The Layers behind the Chemical Peel: a Comprehensive Guide

Dr DEEPALI BHARDWAJ, MD

Today, I’m going to give you my two cents about a trend that’s been in the market for a few years now - chemical peels and home peels and why they’re as different as chalk and cheese.

In the quest for smoother, rejuvenated skin, many turn to chemical peels, a tried-and-tested cosmetic procedure that has been transforming complexions for decades. Founded by an Austrian dermatologist, Ferdinand Ritter von Hebra, chemical peels in simple terms involves applying controlled injuries to the surface of the skin for it to peel off, revealing smoother and younger skin. From its origins to its modern-day variations, chemical peels have evolved into a versatile skincare treatment, offering a range of benefits alongside potential risks.

So, what is a chemical peel?

A chemical peel is a dermatological procedure that involves the application of a chemical solution to the skin, causing controlled exfoliation and shedding of the outer layers. Essentially, it is the process of burning your skin in a controlled manner at a specific spot so that the old skin peels off to give way to the new. This process leads to smoother texture, improved tone, and a more youthful appearance.

Chemical peels are typically used to address various skin concerns that range from mild to moderate and serious - including general skin glow, rejuvenation, getting rid of acne scars, sun damage, hyperpigmentation, and fine lines.

Apart from this, chemical peels are also a popular choice for people with superficial scars that stem from more serious issues such as surgery, accidents, and heavy acne problems.

Additionally, people with autoimmune diseases also subscribe to the chemical peel treatment. The associated skin rejuvenation this treatment brings leads to a definite boost in confidence levels of people suffering from autoimmune disorders of various kinds.

The science behind chemical peels: are “chemicals” safe?

As I always tell my patients, make sure you do your research regarding anything that goes on your face and always consult your trusted dermatologist before going ahead with any procedure.

That being said, just because the treatment involves the application of chemicals, should not automatically negate its value. Basically, a chemical peel treatment is a controlled exfoliation process that harnesses the power of specific chemical solutions to rejuvenate the skin. The key players in this process are various mild-on-the-skin acids, each with unique properties and penetration depths. These acids, such as alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), and trichloroacetic acid (TCA), work by dissolving the bonds between dead skin cells, prompting their shedding and stimulating cellular turnover. This leaves you with fresher, smoother, and more radiant skin that emerges from beneath the surface.

Are there different types of chemical peels?

We can categorise chemical peels based on the profundity of their penetration, which leads us to 3 types of peel treatments:

1. Superficial Peels:

These peels contain mildly acidic ingredients like alpha hydroxy acids (AHAs), such as glycolic acid or lactic acids and target the outermost layer of the skin (epidermis). They require the lowest time-out or recovery period and are often referred to as "lunchtime peels" due to their convenience.

For our Indian skin type, superficial peels are treatments that can be done even during the summertime. Despite being a mild acid treatment, superficial peels are not to be done at home and need to be administered by a dermatological medical professional.

2. Medium Peels:

Medium-depth peels, often formulated with TCA, penetrate deeper into the epidermis and upper dermis, addressing issues such as pigmentation irregularities, fine lines, and acne scars. Medium peels because of the concentrated level of acidic ingredients used are not meant to be salon treatments. They should not be administered during the summer and they definitely shouldn’t be conducted without a trusted dermatologist present as it can lead to inflammatory hyperpigmentation which a salon will not be equipped to resolve for you.

3. Deep Peels:

For those seeking profound skin renewal, deep peels containing phenol penetrate the deep dermis, delivering dramatic results in wrinkle reduction, skin tightening and anti-ageing. These peels are green and sometimes yellow and originate from Spain.  However, deep peels also mean a significantly longer recovery period and greater risk, all of which your dermatologist will communicate with you before the treatment. With deep peels, patients could be peeling for 3-4 days so it’s essential that your dermatologist guides you and makes sure you have enough downtime to recover from your peel.

One of the hallmarks of dermatologically approved chemical peels is their versatility and adaptability to individual skin types and concerns. Your dermatologist will always tailor the peel formulation, concentration, and application technique to address issues specific to your skin type and complexion, ensuring optimal results with minimal risk.

Any sort of chemical peel always needs to be done under the direct care and supervision of your trusted dermatologist. Whatever the level of acid intensity, a chemical peel is NOT meant to be administered in a salon or even at home. 

The big question: what are home peels and how safe are they?

While professional chemical peels are performed at derma clinics in the presence of your trusted dermatologist, there are also peel kits available for at-home use. Thanks to Instagram and its never-ending influencers these DIY peels are quite popular. They typically contain lower concentrations of acids compared to professional treatments and are designed for milder exfoliation. While home peels can offer convenience and cost-effectiveness, they might not give you the same standards of results as professional treatments and carry a higher risk of misuse or adverse reactions.

Chemical peels done at home are dangerous for several reasons. While the science behind chemical peels lays the foundation, it is the skilled application of the solutions that help make the treatment a success. Comprehensive pre-peel assessment, including skin type evaluation, medical history review, and patch testing, ensures suitability and informed personalised treatment plans.

With at-home peels, patients run the risk of the chemical solutions seeping into their eyes, being careless about cuts into which the solution can get, and being unaware of pre-existing facial infections that can worsen with the chemical peel treatment. Moreover, if the at-home chemical peel is excessively used, it could even add new problems of hyperpigmentation to your plate, instead of resolving it for you.

If at all, you still want to resort to an at-home superficial chemical peel - then make sure you do it as rarely as possible with an ideal time frame being once in 3 months. Glycolic acid may seem like an instant top-notch solution to your skin’s woes; however, you also run the risk of overusing it on your skin leading to a host of skin problems like hyperpigmentation, dermatitis and rosacea, which is a condition that will give you angry red skin and a painful rash.

Post-peel care protocols, encompassing gentle skincare, sun protection, and monitoring for potential side effects, are paramount in optimising outcomes and ensuring patient satisfaction -  all of which your dermatologist is trained to watch out and care for.

In my 13 years of experience, mismanaged at-home chemical peels being a complete dud is a well-known trade fact.

Apart from these factors, there could also be various other skin issues that a first-time chemical peel novice or even a veteran could miss out. This could be in the form of skin irritation, or allergies, giving your skin a red flare-up leading to overtly sensitive skin for which you will have to turn to long-term treatment.

Benefits of chemical peels: what does it really do?

1. Improved skin texture: Chemical peels promote cell turnover, resulting in smoother, more refined skin.

2. Even skin tone: Peels can reduce hyperpigmentation, sun spots, and discolouration, leading to a more even complexion.

3. Reduced acne and acne-related scars: Certain peels can unclog pores, control oil production, and fade acne scars.

4. Minimal wrinkles: Peels stimulate collagen production, diminishing the appearance of wrinkles and fine lines.

5. Enhanced glow: By removing dead skin cells, peels reveal a brighter, younger and more radiant complexion.

What are the risks involved?

While chemical peels are generally safe even when performed by qualified professionals, they are not without risks, such as:

-        Skin irritation: Chemical peels can cause temporary redness, stinging, or irritation, especially with deeper peels.

-        Hyperpigmentation: Incorrect administration of chemical peels or post-peel care can lead to skin pigmentation issues causing new problems

-        Scarring: Deep chemical peels carry a risk of scarring, particularly in individuals with darker skin tones.

-        Sun sensitivity: Following a chemical peel, your skin will be more sensitive to sunburn and damage, necessitating diligent sun protection.

Chemical peels represent a powerful tool in the arsenal of skincare treatments, offering transformative results for individuals seeking to improve their complexion. Whether opting for a superficial refresh or a deeper renewal, it's essential to consult with your trusted dermatologist to decide which is the most obvious peel for your skin type.

Dr. DEEPALI BHARDWAJ, MBBS, MD (USA, IM), DVDL, M.Phil (Cosmetology)

Allergy Fellowship Munich, Germany; Cosmetic surgeries, Iran

www.skincareindia.in