Chemical skin peels can improve skin texture and reduce the appearance of fine lines and wrinkles. They work by removing the outermost layers of the skin damaged by sun exposure, age, and skin conditions to allow smooth, healthy new skin underneath to grow. Skin peels may be superficial (mild), medium or deep.
The ideal candidate for chemical peels is someone who:
- Is in good physical health
- Is psychologically stable
- Understands the procedure
- Does not smoke
- Wants to look younger and more refreshed
- Is unhappy with the appearance of wrinkles or brown spots, especially around the mouth or eyes
- Is free of active skin infections, including most kinds of acne
- Is informed about the appropriate skin tone for the type of peel used
- Is not taking Accutane or has not taken it for the previous 18 months.
- Is free from large or unusual scar formations, such as keloids
- Is realistic in his/her expectations
- Is willing to accept the limitations involved in the healing process
Peel Side Effects and Risks
Significant complications with chemical peels are infrequent, but potential complications include:
- Scarring
- Infection
- Temporary or permanent changes in skin tone or uneven tone
- Hyperpigmentation (a darkening of the skin, treatable in most cases with current bleaching techniques)
- Hypopigmentation (a lightening of the skin, more difficult to treat)
- Cold sore breakouts in patients who have a history of recurring blisters and cold sores, like herpes and shingles (an anti-viral medication before the procedure can help prevent this)
- Risks for patients with a family history of heart disease
A chemical peel (except for a superficial peel) may not be done if a patient has:
- Recently used isotretinoin (a drug used to treat acne)
- Had recent facial surgery or facial radiation therapy. This can make regrowth of the skin more difficult
- An active herpes infection affecting the area to be treated
- An impaired immune system. This can delay healing and increase the risk of infection and skin color changes after the peel
- Known allergies to certain medicines
Patients can help minimize certain risks by following the advice and instructions of their doctor, both before and after the chemical peel. Pre-existing conditions may also put a patient at risk. Patients who have a history of heart disease or herpes, have a tendency to form large or unusual scars or have undergone considerable amounts of radiation or facial x-rays should consult their doctor before having a chemical peel.
Managing Expectations
Some types of skin problems respond better to chemical peeling than others. People with lighter skin who limit their sun exposure after the procedure tend to have better results than those with darker skin and those who continue to spend lots of time in the sun. Changes in the color and texture of the skin caused by aging and sun exposure may continue to develop after a chemical peel. Chemical peels are not a permanent solution for these problems.
Chemical peels are designed to wound and remove the upper layers of the skin. Patients will need to prepare themselves for how their skin will look immediately after the peel and throughout the healing process. Patients will also need to be prepared to use cosmetics to blend skin tones between treated and untreated areas, such as between the face and jaw line.
During the early healing period after a chemical peel (before the skin has finished peeling), patients will need to avoid sun exposure. After the early healing period has passed, patients will need to wear sunscreen every day and limit sun exposure as much as possible. New skin is more susceptible to damage and discoloration from sunlight.
Even with realistic expectations, patients may not see results for several weeks or months after a chemical peel.