Chemical peels are a technique used to improve the appearance of the skin on the face, neck, chest, and hands. This technique involves the application of exfoliants to the top layer of skin, which then ‘peels off’ and regenerates, also known as resurfacing. The indications for use of chemical peels is wide, ranging from cosmetic to therapeutic. Patients may receive chemical peels for signs of aging, melasma and hyperpigmentation, or acne vulgaris, among others. The benefits of chemical peels include improved skin elasticity, improved skin texture and skin tone. Chemical peels may be classified based on their strength, concentration, pH, and depth of penetration into the skin. The depth of penetration may range from superficial to deep.
The most common ingredient that is used in chemical peel solutions are a combination of hydroxy acids, which are classified as exfoliants. The choice of hydroxy acid depends on the benefits that the patient would like to see from their treatment. Alpha hydroxy acids (AHA) are chemicals used in superficial and medium- depth peels and are used to treat acne, skin discoloration, uneven texture, and wrinkles. AHAs include glycolic acid and lactic acid. AHAs are highly effective and popular agents that are widely used, but can cause redness, burning, sunburn and UV- related malignancies, or scarring if proper application and aftercare is not followed. More severe adverse events can include anaphylaxis, corneal damage, and cardiotoxicity. Beta hydroxy acids (BHA) are effective in reducing the appearance of fine lines and wrinkles and improving skin texture. Salicylic acid is most seen in professional and commercially available formulas. Salicylic acid is a strong chemical exfoliant that is primarily used for acne vulgaris but is suitable for use in targeting photoaging and pigmentation as well. BHAs carry less adverse effects, such as redness and swelling, and may be a more suitable option for patients that suffer from intolerable or more severe reactions from chemical peels using AHAs.
Professional chemical peels are done in a dermatologist’s office by a trained individual with proper equipment. There are also multiple formulations available on the commercial market that are suitable for patients to use at home because they are weaker in concentration, and thus not as strong. AHAs and BHAs must be used with proper handling and caution in order to prevent any serious side effects, such as avoiding the eye areas, appropriate pre-treatment and after-care steps.
Chemical Peels
Written By: Claudia Kwasiborski
Chemical peels are a technique used to improve the appearance of the skin on the face, neck, chest, and hands. This technique involves the application of exfoliants to the top layer of skin, which then ‘peels off’ and regenerates, also known as resurfacing. The indications for use of chemical peels is wide, ranging from cosmetic to therapeutic. Patients may receive chemical peels for signs of aging, melasma and hyperpigmentation, or acne vulgaris, among others. The benefits of chemical peels include improved skin elasticity, improved skin texture and skin tone. Chemical peels may be classified based on their strength, concentration, pH, and depth of penetration into the skin. The depth of penetration may range from superficial to deep.
The most common ingredient that is used in chemical peel solutions are a combination of hydroxy acids, which are classified as exfoliants. The choice of hydroxy acid depends on the benefits that the patient would like to see from their treatment. Alpha hydroxy acids (AHA) are chemicals used in superficial and medium- depth peels and are used to treat acne, skin discoloration, uneven texture, and wrinkles. AHAs include glycolic acid and lactic acid. AHAs are highly effective and popular agents that are widely used, but can cause redness, burning, sunburn and UV- related malignancies, or scarring if proper application and aftercare is not followed. More severe adverse events can include anaphylaxis, corneal damage, and cardiotoxicity. Beta hydroxy acids (BHA) are effective in reducing the appearance of fine lines and wrinkles and improving skin texture. Salicylic acid is most seen in professional and commercially available formulas. Salicylic acid is a strong chemical exfoliant that is primarily used for acne vulgaris but is suitable for use in targeting photoaging and pigmentation as well. BHAs carry less adverse effects, such as redness and swelling, and may be a more suitable option for patients that suffer from intolerable or more severe reactions from chemical peels using AHAs.
Professional chemical peels are done in a dermatologist’s office by a trained individual with proper equipment. There are also multiple formulations available on the commercial market that are suitable for patients to use at home because they are weaker in concentration, and thus not as strong. AHAs and BHAs must be used with proper handling and caution in order to prevent any serious side effects, such as avoiding the eye areas, appropriate pre-treatment and after-care steps.
Citations:
Center for Food Safety and Applied Nutrition. “Alpha Hydroxy Acids.” U.S. Food and Drug Administration, FDA, 22 Nov. 2022, www.fda.gov/cosmetics/cosmetic-ingredients/alpha-hydroxy-acids.
Center for Food Safety and Applied Nutrition. “Beta Hydroxy Acids.” U.S. Food and Drug Administration, FDA, 25 Feb. 2022, www.fda.gov/cosmetics/cosmetic-ingredients/beta-hydroxy-acids.
Kornhauser A, Coelho SG, Hearing VJ. Applications of hydroxy acids: classification, mechanisms, and photoactivity. Clin Cosmet Investig Dermatol. 2010 Nov 24;3:135-42. doi: 10.2147/CCID.S9042. PMID: 21437068; PMCID: PMC3047947.
Samargandy S, Raggio BS. Chemical Peels for Skin Resurfacing. [Updated 2023 Oct 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547752/
Tang SC, Yang JH. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. 2018 Apr 10;23(4):863. doi: 10.3390/molecules23040863. PMID: 29642579; PMCID: PMC6017965.