What is a chemical peel?

A chemical peel is a minimally invasive, nonsurgical therapy that exfoliates and resurfaces damaged skin to smooth texture and tone. Chemical peels are most commonly used as facial treatments. They can also smooth age- or sun-damaged skin in other areas, such as your neck and hands.

Chemical peels may use mild, medium or strong chemical solutions to peel or remove damaged layers of skin. You can have one or a series of treatments to smooth out rough or uneven patches and reduce visible spots, lines, scars and discoloration. The result is a fresher, brighter look for your face and other areas treated.

Types of chemical peels include:

Light chemical peel – Your skin will have a subtle, healthy glow. This is enhanced with each follow-up treatment.

Medium chemical peel – Your skin looks refreshed and smooth.

Deep chemical peel – You can get dramatic results and younger-looking skin, but you’ll have more discomfort and downtime.

Board-certified plastic surgeons at The Ohio State University Wexner Medical Center in Columbus have extensive training and experience in performing all types of cosmetic procedures, including chemical peels. At the Ohio State Wexner Medical Center, doctors select clinically tested, medical-grade products from reliable sources.

Ohio State’s plastic surgeons also offer other skin-brightening solutions, such as nonsurgical skin rejuvenation and skin care treatments.

Why chemical peels are done? It can address:

  • Sun-damaged skin
  • Spots, blemishes and blotches
  • Uneven skin coloring
  • Rough or scaly areas of skin
  • Minor scars and indentations
  • Conditions not improved by chemical peels include:
  • Loose, sagging skin
  • Deeply scarred skin tissue
  • Certain kinds of deep folds and wrinkles

Ask your Ohio State plastic surgeon about these and other skin problems to find the best procedure or combination of treatments for the results you want.

Types of chemical peels and treatment goals

Your doctor uses a quality, medical-grade product to apply to the areas of skin you want to treat. The doctor will select and adjust the formula to your skin type, condition and treatment goals.

Light chemical peel

This milder peel exfoliates just the outer skin layer (epidermis). It can be an effective option if you have dry skin, acne, uneven pigmentation or fine wrinkling. It may include a blend of relatively mild ingredients such as: 

  • Alpha-hydroxy acid
  • Beta-hydroxy acid
  • Glycolic acid
  • Salicylic acid
  • Lactic acid
  • Maleic acid

Light chemical peels give your skin a subtle, healthy glow. Regular light peels can help you achieve the results you want.

Medium chemical peel

Medium peels can effectively treat acne scars, deeper wrinkles and uneven skin color. This type of peel removes skin cells from both the epidermis, or outer layer of skin, and dermis, the upper part of the middle layer of skin. A medium peel may include these ingredients:

  • Trichloroacetic acid (TCA)
  • Jessner's solution – a formula with a specific ratio of ingredients
  • Glycolic acid

Deep chemical peel

This stronger peel treats sun-damaged, scarred or blotchy skin. It can help some deeper facial wrinkles. Deep peels are sometimes used for precancerous growths carefully evaluated by specialists. Doctors use phenol — a strong chemical that can reach the lower dermal layer of your skin. Compared to other peels, this treatment involves more extensive preparation. It can involve more discomfort and post-treatment recovery time.

You may have a sedative and local anesthetic to manage any discomfort.

Deep peels typically require pretreatment for up to eight weeks to prepare your skin and promote healing.

Pretreatment may include retinoic acid, a topical prescription medication derived from vitamin A. It thins out the surface of your skin. This helps the chemical solution to work more evenly and deeply.

How to prepare for a chemical peel

During your office consultation, the doctor will tell you how to prepare and what to expect before, during and after your chemical peel. Procedures vary, but chemical peels generally include the following steps:

  • Medical evaluation
  • Assessment of your health and skin condition
  • Evaluation of specific areas to be treated
  • Discussion of types of peels, products and treatment choices
  • Review of procedure steps and the healing process
  • Instructions about medications or supplements to avoid
  • Other instructions, such as sun and ultraviolet (UV) light avoidance
  • Products to take or avoid before and after treatment

What to expect

A chemical peel is an outpatient procedure done at one of Ohio State’s easy-to-reach clinics in Columbus or surrounding areas. Your skin will be cleansed and prepared before your procedure. The doctor applies a light, medium or deep solution as discussed in earlier office consultations.

Steps for specific types of chemical peels may include:

Light chemical peel steps

Your doctor gently brushes the chemical solution onto your face or other areas of skin to be treated.

You may feel a mild stinging sensation.

After a few minutes, the doctor washes off the solution.

The doctor may treat your skin with a chemical-neutralizing therapy. 

Medium chemical peel steps

Your doctor brushes the solution onto your skin.

You may feel a burning or stinging sensation.

After a few minutes, the doctor neutralizes the chemicals with a cool compress or other methods.

Deep chemical peel steps

Your doctor will discuss skin treatments you’ll use for up to eight weeks before your peel to prepare your skin and promote healing.

Before applying the chemical peel solution, the doctor may pre-treat your skin with retinoic acid. This is a topical prescription medication derived from vitamin A. It thins the surface of your skin so the chemical solution can work evenly and deeply.

Your doctor gives you a relaxing sedative and a local anesthetic to numb your face.

The doctor carefully brushes the phenol solution onto the area to be treated. Your surgeon will discuss a predetermined length of time the solution stays on to achieve the desired treatment goals. Times can be 30 minutes to an hour or longer.

The chemical is neutralized with water.

The doctor applies a thick layer of ointment or medicated gauze across your skin. This helps prevent dryness and discomfort.

Recovery and results of a chemical peel

After a chemical peel, your recovery process and results will vary depending on the strength of your chemical peel. Your doctor will tell you what to expect and offer individualized guidance before and throughout the healing process. Results are generally as follows:

After a light chemical peel

You can expect some redness, irritation and a stinging sensation, as well as flaking, as your skin begins to exfoliate. These effects typically subside with repeated treatment.

Your doctor will provide specific post-care guidelines, including instructions to use sunscreen and avoid sun exposure.

After a medium chemical peel

In the days after your treatment, your skin may begin to turn red and look like you have a sunburn. The peeling process typically lasts for about a week after this procedure.

Your doctor will give you instructions about what to expect and how to care for your skin. It’s important to protect your skin, avoid the sun, use sunblock and keep skin well-moisturized during this time.

After a deep chemical peel

You can expect some redness and discomfort, and peeling and crusting of your skin. Depending on your treatment and skin condition, this can last for several days or for weeks.

Recovery after a deep peel can take about two weeks after treatment before you’re ready to return to work and routine activities.

Your doctor will prescribe pain medicine so you’re more comfortable while you recover. Swelling should go away in about two weeks. Your skin may remain red for as long as three months.

A deep chemical peel can have dramatic, long-lasting results. Skin looks smoother, brighter and more youthful.

It’s important to protect your skin, avoid the sun, use an effective sunblock and keep skin well moisturized during this time.

Risks of chemical peels

Risks of chemical peels vary with each individual’s health, skin condition and level of treatment. Choosing a board certified plastic surgeon on Ohio State’s experienced team assures you of high-level care and high-quality skin care products to minimize risks. Your doctor will carefully evaluate your health, medical history and skin condition to determine what therapies are safely suited to you and your desired outcome.

When performed by an experienced, board-certified plastic surgeon, complications of chemical peels are rare.

There is a possibility of:

  • Infection
  • Scarring
  • Hypopigmentation (lightening of skin)
  • Hyperpigmentation (too much pigment resulting in brown blotches)

Following pre- and post-treatment instructions carefully, including skin protection, can reduce your risk of complications. Your doctor will discuss potential risks, including any conditions that could raise your risk of complications. Things that can raise your risk of complications include:

  • Certain skin types
  • Hormone medications
  • A family history of developing brown discolored areas on the face
  • A tendency to develop discoloration or scar-tissue overgrowth (keloids) as scars heal
  • A history of cold sores (herpes)
  • Pregnancy
  • Allergies to certain ingredients
  • Heart disease and other medical conditions

If you have had cold sores in the past, there is a risk of reactivation. Your doctor can prescribe medication to lower or manage this risk. For safe, effective results, be sure to ask questions, provide up-to-date and accurate health history details, and follow your doctor’s care instructions as directed.

Risks specific to phenol in deep chemical peels

Phenol, used in deep peels, is a strong chemical solution that requires expert guidance. It’s important to carefully follow the doctor’s instructions from preparation to recovery, as well as post-treatment skin protection. Ask your doctor about these and other possible complications of using phenol:

Phenol can lighten your skin, and the skin may lose its ability to tan normally. It’s especially important to protect treated skin from the sun.

Individuals with heart disease should avoid using phenol. Be sure to provide a complete and accurate medical history, and inform your surgeon of any heart conditions. 

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