Fact-check Friday: What is a chemical peel?

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Sorry for the delayed Fact-check Friday this week! We’re looking at something more hardcore today – not quite surgery, but not something you want to attempt blindly either: chemical peels.

What is a chemical peel?

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A chemical peel is a procedure for treating certain skin disorders, or simply improving the texture and appearance of the skin. It involves applying a chemical that destroys the damaged outer layers of the skin. The treated areas can then regrow and form fresh, new skin.

How deep is your peel?

Chemical peels can be divided into 3 major categories, depending on how much skin is destroyed. Deeper peels mean longer recovery time, pain and potential for side effects, but they also mean more dramatic results.

–    Superficial peels only affect the epidermis. Very superficial peels are essentially controlled, overenthusiastic exfoliation.
–    Medium depth peels affect the epidermis and papillary dermis.
–    Deep peels affect down to the midreticular dermis.

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The depth of the peel required depends on what sort of skin issue you’re trying to correct.

Superficial peels are used to rejuvenate skin, remove razor bumps and treat acne, as well as improving pigmentation and shallow wrinkles, although medium depth peels may be needed for those, depending on the depth of the skin damage. Repeated treatments are often needed for superficial peels, but there is virtually no downtime; on the other hand, medium depth peels generally require about a week of intensive post-care treatment (i.e. you can’t leave the house without people staring), with a couple more weeks of high level sun protection.

Deep peels are suitable for treating deeper pigmentation, wrinkles, skin tumours and acne scars.
They are carried out with sedation and careful monitoring. A long aftercare process is important, involving antiseptic products and heavy moisturisers, and recovery takes about 2 months.

What do they use?

A variety of chemicals are used to achieve different peel depths, though the depth also depends on the procedure used, the application time and the thickness of the skin being treated.

Chemicals used in superficial peels include alpha hydroxy acid (usually glycolic or lactic) or beta hydroxy acid (salicylic acid, 20-30% in ethanol or 50% in ointment), or a combination of them (Jessner’s solution has lactic and salicylic acid, along with resorcinol in ethanol). Tretinoin (Retin A, 1-5%) peels can also be used for a light peel. Trichloroacetic acid (TCA) at 10-30% concentration will also give a superficial peel, and concentrations of up to 50% will give a medium depth peel. High concentrations of glycolic acid (70%) applied for a longer period of time is also used for medium depth peels. Phenol is the main chemical used in deep peels; some croton oil is sometimes added.

What else do I need to know?

Aftercare is very important. Since the skin is new, sun protection is necessary for all levels of peel – deep peels usually require months of total sun avoidance. Camouflaging makeup is usually needed as well to hide redness.

Like any other treatment, chemical peels come with some potential unwanted side effects. Common issues include pigmentation changes (hyperpigmentation is more likely with darker skintypes, but genetics play a major role too), infection, milia and acne formation, and scarring (usually on the lower half of the face).

This is only a brief introduction to chemical peels – before deciding on the procedure, you should consult a dermatologist who can assess your individual skin concerns.

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