Chemical peels for the face

Chemical peels are generally performed to treat areas of concern regarding fine lines, hyperpigmentation, acne and scarring on the face. Light (superficial) peels are generally offered by beauty spas and aestheticians, while deeper peels are conducted by medical professionals such as aesthetic medicine specialists, dermatologists and plastic surgeons.

Superficial or lunch time peel (10-15 minutes on the face)

Superficial peels are the mildest form of chemical peels available, so gentle in fact they’ve been given the name 'the lunch time peel' due to the minimal down time involved, making them the perfect lunch time beauty fix.

Superficial peels, as the name implies, have a superficial action and can be used in nearly all skin types. These peels help to cleanse the pores and address mild skin discolouration. They assist in achieving smooth, soft, even skin without causing redness or irritation.

Glycolic or lactic acid (alpha hydroxy acids or AHAs) or another mild acid and occasionally solid carbon dioxide (dry ice) are applied to gently exfoliate the skin. The acid is only applied to the skin for a time period which is just long enough to penetrate only the epidermis (upper layer of skin).

This type of peel is generally administered by beauty spas and aestheticians and can be used to enhance treatments for an array of conditions such as acne, melasma (hyperpigmentation that causes brown, tan or bluish-grey spots on the face), dyschromia (a pigmentation disorder that results in abnormal skin or nail colour), photodamage and actinic keratoses (rough scaly patches of skin due to years of sun or UV exposure).

Medium peel (15-60 minutes on the face)

Medium chemical peels offer deeper penetrationof the skin than their superficial peel counterparts, as the chemicals are infused below the outer layer of skin (known as the epidermis), travelling down into the upper most portion of the middle layer of skin (dermis) to what is known as the papillary dermis.

This peel can help to improve hyperpigmentation (sun spots & freckles), age spots, fine lines and wrinkles, dyschromia (a pigmentation disorder that results in abnormal skin or nail colour) and superficial scars. It also can be used to smooth rough skin and treat certain precancerous skin growths, i.e. actinic keratosis (rough scaly patches of skin due to years of sun or UV exposure).

These types of peels are generally performed on an outpatient basis by a qualified doctor due to the fact that they are dependent on higher concentrations of acid than superficial peels. Based on the concentration used and the patient’s preferences, a light sedation may be administered, although no local anaesthesia is necessary. A doctor will also need to prescribe the relevant anti-viral medication and antibiotics if/when required.

During the procedure, glycolic or trichloroacetic acid (TCA) is applied to the skin and left on long enough for it to penetrate the outer (epidermal) and middle (dermal) layers of skin to remove damaged skin cells. The chemical solution removes the damaged outer layers of the skin which may be affected by acne, fine lines, hyperpigmentation and other factors.

This type of peel is far more likely to be associated with complications, both temporary and permanent, than superficial peels. It is therefore vitally important to adhere to the administering physician’s advice on using antiviral medication for the prevention of viral outbreaks such as herpes cold sores. He or she will most likely recommend that you start an anti-viral course of treatment prior to the peel being performed.

To avoid any sort of infection during the healing stages it is crucial that you do not pick at the skin – outside of contracting an infection, this is a sure way to end up with long lasting complications such as scarring or skin discolouration. Your physician will also provide you with guidelines around what moisturizers and cleansing agents may be used as well as other precautions to take, especially when it comes to sun exposure.

Make-up should not be worn until the skin is completely healed and fully peeled away. This is due to the fact that make-up contains numerous metals and contaminants. If applied before the ‘resting’ and healing period, heavy metal may deposit in the skin causing discoloration while contaminants may cause an infection and even scarring.

 After the procedure, newly generated skin may appear reddish, but the discoloration should fade within a week or so.

Deep peel (1-2 hours on the face)

As the name implies, a deep chemical peel penetrates deep into the skin all the way through the lower portion of the middle layer (dermis) to what is known as the reticular dermis. The treatment removes severe photoaging, moderate lines, deep wrinkles age spots, freckles and scars.

Deep peels are not suitable for individuals with darker skin tones as they have a bleaching effect, even lightening fair skin. In most cases, the procedure is applied to the face and only can be performed once. 

Deep chemical peels using phenol are generally performed by a qualified doctor in a hospital or fully equipped day clinic setting under carefully monitored conditions using an ECG due to the danger of potential toxicity to the heart and kidneys. The patient is either sedated and a local anaesthesia is administered or placed under full general anaesthesia (under the care of an anaesthesiologist) to ease the discomfort associated with this level of chemical peel. The chemical peel solution also contains anaesthetic that numbs the skin.

The reason why this type of peel is facilitated in hospital is not only because it requires some form of sedation or anaesthesia but also because the absorption of phenol has been known to cause cardiac arrest and even death. Patients have to be strictly monitored in both regards. With that being said, this type of chemical peel should not be done any setting other than a hospital or fully equipped medical facility (day clinic) where emergency back-up is on hand in the event that something should go wrong.

Deep peels maximize the regeneration of new collagen. The restoration of tissue, also known as epithelialization, will occur within 5-10 days. The downtime for this procedure is the longest of all chemical peels and you should probably expect it to be 2-3 weeks before you’re ready to be seen in public. However, deep peels require a lengthy healing time, usually two months or more before the process is complete. Although a deep chemical peel can improve your overall skin dramatically, it does have its limitations in the sense that it cannot eliminate loose, sagging skin and deep scars.