Chemical Peels

Patients interested in a safe and effective method of revitalizing skin and improving acne, rosacea, photoaging, and/or melasma (or other dyspigmentation) may benefit from a series of facial peels. It must be emphasized that superficial peels most often improve but do not “cure” the above problems. 

Results are variable from patient to patient, but some benefits you may observe:

• Healthier and more youthful-appearing skin (enhanced natural glow)
• More even skin tone (lessening of hyperpigmentation)
• Improvement of oily or acne-prone skin (reduced appearance of blemishes
• A chemical peel for acne scars can result in a smoother appearance with less hyperpigmetnation
• Potentially subtle improvement in fine lines and superficial scars
• Enlarged pores may appear smaller

A chemical peel for acne scars will be most effective in improving the color (lessening hyperpigmentation) of your skin rather than correcting the textural abnormalities, which may be only subtly improved.   Do not expect a chemical peel for acne scars to result in removal of pockmarks (pitted scars).   To maximize results for patients with both pockmarks (pitted scars) and acne hyperpigmentation, we suggest combining chemical peels with Lux 1540 fractional non-ablative laser treatments.   Many patients alternate sessions between the Lux 1540 and chemical peels for acne scars.

Those desiring immediate results may be frustrated with the gradual improvement seen with superficial peels. Pregnant or breast-feeding patients and patients with a history of keloid scarring should avoid peels.  Patients with active cold sores or actively inflamed skin should wait until these resolve before the procedure.   Hair removal or bleaching in the two weeks before your peel is discouraged.   If you have received Accutane (isotretinoin), you should wait at least 6 months before beginning treatment with peels.  If you have an allergy to aspirin, you should avoid the salicylic acid peel, Vitalize Peel, and Jessner’s peel.   Patients who smoke tobacco may experience prolonged post-peel healing times.  

By eliminating the dead outer layer of cells from the skin surface, peels stimulate the production of new, more vibrant skin.

During the procedure there will be a burning/stinging sensation. For one to three days after the peel some patients experience redness, itching, tightness, and minor swelling, and many patients report that the outer layer of skin may exhibit peeling.  Rarely, especially when patients have unprotected sun exposure in the 4 weeks preceding or following a peel, the skin may darken or lighten after treatment.  Scarring, allergic reaction, worsening of acne, or infection after superficial peels are also rare complications.

You should not. Unprotected sun exposure in the 4 weeks preceding peels significantly increases the risk of pigmentary side effects (formation of light or dark spots).  Likewise, unprotected sun exposure during the month after a peel can have the same consequences as well as reversing the beneficial effects of the peel.

This varies from patient to patient, but most often a series of 4-6 peels (spaced 4 weeks apart) will lead to significant improvement. The beneficial effects of peels can be maintained with (1) consistent sun protection, (2) appropriate use of topical products that may be recommended by your doctor, and (3) periodic maintenance peels to keep your skin looking and feeling healthy.

• Stop your topical retinoid medication (e.g. retinol, tretinoin, differin, Retin-A, Renova), exfoliating products (e.g. alpha-hydroxy acids), and benzoyl peroxide 3 days before your peel.
• If you have a cold sore the week before (or the day of) treatment, reschedule your peel.
• If you have unintentionally gotten sunburned or tanned in the 4 weeks prior to your appointment, reschedule your peel for 4 weeks after the episode of sun exposure.
• Contact lenses must be removed for the procedure; we advise bringing a pair of glasses and a contact lens case with solution

• First, your face will be washed and degreased. Next, the peel solution is applied to your skin.   In about one minute, you will experience a stinging sensation.   Depending on your response and discomfort level, another peel layer may be applied.
• After a few minutes, depending on the type of superficial peel, it will either self- neutralize (salicylic acid or Vitalize) or your doctor will neutralize the peel with a spray (glycolic). The Vitalize peel has an additional step where retinoic acid is applied. After neutralization, sunscreen will be applied to protect your skin.

• AM: Gently cleanse your face with hydrating face wash (e.g. CeraVe Hydrating Cleanser) and then apply a moisturizing sunscreen (e.g. EltaMD UV Daily SPF 40).  Do not scrub or use a wash cloth if skin is peeling.
• Avoid direct sunlight for at least one week. Re-apply sunscreen in the middle of the day.
• PM: Gently cleanse your face with hydrating face wash (e.g. CeraVe Hydrating Cleanser) and then apply a moisturizing lotion (e.g. EltaMD PM).  Do not scrub or use a wash cloth if skin is peeling.
• A non-comedogenic moisturizer (e.g. CeraVe Moisturizing Lotion) may be used as often as needed to relieve any dryness and control peeling.
• If your doctor prescribes a topical retinoid (retinol, tretinoin, Renova, Differin) cream, you may start or re-start this medication 4-5 days after the peel (start every other day and increase to daily as tolerated)
• DO NOT PICK, PEEL, SCRAPE, OR SCRATCH FLAKY SKIN. THIS CAN LEAD TO DARK OR LIGHT SPOTS!
• Wait at least one week after treatment to have any facial treatments.

Sometimes there is mild exfoliation (light scaling of outermost layer of skin) one to three days after a peel. Even if this does not occur, the peel is still working as intended to renew and revitalize the skin.   Your face may temporarily appear a bit rosy, and this will normalize over the next seven days.  You may experience slight stinging, burning, tightness, and/or itching.   Frequent moisturization will help to speed up healing process.