Chemical Peels

What is a Chemical Peel?

Chemical peels are exfoliative therapies that work to dissolve the superficial (outermost) layers of your skin. In essence chemical peels are used to produce a “controlled burn” of your skin, such that you achieve appropriate and beneficial healing from this burn. This very effective skin care treatment works to remove your old, uneven, worn out, “dead” skin and allows your new fresh, smooth, even toned, soft skin to replace your previous skin. Consequently, a properly administered chemical peel can be useful in the treatment of a variety of skin conditions including aged skin, sun damaged skin, uneven skin tone, acne, rosacea, hyperpigmentation and other skin problems.

How Do Chemical Peels Work?

Chemical peels use various chemicals like salicylic acid (aspirin), glycolic acid (AHA – a type of alpha hydroxy acid), trichloroacetic acid (TCA), phenol, resorcinol (a natural phenol), and Jessner’s solution (a combination of lactic acid, resorcinol and salicylic acid), and phenol.

In essence, all peels work by causing a “controlled burn” to the tissues of your skin and therefore promote a healing of this burned tissue. This healing process tends to accelerate the rate of cellular turnover in your skin and (depending on the depth of the peel) increase the production of collagen and ground substance in your dermal layers, hence improving the appearance of your skin.

Your skin is composed of several layers and different types of peels are designed to promote a “controlled burn” at different depths. Please refer to The Layers of Your Skin

Peeling Depths

Very superficial peels – an ineffective type of peel that does not achieve flaking of your skin
Superficial peels – A peel that extends into your stratum granulosum Moderate peels – A peel that extends into your papillary dermis
Deep peels – A peel that extends into your papillary dermis or upper reticular dermis

In general superficial and moderate peels lead to epidermal wounding which causes a controlled burn limited to the layers of your epidermis, including your stratum corneum, stratum granulosum, stratum spinosum and stratum basale.

These types of peels can be useful for skin problems limited to your epidermis and may be helpful for hyperpigmentation, uneven skin tone, acne, rough textured skin and fine lines.

Deeper peels will lead to dermal wounding which causes a controlled burn into your dermal layers. These types of peels improve collagen remodeling, improve bloodflow to your dermal region, and increase the production of ground substance all of which can improve the appearance of your skin. Hence, deeper peels can reduce fine lines and deeper wrinkles in addition to all of the benefits of more superficial peels.

Should I Get a Chemical Peel?

Both your Skin Type (Fitzgerald Classification) and your Skin Age (Glogau or Rubin Aging Analysis) are useful and necessary parameters to consider when determining the risks and benefits associated with various chemical peels. In general most people have “mixed” skin types and require individualized assessment of their skin type and age.

Benefits of Chemical Peels

Chemical peels are most effective for wrinkles (rhytids), sun damage and uneven skin tone (dyschromias)

Chemical peels are ineffective (and/or contraindicated) for sagging skin, excessive telangectasias and recent (postsurgical) facelifts.

Risk of Chemical Peels

All chemical peels cause a “controlled burn” and this burn must be carefully administered in order to affect the desired skin level. An overly aggressive peel can lead to pain and scarring.

The following conditions must not be present in order use a chemical peel:

sunburn
severe acne
current use of Accutane
active facial rashes (including herpes)
open wounds
recent facial surgery (like a facelift)

Ingredients Used in Commonly Used Chemical Peels

Glycolic acid – derived from sugar cane – comes in different strengths- a relatively light peel
Alpha Hydroxy Acids (AHA) – mild organic acids which allow the shedding of keratinocytes at the level of your stratum granulosum.
Salicylic acid – otherwise know as aspirin, traditionally derived from white willow bark. This is a Beta-Hydroxy acid, very useful for acne.
Trichloroacetic acid – TCA – comes in a variety of strengths – causes the proteins in your skin to coagulate at the level of papillary dermis (or upper reticular dermis) and therefore provides an easy to use and predictable medium depth peel.
Resorcinol - is a natural phenol and is found in argan oil, it has antiseptic and disinfectant properties; it is one of the active ingredients in products such as Resinol, Vagisil and Clearasil.
Phenol - More powerful than TCA also causes the proteins in your skin to coagulate at the level of papillary dermis (or upper reticular dermis) and therefore provides a predictable medium depth peel.

Other substances may also be added to a peel such as lightening agents (to reduce hyperpigmentation) and herbal and other plant based products (to provide anti-inflammatory agents, reduce pain and reduce congestion)

Designer Peels

So called designer peels are peels that employ various combinations of the ingredients listed above. They can be individualized to promote specific results.

One long used designer peel is know as Jessner’s Peel (or Jessner’s Solution) which was pioneered by Dr Max Jessner, a German-American dermatologist.

Jessner’s Peel – a combination of salicylic acid, resorcinol, and lactic acid. Sometimes used in combination with Trichloroacetic acid (TCA) or glycolic acid. – A moderately deep peel

The Vi Peel – this is a line of peels that was developed by Vitality Institute, there are several variants of this peel that are useful for different clinical conditions. The VI peel is composed of; a strong, serum-like combination of TCA (A peeling agent), Tretinoic Acid (A powerful compound to prevent collagen loss and boost cell turn over), Salicylic Acid (Fighting breakouts and promoting clarity of the skin), Vitamin C (A natural brightener and exfoliator) and a mineral blend.