemical peels cannot do

  • Chemical peels cannot tighten loose skin; such change may require a surgical procedure e.g. a face-lift.
  • Chemical peels cannot improve deep scarring. Laser treatment and other procedures are more effective.
  • Chemical peels cannot always totally remove hyperpigmentation in dark-skinned people of Caucasian or Asian background and may not be indicated.
  • Chemical peels cannot remove broken blood vessels on the face.

The Skin

The skin (integument) is the body’s largest and heaviest organ. In adults, the skin covers an area of 1.5 to 2.0 m2 and accounts for about 15% of the body weight.

The skin consists of two layers:

  1. a stratified squamous epithelium called the Epidermis and
  2. a deeper connective tissue layer called the Dermis (Figure 1).

Figure 1. Skin structure

skin structure and layers

Below the dermis is another connective tissue layer, the hypodermis, which is not part of the skin but is customarily studied in conjunction with it. Most of the skin is 1 to 2 mm thick, but it ranges from less than 0.5 mm on the eyelids to 6 mm between the shoulder blades. The difference is due mainly to variation in thickness of the dermis, although skin is classified as thick or thin based on the relative thickness of the epidermis alone.

Thick skin covers the palms, soles, and corresponding surfaces of the fingers and toes. Its epidermis alone is about 0.5 mm thick, due to a very thick surface layer of dead cells called the stratum corneum (see Figure 2). Thick skin has sweat glands but no hair follicles or sebaceous (oil) glands. The rest of the body is covered with thin skin, which has an epidermis about 0.1 mm thick, with a thin stratum corneum. It possesses hair follicles, sebaceous glands, and sweat glands.

The accessory structures include hair, nails, and a variety of multicellular exocrine glands. These structures are located in the dermis and protrude through the epidermis to the surface.

Figure 2. Structure and skin cells of the Epidermis

structure of epidermis

Functions of the skin

The skin is much more than a container for the body. It has a variety of very important functions that go well beyond appearance, as you shall see here.

  1. Resistance to trauma and infection. The skin suffers the most physical injuries to the body, but it resists and recovers from trauma better than other organs do. The epidermal cells are packed with the tough protein keratin and linked by strong desmosomes that give this epithelium its durability. Few infectious organisms can penetrate the intact skin. Bacteria and fungi colonize the surface, but their numbers are kept in check by its relative dryness, its slight acidity (pH 4–6), and defensive antimicrobial peptides called dermcidin and defensins. The protective acidic film is called the acid mantle.
  2. Other barrier functions. The skin is important as a barrier to water. It prevents the body from absorbing excess water when you are swimming or bathing, but even more importantly, it prevents the body from losing excess water. The epidermis is also a barrier to ultraviolet (UV) rays, blocking much of this cancer causing radiation from reaching deeper tissue layers; and it is a barrier to many potentially harmful chemicals. It is, however, permeable to several drugs and poisons.
  3. Vitamin D synthesis. The skin carries out the first step in the synthesis of vitamin D, which is needed for bone development and maintenance. The liver and kidneys complete the process.
  4. Sensation. The skin is our most extensive sense organ. It is equipped with a variety of nerve endings that react to heat, cold, touch, texture, pressure, vibration, and tissue injury. These sensory receptors are especially abundant on the face, palms, fingers, soles, nipples, and genitals. There are relatively few on the back and in skin overlying joints such as the knees and elbows.
  5. Thermoregulation. The skin receives 10 times as much blood flow as it needs for its own maintenance, and is richly supplied with nerve endings called thermoreceptors, which monitor the body surface temperature. All of this relates to its great importance in regulating body temperature. In response to chilling, the body retains heat by constricting blood vessels of the dermis (cutaneous vasoconstriction), keeping warm blood deeper in the body. In response to overheating, it loses excess heat by dilating those vessels (cutaneous vasodilation), allowing more blood to flow close to the surface and lose heat through the skin. If this is insufficient to restore normal temperature, sweat glands secrete perspiration. The evaporation of sweat can have a powerful cooling effect. Thus, the skin plays roles in both warming and cooling the body.
  6. Nonverbal communication. The skin is an important means of nonverbal communication. Humans, like most other primates, have much more expressive faces than other mammals. Complex skeletal muscles insert in the dermis and pull on the skin to create subtle and varied facial expressions. The general appearance of the skin, hair, and nails is also important to social acceptance and to a person’s self-image and emotional state—whether the ravages of adolescent acne, the presence of a birthmark or scar, or just a “bad hair day.”

Who is the ideal candidate for chemical peel

Before you have a chemical peel, your doctor will likely:

  • Review your medical history. Be prepared to answer questions about current and past medical conditions — especially any heart, kidney or liver conditions if you’re considering a deep chemical peel. Tell your doctor about any medications you’re taking or have taken recently — particularly those that might make your skin sensitive to the sun — as well as any cosmetic procedures you’ve had in the past. Be sure to tell your doctor if you’ve been using a retinoid cream such as tretinoin (Renova, Retin-A, others), which can enhance the penetration of some chemical peels.
  • Do a physical exam. Your doctor will inspect your skin and the area to be treated. This will help him or her determine what type of chemical peel you might benefit from most and how your physical features — for example, the tone and thickness of your skin — might affect your results.
  • Discuss your expectations. Talk with your doctor about your motivations and expectations, as well as the potential risks. Make sure you understand how many treatments you might need, how long it will take to heal and what your results might be.
  • Before getting a chemical peel, some patients need to follow a pre-peel skin care plan for 2 to 4 weeks. This plan can improve results and reduce potential side effects. Your dermatologist will tell you whether this is necessary.

Precautionary medications

If you decide to proceed with the chemical peel, you might also need to:

  • Take antiviral medication. If you have a history of herpes infections around your mouth, your doctor will likely prescribe an antiviral medication before and after treatment to help prevent a viral infection.
  • Use a retinoid cream. If you’re having a light or medium chemical peel, your doctor might recommend using a retinoid cream, such as tretinoin (Renova, Retin-A, others), beforehand to shorten your treatment time and speed the healing process.
  • Use a bleaching agent. Your doctor might recommend using a bleaching agent (hydroquinone) and a retinoid cream before or after the procedure to prevent skin darkening.

Safety measures

  • Avoid unprotected sun exposure. It’s important to consistently use sunscreen at least four weeks before the procedure to help prevent irregular pigmentation in treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
  • Avoid certain cosmetic treatments and certain types of hair removal. About a week before the peel, stop waxing or using depilatory hair-removal products. Also, avoid bleaching, massages or facial scrubs in the week before your peel.
  • Arrange for a ride home. If you’ll be sedated during a medium or deep chemical peel, you’ll need help getting home after the procedure.

What does a chemical peel do

A facial chemical peel causes the even, controlled shedding of sev­eral layers of damaged skin cells to leave a new fresh layer of skin which has a more even texture and color.

Superficial peels are usually well tolerated without the need for any pain medication. Discomfort may be decreased by using a fan during the peel or by taking two aspirin an hour beforehand. Medium-depth peels will require stronger pain relief, often in the form of a short general anaesthetic.

Initially the skin is cleaned with a liquid soap and then further prepared with alcohol or acetone to remove all oils and grease from the skin surface. Make-up should not be worn on the day of a chemical peel.

The chemical solution is applied in either a single layer or sometimes several layers. Immediately after application, a stinging sensation may be experienced, which subsides within 5 to 10 minutes. The solution stays on the skin for a variable period of time, as determined by the practitioner, after which it is removed either with water or a neutralizer. It can be removed earlier if excessive discomfort is experienced.

Chemical peel solutions

The mildest form of chemical peel uses alpha-hydroxy acids (AHA) and improves the texture of rough or sun-damaged skin. Examples of alpha-hydroxy acids (AHA) chemical peels include glycolic, lactic, citric, tartaric, and malic acid. These mild acids remove only the outermost layers of the skin and can be useful in treating acne.

Most popular over-the-counter chemical peels use 3–5% glycolic acids, but medical-grade glycolic acid peels generally use 50–70% glycolic acid. The most common anticipated effects with these treatments are a temporary stinging sensation, mild irritation or redness that usually subsides quickly, and peeling and redness that last for several days after the procedure.

Beta-hydroxy acid (BHA) chemical peels that use salicylic acid (the major component of aspirin) penetrate deeply into the oil gland and so are equally or slightly more effective than alpha-hydroxy acids (AHA) for acne. Further, beta-hydroxy acid (BHA) peels generally cause slightly less peeling and redness than AHA peels. Another type of superficial peel is the Jessner’s peel, which is a combination of salicylic acid (a BHA), lactic acid (an AHA), and resorcinol.

Medium-strength chemical peels use trichloroacetic acid (TCA) at 35% or above to smooth and soften fine surface wrinkles, restore a healthy complexion, and treat superficial blemishes and pigment problems. A very common practice is to combine a Jessner’s peel with trichloroacetic acid (TCA). A medium peel is the preferred treatment for more severe cases of melasma (the dark, blotchy lesions on cheeks due to pregnancy or oral contraceptive pills) and sun damage. However, as trichloroacetic acid (TCA) chemical peels affect the deeper skin structures and are more penetrating than superficial peels, trichloroacetic acid (TCA) should be selected for only certain skin types, as trichloroacetic acid (TCA) chemical peels may produce unintended color changes (unnatural lightening or darkening) in the skin and involve significant prolonged redness and some crusting or peeling, sometimes for up to several weeks.

Stronger chemical peels use phenol acid and generally take more recovery time than other chemical peels. Peeling and crusting can be more pronounced. Deep chemical peels are recommended for coarse wrinkles; severely blotchy, sun-damaged skin; and precancerous growths. They can cause permanent darkening or lightening of the skin, and they are not recommended for darker skin tones. Deep chemical peels can pose a pronounced risk for those with a family history of heart disease and usually involve anesthesia, which may have complications.

The vast majority of those who have chemical peels suffer no serious side effects and enjoy a gratifying outcome. So, putting first things first – including your fears – you need to be clear about the benefit and overall effect that you are looking for. Then, work with your dermatologist to learn everything you can about the best peel for you and what to expect afterward. Finally, assess your “fear level” from an informed viewpoint to make the best decision for you.

Superficial chemical peels

  • skin cells removed from the top layer of skin (epidermis)
  • left on the skin for a few minutes
  • skin may feel tight for a couple of hours afterwards
  • regular treatment needed to maintain the effects

Medium chemical peels

  • skin cells removed from the top and middle layers of skin
  • left on the skin for a few minutes
  • a burning or stinging sensation may be felt when the peel is applied
  • skin may go brown or red in the days afterwards
  • it can take up to six weeks for the skin to return to normal
  • treatment is needed every 6 to 12 months to maintain the effects

Deep chemical peels

  • affect deeper layers of skin
  • a local anaesthetic and sedative may be needed
  • a freezing sensation may be felt when the peel is applied
  • can be left on the face for 30 minutes or more, depending on the desired effect
  • your heart and blood pressure need to be monitored as phenol, the chemical used, can cause dangerous effects on the heart and kidneys
  • expect some peeling, redness and discomfort for a few days
  • swelling can last up to two weeks
  • skin redness can last up to three months
  • often results in lightening of the skin, so it’s not really suitable for darker skin
  • it’s a one-off treatment with lasting effects, so doesn’t usually need to be repeated

Chemical peel process

On the day of your peel, you will first be prepped for the treatment. This includes cleansing your skin thoroughly. If you will have a deep chemical peel, you will receive general anesthesia, which will put you to sleep. A deep chemical peel must be performed in a surgical setting.

After you are prepped, your dermatologist will apply the chemical peel quickly and evenly. Your dermatologist will watch your skin carefully to remove the peel at just the right time. With a deep chemical peel, the skin is treated one small section at a time. This limits the effects on your heart and lungs.

After the chemical peel comes off, your skin will be treated as needed. Patients who get a medium chemical peel may need cool compresses followed by a lotion or cream to soothe their skin. If you have a deep chemical peel, you will have a wound that requires a surgical dressing.

During a light chemical peel:

  • Your doctor will use a brush, cotton ball, gauze or sponge to apply a chemical solution typically containing glycolic acid or salicylic acid. The treated skin will begin to whiten.
  • You might feel mild stinging while the chemical solution is on your skin.
  • Your doctor will apply a neutralizing solution or wash to remove the chemical solution from the treated skin.

During a medium chemical peel:

  • Your doctor will use a cotton-tipped applicator or gauze to apply a chemical solution containing trichloroacetic acid, sometimes in combination with glycolic acid. The treated skin will begin to whiten.
  • After a few minutes, your doctor will apply cool compresses to soothe treated skin. You might also be given a hand-held fan to cool your skin. No neutralizing solution is needed, however.
  • You might feel stinging and burning for up to 20 minutes.

During a deep chemical peel:

  • You’ll be given intravenous (IV) fluids, and your heart rate will be closely monitored.
  • Your doctor will use a cotton-tipped applicator to apply carbolic acid (phenol) to your skin. Treated skin will begin to turn white or gray.
  • To limit your exposure to phenol, your doctor will do the procedure in portions at about 15-minute intervals. A full-facial procedure might take about 90 minutes.

What to expect after a chemical peel

After a chemical peel of any depth, follow your doctor’s directions for cleansing, moisturizing and applying protective ointments to your skin.

All peels that a dermatologist performs require some at-home care. The following table shows you what you can expect.

Table 1. What to expect after a chemical peel

Type of Peel Healing timeAt-home care When to wear makeup Follow-up visit 
Refreshing or lunchtime peel1 to 7 days.

Skin will be red. After the redness disappears, scaling may develop, which lasts 3 to 7 days.

Lotion or cream applied until the skin heals, followed by daily use of sunscreen.Usually immediately after the peel, but sometimes the next day.No. However, 3 to 5 peels may be necessary to give you the desired results. These peels may be repeated every 2 to 5 weeks.
Medium 7 to 14 days

Skin will be red and swollen. Swelling worsens for 48 hours. Eyelids may swell. Blisters can form and break open. Skin crusts and peels off in 7 to 14 days.

Daily soaks for a specified period.

Apply ointment after each soak.

Take an antiviral medication for 10 to 14 days.

Apply lotion or cream.

Total avoidance of the sun until skin heals.

After 5 to 7 days, you can wear camouflaging makeup.Yes. Follow-up visit required after the procedure.
Deep14 to 21 days.

Area will be bandaged.

4 to 6 daily soaks while healing.

For 14 days, apply ointment after each soak.

After 14 days, apply thick moisturizer as directed

Take an antiviral medication for 10 to 14 days.

Total sun avoidance for 3 to 6 months.

At least 14 days before you can apply makeup.Yes. The next day, the dermatologist will want to see you. Several follow-up visits are required during the first week.

After a light chemical peel, treated skin will be red, dry and mildly irritated — although these effects might be less noticeable with each repeat treatment. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area.

Treated areas take about one to seven days to heal after a light chemical peel. New skin might temporarily be lighter or darker than normal.

After a medium chemical peel, treated skin will be red, tight and swollen. You’ll feel stinging. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area.

Use ice packs or the breeze from a fan for comfort. Over-the-counter pain-relieving medication, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), may help reduce any discomfort. You’ll likely schedule a checkup soon after your treatment so that your doctor can monitor your healing.

As swelling decreases, treated skin will begin to form a crust and might darken or develop brown blotches. Treated areas take about seven to 14 days to heal after a medium chemical peel, but redness might last for months.

After a deep chemical peel, you’ll experience severe redness and swelling. You’ll also feel burning and throbbing, and your eyelids might swell shut.

Your doctor will apply a watertight dressing to treated skin. He or she might also prescribe painkillers. Sleeping in a semireclined position may help reduce swelling.

Treated areas will develop new skin within about two weeks after a deep chemical peel, although cysts or white spots might appear for several weeks and redness might last for months. Treated skin might become darker or lighter than normal or lose the ability to tan.

You might prefer to remain at home while you’re healing from a chemical peel. Once new skin completely covers the treated area in about two weeks, you can use cosmetics to conceal any redness.

Chemical peel tips after chemical peel

  • Use the moisturizer as directed to keep your skin moist and supple. If your skin dries and cracks, it can scar.
  • If your skin burns, itches, or swells, contact your dermatologist. Rubbing or scratching skin treated with a chemical peel can cause an infection.
  • Do not use a tanning bed or other type of indoor tanning. Your skin will not heal properly.
  • After your skin heals, apply sunscreen every day. This will help you maintain results.

Chemical peel recovery time

Recovery time after a chemical peel will depend on its depth.

In the first few days after most chemical peels, the skin turns darker, will feel somewhat tight and then peels or flakes to leave a new fresh layer of skin. There are no scabs, bandages or bleeding.

The recovery period and side-effects of a superficial chemical peel is much less than with a medium-depth chemical peel. It usually takes 3 to 5 days after a superficial peel for the skin to return to normal. It usually takes up to 7 to 10 days after a medium-depth peel for the skin to settle.

How much time off work is needed after a chemical peel?

Super­ficial peels may warrant a day or two off work, although many people are able to cover up with make-up and continue working the next day.

A medium-depth chemical peel may require one week for the skin to heal and it may be beneficial to arrange two weeks off work. At this time the face will be somewhat reddened with an appearance like sunburn but otherwise should appear unaffected. The redness can be camouflaged by a tinted moisturizer or make-up.

Chemical peel side effects

While chemical peels offer a far less invasive option to smoother skin than plastic surgery or ablative laser procedures (like the carbon dioxide laser), they are not without some side effects – mostly minor – and a few serious risks. The extent and risk of adverse effects depends on the strength of the chemical peel. The higher the strength, the deeper the chemical peel, and a higher risk for numbness, scarring, and infection. And after any chemical peel, you need to be diligent about using sunscreen and moisturizing to protect and nourish the new layers of skin.

In the hands of a doctor who has experience with chemical peels, side effects tend to be mild. Some patients develop:

  • Redness. Normal healing from a chemical peel involves redness of the treated skin. After a medium or deep chemical peel, redness might last for several months.
  • Scarring. Rarely, a chemical peel can cause scarring — typically on the lower part of the face. Antibiotics and steroid medications can be used to soften the appearance of these scars.
  • Changes in skin color. A chemical peel can cause treated skin to become darker than normal (hyperpigmentation) or lighter than normal (hypopigmentation). Hyperpigmentation is more common after superficial peels, while hypopigmentation is more common after a deep peel. Changes in skin color are more common in people who have darker skin and can be permanent.
  • Infection. A chemical peel can cause a flare-up of the herpes virus — the virus that causes cold sores. Rarely, a chemical peel can lead to a bacterial or fungal infection.
  • Heart, kidney or liver damage. A deep chemical peel uses carbolic acid (phenol), which can damage the heart muscle and cause the heart to beat irregularly. Phenol can also harm the kidneys and liver. To limit exposure to phenol, a deep chemical peel is done in portions at 10- to 20-minute intervals.

Chemical peels can’t decrease pore size or eliminate deep scars or wrinkles.

A chemical peel isn’t for everyone. Your doctor might caution against a chemical peel or certain types of chemical peels if you:

  • Have taken the acne medication isotretinoin (Amnesteem, Claravis, others) in the past six months
  • Have a dark complexion
  • Have a personal history of ridged areas caused by an overgrowth of scar tissue (keloids)
  • Have abnormal skin pigmentation
  • Have a history of frequent or severe outbreaks of cold sores

If serious side effects occur, it is often because the patient did not follow the dermatologist’s instructions. Your risk for developing an infection or scarring increase dramatically if you:

  • Fail to protect your skin from the sun.
  • Fail to care for your wound as instructed.
  • Scratch the treated skin or pick off a scab.
  • Apply makeup before your skin heals.
  • Don’t heed your dermatologist’s advice and use a tanning bed or other type of indoor tanning.

Microdermabrasion vs Chemical peel

Microdermabrasion is a nonsurgical, office‐based cosmetic procedure that uses fine crystals (usually aluminium oxide Al2O3 sodium chloride or salt) and a closed‐loop vacuum to remove dead skin cells on the face. The aim of microdermabrasion is to reduce the effect of fine lines and minor skin blemishes. Microdermabrasion works on all skin types and shouldn’t cause any skin color changes or scarring. Microdermabrasion has the advantages of low risk and rapid recovery compared with other techniques such as standard dermabrasion, chemical peeling and laser resurfacing. However, be aware that microdermabrasion can be expensive and has its limitations. Take time to find a reputable practitioner who is properly qualified and practices in a clean, safe and appropriate environment. Ask the practitioner what you should do if something were to go wrong.

Microdermabrasion is an U.S. Food and Drug Administration approved process first introduced in Italy in 1985 and is a popular method used to treat superficial scars, acne, to reduce the appearance of large pores, fine lines, wrinkles, tattoos, severe sun damage, pigmentation disorders and other cosmetic-dermatologic conditions 1).

Microdermabrasion works for:

  • Dull complexion.
  • Uneven skin tone or texture.
  • Fine lines and wrinkles.
  • Age spots.
  • Dark spots that can appear when acne starts to clear.
  • Melasma.

The disadvantages of microdermabrasion are that multiple treatments are needed and there may be minimal improvement in appearance.

Microdermabrasion advantages include:

  • Anaesthesia is not required
  • It is almost painless
  • Facial redness is minimized
  • Simple and quick to perform
  • Can be repeated at short intervals
  • Does not disrupt the patient’s life greatly

Microdermabrasion is now possible using home kits that use virbating foam applicator to massage a moisturizing cream containing aluminium oxide crystals on the surface of the skin. However, the microdermabrasion that a dermatologist performs differs from the one that you can do at home with a kit. A dermatologist treatment goes a bit deeper into the skin. Still, the procedure is safe for all skin colors.

Dermatologists also use microdermabrasion to improve the results gained from using anti-aging products and skin-bleaching products. Microdermabrasion allows these products to penetrate the skin more easily. Because stratum corneum is the skin’s main permeability barrier, controlled microdermabrasion offers a novel approach to increasing rates of transdermal drug delivery. By using microdermabrasion on the skin, topical therapeutics can be applied at the conclusion of the treatment, which will reach levels much deeper than when typically applied to the surface of the skin, as the skin barrier function of the stratum corneum is temporarily compromised 2). Therefore, slightly greater improvements in the histological features of photoaging can be achieved with the combination of microdermabrasion followed by a 5% retinoic acid chemical peel versus a 5% retinoic acid chemical peel administered alone 3). The established clinical safety record and the non-invasive nature of microdermabrasion suggest that this approach should be safe, painless, cosmetically acceptable and effective to deliver a broad range of pharmaceutical compounds.

This study 4) showed that controlled microdermabrasion can be used to selectively remove stratum corneum (outermost layer of the skin) in a targeted fashion without removing viable epidermis. Crystal flow rate and exposure time were the most important parameters in controlling stratum corneum removal, whereas suction pressure and handpiece movement had lesser effects. Notably, this study 5) added the use of a mask (see Figure 3 C below) to limit tissue removal to an array of micron-scale pores rather than one large region of stratum corneum removal. The study authors found that the mask also influenced the depth of tissue removal; the 125 μm-hole mask limited tissue removal to the stratum corneum in a self-limiting manner independent of exposure time to microdermabrasion.

Microdermabrasion benefits

Microdermabrasion is similar to dermabrasion but as its name suggests, it uses tiny crystals to remove the surface skin layers. It is promoted for correcting fine lines and more superficial scars.

What happens during microdermabrasion?

The dermatologist uses a handheld device that gently removes the top layer of skin. You may feel a sanding sensation, but this is not painful. It takes about 30 to 40 minutes to treat the entire face and about 20 minutes to treat the neck.

After the treatment, a moisturizer is applied.

What will I need to do after microdermabrasion?

You may need to apply a moisturizer or other skin care product at home.

You will be given a skin-care plan that includes sun protection. Protecting your skin form the sun helps ensure the best possible results and reduces the risk of side effects.

Is there downtime with microdermabrasion?

You will not have downtime or a recovery period. Some patients’ skin turns pink or red. The skin can swell a bit. These side effects are similar to having a sunburn or windburn for a day or two. During this time, some patients feel uncomfortable returning to work or being in public.

When will I see results from microdermabrasion?

Most patients need a series of treatments to see results. To treat signs of aging, a dermatologist may treat a patient weekly, every two weeks, or monthly. Most patients receive between 5 and 16 treatments.

After a series of treatments, patients usually say they have smoother skin and a more-radiant complexion.

How long will the microdermabrasion results last?

The microdermabrasion results tend to be temporary. Patients who protect their skin from the sun and follow the recommended skin-care plan will maintain their results for a longer time. Yet, no matter what you do, your skin continues to age. Follow-up treatments are usually necessary to help retain smoother skin and a more radiant complexion.

How often can I safely get another microdermabrasion treatment?

Microdermabrasion treats only the top layer of the skin, so the skin recovers quickly. Most people can safely have another treatment a week later. Some patients, however, need several weeks to recover.

What is the safety record for microdermabrasion?

When performed by a dermatologist, microdermabrasion has an excellent safety record.

Microdermabrasion also is performed in salons and non-medical spas. You can reduce your risk for side effects by having microdermabrasion performed by a dermatologist.

Microdermabrasion side effects

The side effects of microdermabrasion, such as redness and swelling, tend to be short-lived.

Your skin may be dry and flaky for a few days after the procedure, and the suction may temporarily bruise your skin.

Your face would be more sensitive to the sun afterwards, so you should avoid sun exposure for a few days and use broad-spectrum SPF30+ sunscreen.

If you’re not happy with the results or are experiencing problems, take up the matter with your practitioner through the clinic where you were treated.

If there are any complications that require medical attention, it is best that you go back to the practitioner who treated you. If this is not possible, you can go to your doctor or local accident and emergency department.

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