Botox and fillers may be the minimally invasive cosmetic procedures of our time, but the chemical peel is still going strong.
In simple terms, chemical peels use acid (there are different types) to break down the top layer, or layers, of skin to help diminish the look of fine lines, wrinkles and uneven skin tone. Believe it or not, chemical peels have been around since the mid-1800s, though they really seemed to gain mainstream popularity in the late ’90s and early 2000s. (We’ll never forget Samantha’s chemical peel on “Sex and the City.”)
Fast forward a decade or two, and roughly 1.4 million chemical peels were administered in the United States in 2017, according to a report by the American Society of Plastic Surgeons.
To learn more about the procedure and what exactly happens to the skin in the process, we spoke to Dr. Michelle Yagoda, a cosmetic facial plastic surgeon in New York, and Dr. Elie Levine, a board-certified plastic surgeon and director of plastic surgery at Plastic Surgery & Dermatology of NYC.
Here’s what you should know.
First of all, not all chemical peels are the same.
“Chemical peels run a range of different types of products that can be used, and there’s a big difference in how deeply the chemical that’s being applied affects the skin,” Yagoda told HuffPost.
Yagoda further explained that there are three types of chemical peels ― superficial, medium-depth and deep-depth.
When people refer to chemical peels, Yagoda noted they’re usually talking about superficial peels (sometimes referred to as “lunchtime peels”). These are the mildest of the bunch, as they require little downtime. You may experience some redness for 20 minutes to half an hour afterward, and you may experience some dryness or flaking over the course of a few days, but otherwise, you can get back to business as usual. Typical acids used in superficial peels include glycolic, salicylic, kojic acid and malic acid, Yagoda said. Superficial peels are good for treating fine lines and wrinkles, large pores and dark spots, and to help tighten the skin.
Levine added, “If you have a big event, doing a light chemical peel a few days before is spectacular.”
Medium-depth peels generally use trichloroacetic acid at concentrations of 35 percent or less, Yagoda explained. These types of peels usually use a pure form of the acid that isn’t neutralized, and they aren’t typically made available for spa facials. Medium-depth peels can help treat skin that has a significant amount of photodamage, sun spots, mild to moderate acne scars, crepey skin under the eyes or dark circles.
The downside is the recovery period, which Yagoda noted runs anywhere from five to seven days. The skin is left raw and red, and needs to be constantly covered with ointment, though she said it shouldn’t be painful.
“That means, for those five to seven days, it’s fairly labor-intensive, because you’re gooey and putting on stuff all the time,” she said. “You can’t really go out.”
The deepest peels, which target more serious skin issues such as severe acne scars, excessive sun damage or looseness of the skin, also uses trichloroacetic acid, though at concentrations starting at 50 percent to 70 percent, or phenol acid, Yagoda said. She also noted that deep-depth peels may not be suitable for those with darker skin tones, as they could result in scarring or hypopigmentation. Typical downtime is about seven to 10 days, but could even last two weeks.
As Levine explained, for those who regularly get peels, the strength of each peel can be increased each time. As a result, the person’s tolerance increases, and over time, patients are able to get stronger peels with decreased downtime.
What actually happens during a chemical peel?
Before the actual peel, your doctor (or facialist) will clean the skin to remove any makeup, sunscreen and oil ― because as Yagoda told HuffPost, if there is oil on your skin, it “acts as a barrier and prevents the acid from getting in deeply.”
Levine told HuffPost that he also applies an ointment to the skin around areas like the eyes, nose and mouth, where you don’t want the peel to pool. He also uses a lip ointment to keep the mouth protected. Then comes the acid.
Both Yagoda and Levine explained that the length of time the acid stays on the face depends on the strength and type of peel. If it’s mild, Yagoda said, it will neutralize itself in a period of time, and then the patient is able to wash it off. If the peel is stronger, it requires a neutralizing agent to stop the acid from working.
During the peel process, the chemicals cause a reaction with the skin and dissolve the outer layers of dead skin to help even the skin tone and texture and promote the building of collagen, Levine explained.
The treatment causes a small injury to the skin, Yagoda said, which allows it to not only build new collagen, but to “regenerate itself and make fresh, new skin.”
What about at-home peels ― do they work?
Yagoda and Levine agreed that at-home chemical peels are effective, but the results are minimal. As you may expect, the strength of a peel you can buy over the counter is going to be much lower than what’s administered by your dermatologist or plastic surgeon. The effect of an at-home peel is similar to using a physical exfoliant or facial scrub, Yagoda said.
Still, she sees a benefit to using them.
“I am a very firm believer that when you get over the age of 40 and your skin starts to age more and lose a lot more collagen, elastin and oil, most people, unless you have very significantly oily skin, should change from a physical scrub to a chemical scrub because it’s more delicate on your skin,” she said. “There’s a lot less pulling and irritating of the skin to still get increased skin turnover and more rejuvenated skin.”
Is a chemical peel right for you?
Yagoda explained that chemical peels are just one method to regenerate and rejuvenate the skin. There are also light energy or laser treatments, or mechanical treatments such as dermabrasion.
“All three things really can cause the same benefit in skilled hands,” Yagoda said, adding that she prefers chemical peels “because it’s less expensive, it’s less painful and it’s quicker.”
If you’re interested in having a chemical peel, or perhaps wondering whether a peel is even right for you, you should consult a dermatologist or plastic surgeon who can advise you with their expertise. You can also try at-home peels, but know that you likely won’t see any drastic results.