What are chemical peels? What are they really doing to my skin?
Chemical peels are a controlled and predictable treatment, breaking down the protein glues that hold our skin cells together, whilst removing damaged skin cells too. This results in surface exfoliation and clinical rejuvenation of the skin. Clinical rejuvenation can vary from an increase in hydration, plumpness, firmness, brightness, and softening of lines, to a reduction in red and brown discolouration, texture, and congestion. Chemical peels can target both the epidermis and dermis of the skin, with different ingredients and concentrations of peels, constituting the ability for the peel to penetrate to different depths of the skin. Chemical peels have been demonstrated to be a cost-effective, flexible, and efficient tool for achieving the desired clinical improvements in a short amount of time safely. Talking to a clinician about what peels would be best suited for you is a great way to get started in the amazing world of peels.
What can they treat? Who are they best for?
The fascinating thing about chemical peels is they are flexible, universal, and can be adjusted to be performed at different strengths required to achieve incredible results. At Clinica Lase, combination therapy is often used to achieve the best clinical outcome in each appointment we have with you. You will find that 90% of the time we are combining peels, more often superficial and medium-depth peels, with lasers and other modalities in our skin treatments. Chemical peels are great for aging concerns induced by UV damage, dryness, dehydration, wrinkles, lines, pigmentation, discolouration, acne, scarring, and texture irregularities. Depending on the ingredients, some peels can be suitable during pregnancy. Below is a table with conditions that are often treated alone or in combination with peels.
| Pigmentary conditions | Inflammatory conditions | Scarring | Chronic aging |
| - Ephiledes - Letingines - Melasma - Actinic and seborrheic keratosis |
- Acne - Rosacea - Diffuse Redness |
- Acne scarring - Traumatic scarring - Surgical scarring |
- Superficial and medium depth rhytids (wrinkles) |
Table 1. Indications for chemical peels.
Note. Adapted from “A practical approach to chemical peels.” (Soleyamni et al., 2018
What are the different types of peels out there?
Chemical peels have demonstrated an excellent tool in achieving the desired clinical improvement efficiently in this industry. Generally, all peels give a level of clinical rejuvenation, however, there are gold standard peels that are often suggested to meet a skin concern you have. This can be categorized by the depth it reaches the skin, controlled by the different types of ingredients, concentration, skin types, and application method and layers. Ingredients often are the main cause of skin cell breakdown, however, there are also ingredients that aid penetration of the peel into the skin. The sensations whilst having a peel is often described as hot, stinging, tingly, itchy, and bitey. As expected, all the different factors controlling the depth of penetration of the peel, can also sway the level of sensations you may feel whilst having the peel done.
Superficial peels
These peels reach the epidermis only and they often contain ingredients like lactic acid, salicylic acid, glycolic acid, stem cells, enzymes, pigment inhibitors, antioxidants etc. You'll find that we often combine these peels with pigmentary, vascular, and rejuvenation laser treatments and modalities to enhance and support the results. More often than not, there is no downtime associated with these peels alone, except for some post-procedure redness. Some mild flaking can sometimes occur if higher concentrations are used.
Fun fact: The history of efficacy and popularity of peels are the reason why they started
implementing lactic, glycolic, and salicylic acids as ingredients in homecare products.
Medium depth peels
These peels penetrate past the entire epidermis and reach the upper dermis of the skin, also known as the papillary dermis. They often contain ingredients like glycolic acid, salicylic acid, retinol, trichloroacetic acid etc. These peels will have downtime associated with mild to moderate redness and flaking of possibly up to a week or so. These peels can be combined with lasers for an advanced treatment at our clinic, for the appropriate indication and skin type when assessed.
Deep peels
These peels penetrate past the entire epidermis, through to the deeper dermis also known as the mid- reticular dermis. These peels often have the highest concentrations and contain multiple strong ingredients. They are often advanced peels that are done at most once a year, where downtime can be from 2 weeks to a month. Often moderate erythema, bronzing, and swelling can occur followed by excessive peeling. These peels although have a great clinical rejuvenation outcome, can pose the most risk and can only be performed on the correct candidate. Therefore, consulting with a dermal clinician about these peels is very important and is generally never combined with any laser or treatment at Clinica Lase. Below is an excellent visual demonstration of where the different peels reach deep into the layers of skin cell.
A tool attached below demonstrates the process of selection of peels when chosen for the correct indication once a consultation and consent is received.
When are they best to have? How often can you have them?
Chemical peels are one of the most flexible treatments that can be done alone, in combination with other modalities, at any time of the year. As it is a rejuvenating treatment, like all of our other treatments, sun protection is always required and sun avoidance is a must 2 weeks prior to and post-treatment. Depending on the chemical peel for the correct concern, some peels can be done as little as 2 weeks apart, but generally, 4-8 weeks is adequate. As mentioned above, some deep peels can only be done once a year. This can be further discussed with your clinician.
References
Soleymani, T., Lanoue, J., & Rahman, Z. (2018). A Practical Approach to Chemical Peels: A Review of Fundamentals and Step-by-step Algorithmic Protocol for Treatment. The Journal of clinical and aesthetic dermatology, 11(8), 21–28.