Chemical Peel Overview
Over time, skin damage is caused by aging, sun exposure and many other factors. This damage can appear on the face and body as age spots, wrinkles, discoloration and acne scars. Damaged skin can take on a dull, worn appearance and make a person look older than they feel.
A chemical peel is a non-invasive skin resurfacing procedure that works by using a chemical solution to exfoliate dead skin cells from the outer layer of skin and reveal bright new skin as part of the body's natural healing process. Removing dull, damaged skin from the face and other areas of the body with a chemical peel can dramatically restore a glowing, youthful appearance to your skin and provide a boost to your self-esteem.
Patients with deep wrinkles or sagging skin in addition to skin damage may consider other cosmetic procedures in conjunction with a Chemical Peel. A variety of plastic surgery procedures, including a Facelift, Forehead Lift or Eyelid Surgery, can be used as part of an overall treatment plan to smooth, firm and tighten the skin.
Types of Chemical Peels
Light, medium and deep chemical peels are available for patients with different skin problems and aesthetic goals. Each of these peels provide different levels of treatment and offer unique benefits for the skin. The exact strength of the chemical solution is determined by your doctor based on your specific needs.
Light chemical peels offer a gentle skin treatment using alphahydroxy acids (AHAs) or betahydroxy acids (BHAs). These natural ingredients are derived from fruit and other natural sources. AHAs include glycolic acid (the most common type of AHA used for chemical peels), lactic acid, malic acid, citric acid and tartaric acid. Many home skin care products include glycolic acid or other AHAs. The most common type of BHA used for chemical peels salicylic acid.
Light peels can be used to gently rejuvenate skin on the face, neck, hands, arms, legs and chest. The peel can be performed on the full face or just a problem area of skin. Formulated according to your specific needs, AHA and BHA peels are effective in smoothing out fine lines and wrinkles, improving the texture of rough or dry skin, evening out skin pigmentation and diminishing mild acne scars.
A series of treatments may be needed to achieve best results with a light chemical peel. The number of treatments is usually five to eight, depending on the patient's specific treatment plan. These light peels are performed at intervals of at least a week and patients see improvements after each peel. A light peel for the full face usually takes from 10 to 15 minutes and is performed in your surgeon's office. No anesthesia or sedation is required.
Medium chemical peels use a stronger chemical solution than AHA and BHA peels to penetrate the skin more deeply and produce more dramatic and long-lasting results. The trichloroacetic acid (TCA) used for a medium peel is an effective treatment for moderate skin conditions. The precise strength of the TCA chemical peel solution is specifically formulated according to the needs of each patient. TCA peels can be used on the face as well as other areas of the body and are usually recommended for patients with darker skin.
A series of medium peels are usually needed for optimal results. TCA peels are generally performed at intervals of 1 to 3 months. After each peel, the tone and texture of the skin improves and the skin appears smoother and younger-looking. Medium peels are used to smooth wrinkles and treat skin with moderate sun damage, uneven skin pigmentation (such as age spots), scars (including acne scars) and other imperfections.
A TCA chemical peel for the full face usually takes about 10 to 15 minutes and is performed as an outpatient procedure in your surgeon's office. No anesthesia is required because the chemical solution works as an anesthetic and numbs the skin. Light sedation may be used depending on the preferences of you and your surgeon.
Prior to a medium peel, Retin-A (a medication derived from vitamin A) or an AHA cream may be used to pre-treat the skin. These products may be used for up to a month to thin the outer layer of skin and allow the TCA peel solution to penetrate more deeply and evenly. Retin-A or AHA may be used in conjunction with hydroquinone, a bleaching cream, to improve blotches, age spots and other problems with skin pigmentation.
Deep chemical peels use phenol, or carbolic acid, to penetrate the skin deeper than a light or medium peel. Phenol is the strongest chemical peel solution and is only used on the full face. Improvements to the skin are dramatic and can last for many years. Phenol peels require only one treatment and are used for more serious skin imperfections and conditions, such as facial skin with severe sun damage, deeper wrinkles, significant discoloration, acne scars and pre-cancerous growths.
A deep chemical peel for the full face can take from 1 to 2 hours and is performed in your surgeon's office as an outpatient procedure. As with the TCA chemical solution used in medium peels, anesthesia is not required because the phenol solution acts as a local anesthetic by numbing the skin. Sedation may be used prior to and during the procedure to make you relaxed and comfortable.
Phenol chemical peels are usually not recommended for darker-skinned patients because the peel solution can change skin pigmentation and cause permanent lightening. Deep peels may also permanently remove freckles.
The best candidates for chemical peels are in good health and want to enhance the appearance of their face, neck, arms, legs or other area of the body with smoother, more youthful skin.
Generally, the best candidates for chemical peels:
- Are in good physical and psychological health.
- Are well-informed about treatment options and have realistic expectations.
- Want to improve their appearance by effectively treating wrinkles, age spots, rough skin, pigmentation problems and other skin conditions and imperfections.
- Would benefit psychologically and emotionally from more youthful-looking skin with an improved tone and texture.
Chemical Peel Risks
Complications are rare and usually minor when a chemical peel is performed by a qualified plastic surgeon. In general, deeper chemical peels carry a greater risk of complications and side effects. To minimize your risk, carefully follow all of your surgeon's instructions both before and after the procedure. Contact your doctor's office immediately if you experience any symptoms you believe may indicate a complication.
The most common risks associated with chemical peels include:
- Pain or swelling beyond normal levels
- Changes in skin tone
- Risks for patients with a family history of heart disease
People with certain types of skin are at risk of experiencing temporary or permanent color changes in the skin. Changes in pigmentation may cause the skin treated by a chemical peel to be lighter or darker than the surrounding skin.
Chemical Peel Costs
According to the American Society of Plastic Surgeons, the national average surgeon/physician fee for a chemical peel in 2020 was $519. This figure does not include other costs, such as anesthesia, operating room facilities or other related expenses. Your plastic surgeon will provide you with complete information on costs and financing options at your consultation. The total fee for a Chemical Peel can vary considerably depending on the region of the country, the type of chemical peel (light, medium or deep) and the patient's specific needs.
Health insurance will usually not cover the cost of a chemical peel performed for cosmetic purposes. However, a chemical peel may be covered if the procedure is performed to treat pre-cancerous growths or certain types of scars. Check with your insurance company to find out if a chemical peel is covered and to determine the eligibility requirements.
Chemical Peel Consultation
Prior to your chemical peel, you will have a consultation to evaluate the condition of your skin and take a complete medical history. Be sure to tell the surgeon if you have a family history of heart disease, recurring cold sores or fever blisters, unusual scarring tendencies or a history of facial x-ray treatments.
Your practitioner should carefully listen to your goals for your appearance, fully answer all of your questions and explain the different options that are available. He or she may recommend a light, medium or deep chemical peel or an alternative skin resurfacing procedure such as Laser Skin Resurfacing, Dermabrasion or Microdermabrasion. The practitioner should give you the full details of the recommended procedure, including the benefits, risks, costs and recovery time.
As the consultation concludes, you may wish to schedule your procedure, take some time to think or seek a second opinion. If you decide to proceed with the procedure, you will be provided with specific instructions on how to prepare for your chemical peel or series of peels.
How a Chemical Peel is Performed
Your surgeon will begin the procedure by thoroughly cleansing the skin on the face or other body area where the peel will be performed. He or she will then apply the light, medium or deep chemical peel solution. The exact strength of the solution is formulated according to the specific needs of each patient. Many patients experience a tingling sensation as the solution is applied.
The chemical peel solution remains on the skin for a certain amount of time and is then washed off with water. After a medium peel, a thin layer of ointment is applied to the face. After a deep peel, a thick coating of petroleum jelly or waterproof dressing may be used to cover the face for a couple of days. No ointment or covering is usually required after a light chemical peel.
Chemical Peel Recovery
The recovery time after a chemical peel varies greatly depending on the type of peel. Deeper peels penetrate the skin more deeply and offer more impressive results, but have a longer recovery time.
After any chemical peel, the newly regenerated skin must be protected from the sun. Sun protection is especially important after a phenol (deep) peel because the skin will not produce pigment and will be unable to tan. Patients should always take proper precautions against sun exposure, including daily use of sunblock that provides an adequate amount of UVA and UVB protection.
Light Chemical Peel Recovery
After a light (AHA or BHA) peel, there is virtually no recovery time and very little discomfort. Patients may experience some temporary crusting, dryness, flaking and redness.
Most people can return to work and resume normal activities immediately after a light chemical peel. When a series of peels is performed, improvements in skin tone and texture are seen after each treatment.
Medium Chemical Peel Recovery
After a medium (TCA) peel, a crust or scab forms on the treated area of skin. This crust will flake off in 3 to 7 days to expose a new layer of skin. Patients may experience temporary redness and mild swelling. Complete healing usually takes about 2 weeks. Any discomfort usually subsides quickly and can be controlled by prescription medication.
Most patients can go back to work and return to their normal activities in 7 to 10 days after a TCA chemical peel. Improvements in the tone and texture of the skin are seen after each peel if a series of treatments is performed.
Deep Chemical Peel Recovery
Recovery from a deep (phenol) peel is usually significantly more difficult than recovery from a light or medium peel. The crust or scab that forms on the treated skin will flake off in 7 to 10 days. It may take 2 to 3 months for skin redness to fade and complete healing to take place.
Immediately after the procedure, patients may experience moderate discomfort and pronounced swelling. Pain can be controlled with medication prescribed by your doctor. If the peel was performed on the face, the eyes may be temporarily swollen shut.
The layer of petroleum jelly or waterproof dressing applied to the treated skin is removed after a day or two. During the first few days of recovery, you may be asked to stick to a liquid diet and avoid talking as much as possible. Most patients can return to work and resume everyday activities after about 2 weeks. Thereafter, makeup can be applied to improve the appearance of the treated area until the skin fully heals.