Understanding Chemical Peels
20 April 2018
Chemical peels have been an important part of a Dermatologist’s tool kit for skin rejuvenation ever since Cleopatra had her first milk bath in ancient times.
How do chemical peels work?
Quite simply, chemical peels injure the skin to a specific depth in order to stimulate the regrowth of fresh new skin which has an improved appearance.
Most patients have heard of superficial, medium and deep depth peels and, as a general rule, the more severe the skin condition, the deeper the peel required.
Different acidic and basic peel solutions are used to penetrate to different levels in the skin.
Superficial Chemical Peels
Superficial peels affect the epidermis and the papillary dermis, which are the top-most layers of the skin.
These peels both weaken the intercellular adhesion and create a swelling of the keratinocytes in the epidermis which result in a thorough exfoliation of the skin.
Mild sun damage, acne and epidermal pigmentation such as freckles and lentigines can be treated by common superficial peels, including:
- Alpha-hydroxy acids (AHA) such as glycolic acid (derived from sugarcane), lactic acid (from sour milk – just like Cleopatra!)
- Beta-hydroxy acids such as salicylic acid (from willow bark)
- Jessner’s solution
- Tretinoin (a vitamin A derivative)
- Trichloroacetic acid (TCA) up to 30% concentration
Long term daily use of AHAs has the beneficial effect of increasing collagen density, improving elastic fibre quality and mucopolysaccharides, which plump up the dermis.
Medium and Deep Chemical Peels
Medium to deep depth peels have previously included phenol, stronger concentrations of TCA and combination peels such as Jessner’s/TCA which penetrate into the deeper reticular layer of the dermis.
However, these deeper peels have generally been superseded by the advent of modern ablative lasers such as the CO2 (Carbon Dioxide) and Erbium:YAG lasers, which are able to more precisely removal of layers of the epidermis and dermis.
More recently, fractionated laser treatments with lasers such as the Fraxel Re:store and Fraxel Re:pair have further increased safety and efficacy compared to more the more invasive peels.
The Chemical Peel Treatment
The chemical peel treatment process is quick and straight forward.
Most peels are completed within 20-30 minutes, and involve a relaxing cleanse, the peel products are applied and remain on the skin for a length of time determined by the desired strength of peel.
Products are then applied to neutralise the peel chemicals and then all products are removed from the skin.
Skin is then moisturised and patients can re-apply sunscreen and make up immediately.
Peels can involve a slight sting, but if this becomes too uncomfortable, the neutralising product can be applied immediately, stopping the peel process.
We recommend your initial chemical peel be a lighter option and as you become more used to the process, we can increase the strength for future peels, if desired.
Want More Information?
You can read more about our chemical peels here.
To learn whether a chemical peel is the right choice for your skin type and the conditions you’re hoping to improve, make an initial appointment with our dermatologist by contacting our clinic on (02) 9953 9522
Written by Dr Terence Poon.
Terence is the owner of our clinic and one of Australia’s most experienced laser dermatologists.
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