Dr Lauren Evans MBChB (Gla) Dip Derm (RCPSG)
Aesthetics Practitioner & Associate at Advanced Dentistry, Hyndland
Director of Education and Development & Advanced Trainer at Facial Aesthetic Courses
Previously an NHS Dermatology Specialty Doctor
What are Chemical Peels and how do they work?
A Chemical Peel is a skin resurfacing treatment that is used to improve the quality and appearance of your skin. A chemical solution is applied to the skin to soften the superficial dead skin layer and exfoliate the skin. This stimulates your skin’s natural healing process, stimulating cell turnover, and producing new, healthier skin layers that give the face a more youthful appearance. Peels can be a simple, fast and highly effective way to achieve radiant skin for a special event and can also be used to dramatically lessen the effects of more serious skin conditions.
Chemical Peel treatments are categorised in terms of the acid solution used in the peel and how deeply they penetrate the skin: superficial, medium, or deep. Lauren performs superficial and medium depth Chemical Peels. A variety of chemicals can be used as peeling agents, including AHAs (Gycolic acid, Mandelic acid, Lactic acid, Malic acid), BHAs (Salicylic acid), or trichloracetic acid (also known as TCA). Each chemical works slightly differently, so your Chemical Peel can be tailored to your requirements.
What conditions can be treated with Chemical Peels?
The following skin concerns are commonly treated with Chemical Peels:
Acne –Chemical Peels exfoliate the skin, allowing dead skin cells to be removed more effectively. Excess oils on the skin are also removed, and some peels can have an anti-inflammatory action. All these actions help to unblock hair follicles and pores, leading to an improvement in acne. The Chemical Peel will also improve the skin texture that is damaged by acne.
Reduce fine lines and wrinkles – Chemical Peels can reduce the appearance of fine lines and wrinkles by increasing the amount of collagen in the upper layer of the skin. Chemical Peels are particularly effective on photo-ageing secondary to sun damage.
Rough skin texture or dull skin– Chemical Peels remove the dead cells on your skin’s top layer which can appear as rough skin to reveal more radiant skin which is free from very fine lines.
Skin hyperpigmentation, including lentigines, liver spots, age spots, melisma (also known as chloasma) - A course of Chemical Peels can lighten these pigmented areas and even out the tone and appearance of the skin.
Is the procedure painful?
Superficial and medium Chemical Peels may give a mild stinging or tingling sensation whilst being applied, but this should not be painful and it quickly subsides once the peel is neutralised or removed. Sometimes a fan is used to help keep the skin cool during the procedure, which helps to keep the skin more comfortable. In general, most patients tolerate the procedure very well.
Advice prior to treatment
One week prior to your peel, avoid electrolysis, waxing, hair removal creams and laser hair removal to the area to be treated, and stop any products containing retinol eg. Retin-A, Renova, Differin (Adapalene 0.1%) Tazorac.
Twenty four hours prior to your peel, stop using any exfoliating products or products that may be drying or irritating including products containing alpha or beta hydroxyl acids or benzoyl peroxide.
On the day of your peel, cleanse your skin in the morning and do not apply makeup on the face other than eyes or lips.
What can I expect when I have a treatment?
There are numerous chemical peels and each one is performed slightly differently. In general, the treatment will start with your skin being thoroughly cleansed. Lauren will make sure your eyes are protected with eye protectors. The Chemical Peel is then applied to your skin using a fan brush or cotton buds. The peel with then be left on your skin for between one and five minutes, depending on the type of peel and your requirements. The peel is then gently removed using wet gauze, and then wet gauze is draped over the areas that have been treated to soothe them. Your skin will then be moisturised and a sun screen will be applied. The total consultation and procedure time is approximately 30 minutes.
What can I expect directly after treatment?
The skin is often pink after the treatment is completed. Directly after treatment, there may be a faint white colouration in some areas, or a blotchy appearance of the skin that usually fades within a couple of hours.
Redness is usually minimal and may persist for a few days, and very rarely for a few weeks. Swelling can sometimes occur, but is usually minimal and short-lived. The skin may also feel tight, sensitive, and dry in the days following treatment. Peeling is usually superficial, mild, and of short duration.
In general, the deeper the peel the longer the potential down time. Those who have had a superficial Chemical Peel have no or very limited down time. Dryness and mild peeling may occur for up to three days. Some people who receive a superficial Chemical Peel do not experience any visible peeling of the skin after treatment, but the treatment still has a beneficial effect. Those who receive a medium Chemical Peel may find the redness and flaking lasts up to seven days. Patients having medium depth peels are often do so before a week off work.
How can I improve the results of my Chemical Peel?
Follow your homecare regime as recommended by Lauren. Best results are achieved and maintained from peels if the right skin care for your skin is used on a regular basis.
Apply high factor (at least SPF 30) UVA and UVB block when outdoors, for at least six weeks. This also applies to cloudy and dull days when the sun is not visible. This helps prevent uneven skin tone and excess pigmentation.
Use a gentle cleanser designed for sensitive skin in the weeks following your peel.
If you experience any excess dryness, tightness, or peeling, then use a hydrating moisturizer, for example one containing hyaluronic acid, regularly.
Scratch or pick off any dead/ peeling skin as this may cause bleeding, discolouration, or even mild scarring.
Use products that have acids in them (e.g. retinols, AHAs, harsh cleansers, resurfacing products) for at least 48 hours.
Expose yourself to extreme heat (including strenuous exercise) for at least 48 hours.
Use a sun bed for at least three months.
Have any other facial treatment for at least one week.
Are there any risks to the procedure?
There is a small risk of infection as the skin barrier function becomes compromised. This may include an attack of facial herpes, and Lauren will ask if you are prone to these. Scarring is very unusual, but may occur with medium peels. Hyperpigmentation (dark areas of skin) or texture changes may occur and although very rare, may be temporary or possibly permanent. In extremely rare cases, a significant allergic reaction can occur. This could include redness, facial swelling, and soreness lasting several days. Eye injury if chemicals get into the eye may result in scarring and visual disturbances. I will ensure you are wearing eye protection to help prevent this.
Am I a candidate for a Chemical Peel?
If you have a darker skin tone, a Chemical Peel may still be appropriate for you after an assessment. You may require a specially prescribed skin prep regime, or a test spot with follow-up a month later to ensure the peel does not cause pigmentation problems.
If you have sensitive skin, a Chemical Peel can still be a very effective treatment. You may require a specially prescribed skin prep regime, and it is best to start with very light peels and slowly work your way up. A test spot may also be appropriate.
Chemical Peels are not suitable for patients who:
Have used Roaccutane (Isotretinoin) within the last twelve months;
Are on medication that make you more sensitive to the sun;
Have Eczema, Psoriasis, active Acne, Rosacea, or other chronic skin conditions in the area to be treated;
Have had sunburn or excessive sun exposure in the past four weeks;
Have open wounds, cuts, abrasions, or active skin infection in the area requiring treatment;
Have had radiation treatment to the skin on or around the area to be treated within the last twelve months;
Are prone to Herpes Simplex or Zoster infections as treatment can trigger breakouts;
Are pregnant or breast feeding;
Have any history of keloid or hypertrophic scars, or are prone to poor wound healing;
Have a history of Immunosuppression.
How many treatments will I need and how often can they be repeated?
Whilst you may see some very minor benefits after a single superficial Chemical Peel, Lauren recommends a course of six superficial peels, two to three weeks apart for most skin conditions. After this, a maintenance peel every few months is advised as part of an ongoing skincare regime, or you can wait three months before embarking on another course of peels.
For medium peels, fewer treatments are required to reach the desired outcome, but it is not always recommended to go straight to a medium depth peel. You may be advised to start with superficial peels and work your way up to a medium peel.