Ah, beauty. It’s one of our most elusive and long-standing pursuits, and why wouldn’t it be? For as long as we’ve been able to look, we’ve wanted to look good. Thousands of years ago, people were limited to rudimentary headdresses and basic dyes and craftsmanship, and yet the depiction of their fancy digs still managed to make it to the present day, carved on artifacts like pottery.
It probably wouldn’t surprise anyone if we told you many of the beauty trends stuck at different points in history were extremely hazardous. But while people might’ve been doing some whacky things trying to look good back in the day, we’re inclined to think we’ve moved past that “experimental” phase and into an age led by science – so today’s treatments and products must be safe right?
Safe? Probably. Comfortable? Probably not.
While we’ve moved past lead face masks and arsenic complexion wafers (yes, those were a thing), some beauty treatments are still going to sting a little, even in the present day. The modern woman isn’t one to shy away from a little discomfort to perfect her best look, so a trip to the salon might come with a recovery period afterward.
Some background on chemical peels
This brings us to chemical peels. While that introduction might not make sense for many beauty products, you’ll get why it suits skin peels by the time you finish reading this article. See, the modern skin peel, like many other treatments, has its roots in ancient history.
The oldest treatment we can compare to a skin peel came all the way from ancient Egypt, where women would apply sour milk to their faces and necks to help rejuvenate their skin. Sour milk contains lactic acid, an alpha-hydroxy acid, which helped revitalize the skin, giving it that youthful glow that the Egyptians used it for. Later in history, civilizations like the Romans would use grapes (which contained tartaric acid) and oranges (which contained citric acid) to help them with their skin woes.
You’ve probably started noticing a pattern there; all of these treatments involved some kind of acid. Acids are the fundamental ingredients of modern chemical peels as well, though we’ve moved on from grapes, oranges, and milk. So which acids do we use now, and what do we want them to do?
What is a chemical peel? | The process
A chemical peel is a skin resurfacing procedure that involves using acids to react with, and subsequently burn off, layers of dead or damaged skin. This dead skin (in most cases limited to just the topmost layer) is prone to scarring, discoloration, and other undesirable affectations, and removing it allows the regrowth of the epidermis from scratch, giving you quite literally, new skin.
The level of penetration we want from our acidic agent depends on how much damage (or how many layers of skin) we’re trying to work through. Broken down in order of depth, from lightest to deepest, the three kinds of chemical peels are
- Superficial Peels
- Medium Peels
- Deep Peels
Superficial peels are your lightest peels and the fastest peels to do, while deep peels aren’t your typical cosmetic procedure and can usually only be conducted in a clinical environment. So, without further ado, let’s take an in-depth look at each of these procedures, who they’re intended for, and the risks and rewards associated with them.
Superficial peels, also colloquially referred to as lunchtime peels, are used to treat mild skin discoloration or keratinization and are the lightest in the peel family. The ‘Lunchtime peel’ moniker comes from the lack of downtime associated with the process of a superficial peel. Usually, someone undergoing one of these only needs to take out an hour or so from their schedule while accounting for the time it’ll take you to get to a nearby dermatologist and wait your turn. The process itself doesn’t take more than half an hour (usually around 15 minutes for facial treatment, longer for larger body parts).
Superficial peels only penetrate into the first few layers of the epidermis, which itself is the topmost layer of the skin. This usually means they’re effective as a method to fix mild sun damage, superficial acne scarring, dry skin, very light pigmentation problems, or the lightest wrinkles or skin lines (photoaging), and not much else.
Superficial peels usually involve no discomfort or the risk of serious aftereffects. The most you’re going to feel is a slight tingling or stinging sensation on the surface of your skin if anything at all. You should start to see some results immediately after treatment; people report seeing a slight ‘glow,’ and the best results can be seen within 5-7 days of treatment, though you can go about your regular day immediately after you’ve got one.
Most of these peels entail aftereffects are slight shedding of the skin, but this can be easily covered up with makeup. This is one of the major reasons why superficial peels are a popular entry procedure for people who’ve never opted for peels before.
These kinds of peels use only the weakest of peel formulations, such as low-potency AHAs and BHAs (Beta hydroxy acids) such as citric acid, lactic acid, glycolic acid, salicylic acid, and retinoic acid. In some cases, very low concentrations of trichloroacetic acid (between 10% – 20%) may be used as well. Most of these are derived from edible crops.
While superficial peels are a minor procedure with absolutely no downtime, the other side of that is that they have very little effect on the overall look of your skin. For optimal results, you may have to repeat the process 4 – 6 times depending on your skin tone and the type and the damage you’re trying to fix. Generally, you should allow for at least a 3 – 5 week waiting period between peels, though you should consult your dermatologist for advice that’s specific to your case.
Medium Peels are a more aggressive form of treatment that is a viable option for people with more extensive skin damage or irregularities of texture. Medium Peel procedures take anywhere between 30 – 120 minutes to complete. Like superficial peels, there is generally no need to put you under, so the dermatologist or technician conducting the procedure can talk you through it.
Medium Peels penetrate the epidermis fully, and sometimes even up to the reticular dermis (the second layer of the dermis, which itself is the second layer of your skin after the epidermis). The peel formulation destroys all of the epidermis and part or all of the papillary dermis, allowing for the formation of an entirely new layer of skin.
Given that you’re trying to reach deep into your skin to undo imperfections that go beyond the first few superficial layers, there are some risks to medium peels, and the procedure does involve slight discomfort or pain.
These risks are especially applicable to people with darker skin tones (Fitzpatrick skin types III-VI) and connective tissue diseases. People who have recently made use of the oral acne treatment isotretinoin within the past six months are also advised against medium or deep peels, though they may be able to undergo a superficial peel after consulting their doctor. In terms of sensation, you might feel a burning sensation on top of your skin, and your doctor may make use of an ice pack or fan to help alleviate discomfort. Most negative sensations will go away as soon as the peel solution is removed or neutralized, though some soreness may persist for 1 – 2 weeks.
The term ‘medium peel’ can apply to peels of a variety of concentrations and strengths. The lightest of medium peels will use blended solutions of 15-20% TCA and Jenner’s solution, and even potentially BHAs. A person should recover fully from one of these peels within 7 – 10 days, though redness, discoloration, and other superficial aftereffects may persist for a month or more. Deeper medium peels will utilize either just 25-45% TCA (or in some cases, even slightly higher), or a similar concentration of TCA mixed with Jenner’s solution.
Higher concentrations come with the long-term risk of epidermal necrosis, the short-term risk of post-inflammatory hyperpigmentation, and other complications. On the other side, these higher concentrations can completely undo the effects of actinic keratosis, solar lentigo, and moderate to severe photoaging and lessen the impact of pigmentation disorders. Modern medium peel treatments usually use blended solutions to achieve the desirable outcomes while reducing the risk of complications that may arise from using TCA alone. Ideally, aftereffects should subside within one month of treatment.
Medium peels are usually one-time procedures that look to tackle specific skin or pigmentation issues and are generally not repeated. They can completely erase superficial scars (such as those from acne and past trauma) and wrinkles. Individuals with darker skin face a greater risk of post-inflammatory pigmentation and scarring, though this risk can be alleviated or somewhat reduced by selecting the right solution.
Deep peels are uncommon nowadays due to the risks associated with the procedure. Phenol-Croton oil solutions are the most common deep peel formulation, also known as the Baker-Gordon solution. TCA-based solutions may also be used as the use of phenol, and its subsequent release into the bloodstream can lead to cardiotoxicity and arrhythmia.
Deep peels are lengthy, intensive procedures that cannot be typically carried out in an aesthetic clinical environment, such as a spa or clinic, and are usually conducted in hospitals. The patient will be sedated, and due to the risk mentioned above of arrhythmia, cardiac monitoring and resuscitation equipment are required to be present. The procedure itself can take up to a day and requires the use of a face mask for 24 hours or potentially more. In this time, the solution will penetrate up to the mid-reticular dermis.
Recovery can take anywhere between 3 – 6 months and can be a painful process. It is common for patients who have had a deep facial peel to have their eyes swollen shut for a brief period following the procedure. After successful recovery, patients will see reduced signs of severe photoaging, and older tissue will be completely replaced by new tissue as the epithelial layer reforms over the recovery period. Recovery can be a cyclical process, with layers of the skin reforming and repeatedly shedding before stabilizing over the coming months.
Deep peels may permanently alter the skin’s pigmentation, and in some cases, may completely strip the skin of the ability to tan naturally via exposure to the sun. Due to the risk of permanent pigment damage, dark-skinned individuals are generally not candidates to receive deep facial peels.
Due to the risks involved with deep peels, and the ongoing development of superficial and medium peels that can be applied in repeated procedures, deep peels are neither recommended nor necessary in most situations.
When left in the hands of a trained professional, chemical peels are a simple, routine procedure that can take years of aging or damage off your skin. At the same time, not all individuals can receive all kinds of peels, and the risk of allergic reaction or infection must be evaluated and mitigated by your dermatologist.
If you’re interested in a chem peel, and you’re in the Lone Star state, or specifically, the Dallas-Rockwall area, consider dropping by for a consultation or giving us a call. We’ve been conducting chemical peel procedures for a while and can confidently say we’ve done some of the best chemical peels in Texas.