Chemical Peel

Reviewed by Linda Nelson, National Technical Director, Skin Authority

Along with aging come wrinkles, skin discoloration, enlarged pores, sun damage, and freckling. Chemical peel is one of the most popular treatments for an aging face. In the United States, 1.06 million chemical peels were performed in 2006.* (Read on for more chemical peel statistics.)

Additional or Alternative Treatments

Many conditions and imperfections can be treated with a chemical peel; however, there are several that require additional or alternative treatments. Other treatment options may include facelift, brow lift, and chin or cheek implants.

Laser skin resurfacing, collagen fillers, Botox, and Restylane can be incorporated into your treatment plan as well. Combination treatment plans tend to be the most successful.

Indications for Chemical Peel

Chemical peel can improve the appearance of:

• fine lines
• hyperpigmentation (skin discoloration or age spots)
• enlarged pores due to an improper daily skincare regimen
• light sun damage
• light freckling
• minimal scarring
• treatment for the face, arms, legs, neck, chest, and hands

Symptoms that Require Alternative Treatments

Chemical peel cannot improve the appearance of:

• deep wrinkles
• sagging, hollow, or fatty skin
• deep sun damage or freckling
• deep scarring

The Chemical Peel Solution

There are many types of chemical peels on the market today. There may be one chemical (i.e., glycolic acid or trichloroacetic acid) or a combination of chemical agents used in the solution. These chemical solutions are offered in various strengths. The doctor will select the appropriate strength and combination of chemical agents based on your condition. The chemical peel may be classified as a light or superficial peel, medium, or deep peel.

The Chemical Peel Procedure

The procedure is performed in a physician's office by a dermatologist, plastic surgeon, and more often by a licensed esthetician or RN. Deeper peels require anesthesia, lighter peels often do not. The procedure takes about 15 minutes, then one to three weeks of recovery. The number of treatments varies among individuals. Final results can last up to several months.

During the procedure, the treatment provider will apply the chemical solution to the affected area, most often over the entire face. The chemical agents then work to separate and "peel" the outer surface layers of the skin. These layers often contain dead skin which is removed during the process. The chemical agents serve to stimulate the generation of new skin cells through the healing process. During the application, patients may experience a cool, warm, or hot sensation that can last for ten minutes or more. This feeling may be accompanied by stinging.

The aging process, including new fine lines and age spots, will continue over time. A maintenance program of chemical peels may be part of your long-term plan.

Recovery After a Chemical Peel

In order to promote healing and reduce the risk of complications, follow the directions of the treatment provider carefully. The post-op instructions will warn against any use of makeup or exposure to the sun for up to two weeks. You will need sun block SPF 15 or higher to go outside.

The reaction to a chemical peel depends upon many factors, including skin type and peel strength. During the first two weeks, the skin may break out until it is renewed at the end of recovery. Additional reactions can be similar to sunburn. Lighter peels can produce redness and skin peeling for a few days. Deeper chemical peels can result in blisters that burst, scabs, or skin peeling for up to two weeks. This may be accompanied by swelling. In the case of a severe reaction, the doctor may prescribe ointments, creams, oral steroids, and the use of dressings. The treated skin is highly susceptible to injury after treatment. It is important to communicate any adverse conditions or reactions to your doctor.

The doctor will recommend a daily skincare regimen that is essential to the healing process. Be sure to follow your doctor's regimen and report any complications that result from the peel or from the new skincare regimen.

Consult a Qualified Doctor

Talk to a qualified doctor about your goals and the treatment options available for your condition. Dermatologists and plastic surgeons may have extensive knowledge and experience with anti-aging procedures. To identify appropriate treatments, meet with a specialist first. Licensed estheticians or RNs perform most chemical peels. Deeper peels may be performed by a dermatologist or plastic surgeon.

Consider these tips when consulting a doctor or other qualified treatment provider:

• Review credentials, education, training, type of certification held, and number of times the treatment has been performed by the treatment provider.
• View before-and-after photos of patients with similar conditions who received chemical peels and alternative treatments.
• Inquire about the type of chemical peel to be used, the strength of the peel, and possible side effects from treatment. Each peel type has its own advantages and disadvantages.
• Ask the treatment provider to estimate the number of treatments required to achieve and maintain the benefit.
• Identify the type of support available through the healing process: Support may be phone or email, possibly 24 hours a day, seven days a week.
• Ask for a list of pre-op and post-op instructions.

The Cost

The costs for a chemical peel procedure include:

• the number of treatments required to achieve the desired result
• the ongoing treatments required to maintain the result
• the anesthesia
• the type of peel
• the aftercare daily skincare regimen

Costs vary among treatment providers and skincare manufacturers. Often, treatment providers will offer packaged pricing for multiple treatment sessions and the aftercare skincare regimen. Costs for the peel itself can range from $75 to $600 or more. Annual costs for a daily skincare regimen can be $750 or more.

About the Reviewer of This Article

Linda Nelson is the national technical director for Skin Authority, which has Skin Authority Skin Clinic locations in the Orange County, San Diego and Riverside areas of southern California.

*American Board of Plastic Surgery

[page updated June 2008]