Chemical peels

Peels

Once a year, we celebrate glowy skin with our Peel Party. When attendees purchase a peel, they receive a complimentary peel on their account for future use. Still, we realize a lot of people are new to peels or hesitant about the level of commitment that comes with taking the peel plunge.

How often should someone get a peel?

We recommend every 4-6 weeks because it takes about 30 days for your skin to turn over. A total of six treatments is recommended.

Do peels hurt?

With most peels, you will feel a tingle. It goes away in a couple minutes, and we follow up with a sunscreen that neutralizes any sensation. Throughout the treatment, we’ll check in on a scale of 1-10 — your peel shouldn’t be painful.

I feel like my skin is in great condition. What would be the benefit of getting a peel?

If you live in Texas, the sun can be intense. There are pollutants in the air that can be detoxed by, say, the antioxidant peel. Some peels can also help to create a protective layer against these pollutants.

Are there any things you can’t or shouldn’t do immediately after getting a peel?

You should avoid heat of any kind. Skip going out in the sun, working out, or taking a really hot shower so your skin can heal.

WHAT CAN PEELS BE USED FOR?

They are versatile and can be used to treat:

• Acne

• Sun damage, including age spots and fine wrinkling

• Skin texture

• Pigmentation issues like melasma and post-inflammatory hyperpigmentation

• Superficial scarring

What you need to know before picking up an at-home peel 

Skincare information is aplenty in this internet age and if you’ve been paying attention, exfoliation is in. Spending big bucks on moisturizers and cleansers can be a waste if you’re skipping this important step. It helps slow aging, brightens skin, and clear breakouts.

One type of exfoliation, chemical peels, are gaining in popularity because of how effective they are at solving problem skin. Acid exfoliants can now be found in at-home peels, body lotions, cleansers, serums and toners, and for good reason. It’s a simple, easy way to see real skin changes without the dermatologist price tag.

Since there are so many products and types of chemical exfoliants you should know a thing or two before picking up a bottle.

Am I a candidate for chemical peels? 

In short, yes! Most people could benefit from the benefits of chemical exfoliation. The benefits range firming the skin, improved texture, softened appearance of fine lines and reduced breakouts. They are also a great way to maintain healthy skin and provide collagen-boosting benefits.

And those who shouldn’t use a peel are those with infected wounds, extremely inflamed acne, and those with extremely sensitive skin. However, Perfect Image Peels offers a Daily Use peel which is a very low and tolerable concentration that many people with sensitive skin can handle. You’ll want to handle extreme skin issues before adding in a chemical exfoliant.

If you are unsure, ask your dermatologist.

Chemical peels

How Chemical Peels Work

“The majority of chemical peels use various acids on the skin to create a controlled wound,” says Joshua Zeichner, MD, a board-certified dermatologist in New York City. While we typically think of wounds as bad things, in this circumstance they’re not. The treatment takes advantage of the skin’s ability to heal itself, and as a result, the wound-repair process can actually improve the appearance of pigmentation and skin texture, Dr. Zeichner adds.

Types of Chemical Peels

Not all chemical peels are alike, so you can expect a different experience depending on the strength of the acid and the depth of the peel, says Wattenberg.

Here are the three major types.

1. Superficial or Light Chemical Peels

“These types of peels are used to treat mild acne or uneven skin tone, or just to brighten up your skin, and most commonly they contain glycolic or salicylic acid,” says Wattenberg. Salicylic acid can help minimize acne bumps on the face and in other troublesome areas, like the back. Because this acid is are a beta-hydroxy acid, it can travel into pores and follicles and treat acne at its core.
Meanwhile, glycolic acid is a type of alpha hydroxy acid that stays on the surface of the skin and acts as a peeling agent.
It is a light peel, so you can expect dryness and mild exfoliation, says Wattenberg. And because this type is so superficial, the peels can be done every two to five weeks.
“But remember, even the glycolic and salicylic acids can vary in strength,” says Wattenberg. That means there are varying degrees of what’s considered a light peel.

2. Medium Chemical Peels

These can be used to correct the physical signs of more extensive sun damage, deeper lines, and more significant wrinkling, says Wattenberg. “Traditionally these peels contain trichloroacetic acid (TCA) in combination with other chemicals, and peeling may continue for five to seven days,” says Wattenberg. TCA is a type of acid that can reach a number of depths in the skin (depending on how much is used), so it’s considered the workhorse of chemical peels.

3. Deep Chemical Peels

This is the most aggressive type of chemical peel. These require more downtime and are usually reserved for those with extensive sun damage, wrinkles, and fine lines, says Wattenberg. “These may contain stronger combinations of TCA, phenol, and other chemicals,” she adds. Phenol is the strongest chemical used in deep peels, and it can penetrate to the lower layers of your skin.

Who to See for a Chemical Peel

“The depth of the peel, the skin type, and the issue you are addressing should determine who should be performing the procedure,” says Wattenberg.

Certain light chemical peels are available over the counter at relatively low concentrations of active ingredients, and other light peels can generally be performed safely at medical spas or in an aesthetician’s office, says Zeichner.

Medium and deep peels are a different story. “Professional peels contain high concentrations of the active compound that penetrates deeply into the skin, so it is important that it’s performed by a professional like a dermatologist or plastic surgeon to make sure you have an even, safe, and effective peel,” Zeichner adds. Be sure your dermatologist or surgeon is board certified by looking them up on the American Board of Dermatology or the American Board of Plastic Surgery websites.

Wattenberg’s rule of thumb: “The deeper the peel, the darker your skin, the riskier the procedure, and therefore the need to see a more trained and qualified professional.”

When to Get a Chemical Peel

First and foremost, talk to your doctor about chemical peels and whether you’re a good candidate. “Chemical peels are a great option if you have dark spots, fine lines or wrinkles, prominent pores, or irregular texture,” says Zeichner.

Potential Skin Benefits of a Chemical Peel

As for the benefits, a light chemical peel may help improve your skin texture and tone, and decrease the visibility of fine lines and wrinkles. Meanwhile, if you have a medium chemical peel, your skin will likely appear markedly smoother, and a deep peel offers a dramatically different look and feel to your skin.

In addition to the cosmetic benefits, chemical peels can be used to treat acne scars as well as skin conditions that affect the color of the skin.
Chemical peels may also help remove precancerous skin growths.

Possible Complications of Chemical Peels

While it is a rare result, high-concentration chemical peels can cause permanent scarring, says Zeichner. “The most common potential risk associated with a chemical peel is a permanent or long-term change in the skin pigmentation,” Zeichner adds. People with darker skin tones are more at risk of changes to the skin color.
“Inflammation can cause the skin to heal with extra pigment in the form of a dark black blotch, or it can block pigment production, leading to a light blotch,” says Zeichner. The good news? “These pigmentary changes usually improve on their own over several months,” he adds.

Still, certain people should avoid chemical peels altogether. If you have a risk of heart disease, you should avoid deep peels with phenol.
Deep peels can (but rarely) cause serious complications such as heart, liver, or kidney failure.

People who are pregnant, have routine outbreaks of cold sores (a peel can lead to flare-ups), have scar tissue called keloids, or have used the medicine called isotretinoin (Myorisa, Claravis) in the past six months should avoid chemical peels.

Also worth knowing: Deep peels happen in a surgical setting, and you will be under general anesthesia.

How to Prepare for a Chemical Peel

When you visit your doctor, they’ll do an exam and help determine which type of peel is right for you and your skin, says Wattenberg. They’ll also go over your medical history and let you know of any risks with the procedure.

Then if you are getting a medium or deep peel, your doctor will likely ask you to do a special skin-care routine for about two to four weeks prior to your peel. This regime will help you prepare your skin for a better outcome.

The pretreatment regime could include a prescription retinoic gel or cream. Retinoids are derived from vitamin A and help thin your skin’s outermost layer, so that the chemicals can go deeper and more effectively into your skin.
You might also be prescribed a bleaching agent called hydroquinone in combination with the retinoic product if you have hyperpigmentation or blotchy skin.

In addition, your doctor may ask you to take an antiviral medicine to prevent infection and may suggest that you avoid sun exposure in the weeks leading up to your peel. You may also be advised to avoid facial masks and scrubs as well as hair removal procedures in the week prior to the peel.

Last, be sure to arrange a ride home afterward (especially if you’ll be sedated during the procedure). And when scheduling your peel, don’t choose a date close to an important event, says Wattenberg. “It takes time for the skin to recover from the peel,” she adds.

Chemical Peel Results and Follow-Up Care

After your peel, you can expect different results depending on the type of peel you received. A superficial peel will likely make your skin look brighter, a medium peel can make your skin smoother, while a deep peel will even out your skin tone and reduce wrinkles.

Your follow-up care will also depend on the type of peel.

A light peel takes one to seven days to heal, and there is no follow-up care needed with your doctor. After the peel, you will likely need to apply cream daily as well as sunscreen.

A medium peel can take 7 to 14 days to heal and will require a follow-up appointment with your doctor. To help you heal, your doctor will probably ask you to soak your face and use an ointment each day, as well as apply a cream and completely avoid the sun while your face heals.

A deep peel takes 14 to 21 days to heal, and your dermatologist will likely want you to visit the next day as well as several times after that. You’ll need to do multiple soaks with ointment application per day, use a thick moisturizer after 14 days, and completely avoid the sun for three to six months.

One thing to remember: “It is important to let the skin shed on its own and not to pull the peeling skin — physically removing skin that is not ready to be shed can lead to potential scars,” says Zeichner.

What type of acid should I use?  

All acids exfoliate, but some acids target certain issues better than others. Because each skin concern affects different aspects of the skin, there are specific types of chemicals better suited to address your particular issue.

First, there are two main types of acids used in chemical peels are AHAs (alpha-hydroxy-acids) and BHAs (beta-hydroxy-acids). The main difference is that AHAs are water-soluble, and BHAs are oil soluble.

The most common BHA, salicylic acid, is able to break through the oil clogging pores and deeply expel the sebum and dirt that has accumulated. Salicylic acid is by far the most helpful peel for those trying to treat acne, blackheads, whiteheads, or oily skin. This acid combats the oil in a way that the other water-soluble acids cannot.

In the AHA family, we have acids like glycolic, lactic, malic, and mandelic acids. These all are water-soluble and penetrate deeper into the skin.

Glycolic acid is best for aging as its small molecule dives deep to address lines and wrinkles, firmness, and elasticity. Lactic acid is the best for hyperpigmentation, fine lines and wrinkles, and to increase brightness.

Alternatives to Chemical Peels

Not sold on the chemical peel? There are other options. “Skin resurfacing is a broad category that can be done with retinoids, chemical peels, microneedling, and a variety of lasers,” says Wattenberg. “There are a wide variety of choices, and determining the best procedure requires seeing a professional that can assess your skin and your issues, and determine the best option to achieve your goals.”

For example, when it comes to addressing acne scars, Zeichner prefers lasers or microneedling to chemical peels. “These can penetrate deeper into the skin than most peels to better address the irregular collagen that leads to scars,” he says. One review of research shows that lasers have become more popular than deep peels (at the same time, though, superficial chemical peels are on the rise).

Microneedling creates small puncture wounds in the skin that help stimulate the production of collagen.
Collagen is a protein that keeps our skin looking plump and smooth.
Lasers can stimulate the production of collagen, too. An ablative laser, for example, removes the epidermis and heats up the dermis (the layer of skin below the epidermis), which creates more collagen.

Which chemical peel is best for beginners?

Lactic acid is another good starting peel because it's considered lightweight and gentle. It smooths skin, provides a glow, helps with minor wrinkles, and is better than glycolic acid in treating hyperpigmentation and general skin discolorations. In addition, it's more hydrating.