Chemical Peel – A Quick Introduction

Chemical peeling has been around for decades but it is still considered one of the most popular aesthetic treatments right now.  It is a very versatile treatment that can address different skin concerns with minimal risk and downtime.  The main aim of a chemical peel treatment is to selectively remove the upper layer of damaged skin and allow for subsequent skin healing and rejuvenation to take place.

We use different chemical agents with varying concentrations to allow us to target different skin concerns. They can be broadly classified by the depth of action into superficial, medium and deep peels.  We shall discuss some of the more common chemical peels below.

 

Superficial peels

 

1. Alpha Hydroxy Acid (AHA) peel

 

Glycolic acid is one of the most popular chemical peel and is commonly used to treat superficial pigmentations and photoaging. It promotes exfoliation and collagen synthesis, leading to healthier and thicker skin. It also helps with dispersion of melanin  and is used to treat pigmentary disorders. It has to be neutralised with a neutralising agent to bring the treatment to an end.

 

Mandelic acid is another AHA that is commonly used to treat acne. In addition to exfoliation, it also has anti-bacteria and anti-inflammatory properties. It can be used in combination with salicylic acid to treat mild to moderate acne or as a single agent for those who cannot tolerate salicylic acid peel due to side effects.

 

 

2. Beta Hydroxy Acid (BHA) peel

 

Salicylic acid is highly lipophilic which makes it an excellent agent in treating conditions with excess sebum production such as acne. It can penetrate comedones and pores to reduce clogging and also target skin bacteria. It also has anti-inflammatory properties.

 

Medium peels

 

1. Trichloroacetic Acid (TCA) peel

 

TCA peel is used to treat more stubborn pigmentory disorders and acne scarring. It helps to remove dead skin cells and promote new skin cell growth. As a medium depth peel, the downtime after treatment is longer and it has to be performed with greater caution to reduce complication risks. It is self-neutralising and skin re-epithelialisation will occur over the next 1 to 2 weeks. TCA peel can be combined with other skin resurfacing treatments (Fractional Laser/ Fractional Radiofrequency) to treat acne scarring as well.

 

Post treatment care

Superficial peels can result in mild redness and erythema depending on the concentration of chemical used. Peeling is usually mild and the redness will subside within 1 to 2 days. Medium peels will result in more visible redness and peeling . These will usually subside within 7 to 10 days. It is vital to use sunblock and moisturiser diligently after chemical peel treatment to reduce the risk of post-inflammatory hyperpigmentation (PIH).

 

Reference:

 

1. Castillo DE, Keri JE. Chemical peels in the treatment of acne: patient selection and perspectives. Clin Cosmet Investig Dermatol. 2018;11:365-372.
2. Soleymani T, Lanoue J, Rahman Z. A Practical Approach to Chemical Peels: A Review of Fundamentals and Step-by-step Algorithmic Protocol for Treatment. J Clin Aesthet Dermatol. 2018;11(8):21-28.
3. Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B. Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing. J Clin Aesthet Dermatol. 2010;3(7):32-43.
4. Sharad J. Glycolic acid peel therapy – a current review. Clin Cosmet Investig Dermatol. 2013;6:281-288.

 

Written by Dr. Wu Jiwei,

MBBS, PG Dip (Clinical Derm) (UK)