Glycolic
Chemical Skin & Face Peel
Chemical peels, also known as chemical
resurfacing, are cosmetic treatments to
produce an improved appearance of the
face. Chemical peels are used for the
treatment of photoaging (from sun damage),
wrinkles, scarring, acne, precancerous
lesions, and discoloration (or dyschromia).
Chemical peels produce controlled injury
to the skin that promotes the growth of
new skin with an improved appearance.
Many different chemicals are used including
glycolic acid, trichloroacetic acid (TCA),
salicylic acid, “Jessners”
solution, and phenol. The different chemical
solutions produce different degrees of
injury to the skin. There are two layers
of the skin; the outer layer is called
the epidermis and the inner layer, the
dermis. Superficial peels (e.g. glycolic
acid) produce very superficial injury
confined to the epidermis. Superficial
peels can help improve conditions such
as acne and dyschromia. Deeper peels (e.g.
phenol peels) produce injury within the
dermis and can reverse moderate-to-severe
photoaging and wrinkles. In general, the
deeper peels offer the most dramatic results
but require longer recovery periods and
carry a higher risk of complications.
Chemical peels have actually been used
for hundreds of years and have a proven
safety record in the proper hands. However,
chemical peels are not for everyone. For
example, people who are in poor general
health should not get peels. Also, active
infections and certain medications (i.e.
isotretinoin (Accutane)) may preclude
the use of certain types of chemical peels,
especially medium and deep. Sometimes,
people with abnormal scarring, certain
skin diseases, or recent surgeries should
not have a chemical peel. You and your
physician should decide if chemical peels
are safe for you.
Chemical Peel Procedure:
Chemical peels usually begin with vigorous
cleansing of the skin. The depth of the
peel depends on the chemical used. Very
light peels (e.g. low potency glycolic
acid, 10-20% TCA) only penetrate the dead
skin cells that sit atop the epidermis
and produce almost no injury. Sometimes,
this level of peel is called “exfoliation”.
Light peels (70% glycolic acid, 25-35%
TCA) injure the entire epidermis and stimulate
the regeneration of a new epidermis. This
level of chemical peel may produce a burning
sensation during the procedure. Recovery
from light peels is quick- hence the name
“lunchtime peel”. Improvement
in the appearance of photoaged skin and
scarring is usually subtle at best. Medium
depth peels involve injury to the upper
level of the dermis. Injury to the dermis
stimulates the formation of collagen and
“plumps” up the skin. Usually
35% TCA, in combination with another chemical
such as glycolic acid, is used safely
with minimal discomfort. Burning is the
most common complaint during the procedure
and this is usually well controlled with
cool compresses or topical anesthetics.
Deep peels involve injury to the mid dermis
and are usually performed using a phenol
solution. A deep chemical peel may offer
dramatic results such as elimination of
deep furrows and scars. However, complications
such as scarring, permanent textural changes,
darkening and redness of the skin can
occur. Furthermore, during a deep peel,
anesthesia must be used and vital signs
must be monitored throughout the procedure.
Recovery from a deep peel requires occlusive
bandages and can take up to a month under
normal circumstances. The phenol peel
should only be performed by qualified
physicians with proper monitoring equipment.