A chemical peel is a method of skin resurfacing in which an acid is applied to the skin for the purpose of initiating a reaction that will alter the skin surface and perhaps its deeper layers. Peels can reduce pigment irregularities and some wrinkling (deeper peels), but not all skin conditions can be improved with chemical peels. Chemical peels are categorized as light (or superficial), medium, or deep. The depth of effect is controlled by the choice of acid, the method of application, and the length of time the chemical is left on the skin. Some techniques require multiple applications before the desired effect is achieved.

The acids most commonly used for peels are (in approximate order of intensity) alpha hydroxy acids (AHA) such as glycolic acid, lactic acid, and fruit acids; beta hydroxyl acids; vitamin A (tretinoin); trichloroacetic acid (TCA); and phenol. All acids can be used diluted or full strength, depending on the patient’s skin type and the goals of treatment.

Before undergoing certain types of chemical peeling, patients may be required to pretreat their skin at home with a topical medication like Retin-A. Lighter chemical peels (AHA peels) are performed in an office setting without anesthesia. The chemical solution is painted on the skin, and the patient may experience a mild burning sensation and slight, temporary redness. Patients can resume normal activities immediately, as long as they use sun protection. TCA peels may cause a more intense reaction, especially in higher concentrations, and the patient will have some activity restrictions for a few days. Read the rest of this entry »