• acne
• acne scarring
• birthmarks - brown
• birthmarks - port wine stains (red)
• facial volume loss
• fat deposit reduction
• gynaecomastia / man boobs
• hand rejuvenation
• injectable lip enhancement
• keloid / hypertrophic scarring
• laser hair removal
• laser tattoo removal
• leg veins / spider veins
• neck rejuvenation
• non surgical facial shaping
• rosacea and facial capillaries/redness
• skin analysis
• skin pigmentation
• sweating - excessive
• wrinkles

• anaesthesia/analgesia for procedures
• anti-wrinkle injections
• chemical peels
• dermal fillers
• laser - apogee
• laser - gemini
• laser - medlite
• laser - ruby
• lipodissolve
• make-up - dermacolour
• make-up - glo minerals
• microdermabrasion
• photodynamic therapy
• plasma skin regeneration
• retinoids - topical
• sclerotherapy
• skin care - asap
• skin care - cosmedix
• skin care - rationale
• skin needling

Chemical Peels

What are chemical peels?

Chemical peels are a method of resurfacing the skin by inducing a controlled wound to the skin. They remove the top layers skin to help induce collagen remodelling and therefore improve sun-damage, pigmentation, wrinkles, scarring, and the overall appearance of the skin. The strength of the chemical peel will determine its depth. Deeper peels will have a greater of complications and a longer recovery, but also will result in a greater improvement in the skin.

What types of chemical peels are there?

Alpha-hydroxy-acid peels ñ glycolic and lactic acid peels
Beta-hydroxy acid peels/Salicylic acid peels (including Purity peel from Cosmedix)
Retinoic acid peels (including the Benefit peel and Timeless peel from Cosmedix).

Trichloroacetic acid 35-40%*
Phenol 88%*

Baker-Gordon phenol peel*

Chemical Peels Case Study

This is a picture of a patient who has had a 20% TCA chemical peel. The concerns with her skin were melasma (hormonal pigmentation) on her cheeks and forehead, acne, and she just wanted to improve the overall quality and texture of her skin. The post photograph shows a picture of her one week after the peel.

Which chemical peel is right for me?

As a rule, the deeper the peel, the more side effects, complications, and recovery are needed. Another rule of thumb is that the darker the skin type, the more problems that may be encountered post-peel ñ especially pigmentation problems such as post inflammatory hyperpigmentation where the treated skin may become darker than the untreated skin. Therefore, deeper peels in darker skin types must be considered with caution and sometimes it may be better to perform a series of more superficial peels rather than fewer deeper peels.

The degree of skin ageing will also determine which peel to use. For younger patients with less sun-damage, pigmentation and wrinkles, only superficial peels may be required. The opposite is also true.

How can I prepare myself for a chemical peel?

Skin priming can be achieved by commencement of a retinoic acid such as Refine 4% from Cosmedix or Retin-A/Stieve-A (available by prescription only) as well as a lightening agent such as hydroquinone, kojic acid or arbutin (as found in Lightening from Cosmedix). This needs to be commenced at least 2 weeks prior to peeling to help with uniform penetration of the peel, accelerated healing, and to reduce post-peel complications such as post-inflammatory hyperpigmentation. Use of alpha-hydroxy acid cleansers/exfoliants in the weeks prior to chemical peeling can also help the peeling agent (especially in eveness of penetration), but do not reduce the risk of post-inflammatory hyperpigmentation.

How are chemical peels performed?

In our opinion, chemical peels are best performed by an experienced doctor or nurse. The skin is thoroughly cleansed with an appropriate cleanser first. Vaseline is sometimes used to protect the peel from entering the eye. A fan may be present to help cool the skin for comfort during the peel. Your eyes should be closed during the procedure.

The chemical peel solution is then applied to the face. The procedure is timed, and you will be asked about your comfort level. Neutralisation of the peel (generally with sodium bicarbonate) is performed at the end of the peel, or if there is an untoward skin reaction, or if the pain is excessive.

The peel is completed usually by placing sunscreen and a soothing balm on the face.

Are there any medical problems that your doctor should be aware of prior to having a chemical peel?

Patients with a history of, or a current infection of herpes simplex virus (cold sores) should ensure that their doctor is aware of this before chemical peeling. If there is an active infection present, you may be asked to wait until it has passed prior to having a chemical peel. Also if you have a history of cold sores, you doctor may place you on anti-viral medication as a prophylaxis to an outbreak during your treatment.

If you have a history of keloid (thick, pigmented scars) you may also be excluded from all but the most superficial of peels.

Patients with HIV/AIDS or immunosuppression should avoid chemical peels because this may impair wound healing and increase the likelihood of infection and scarring.

Also those who have recently had a course of oral isotretinoin or Roaccutane should avoid chemical peels for at least 6 months before undergoing medium or deep chemical peels. Similarly, patients who have had a recent face or browlift should wait at least 6 months.

What are the complications or side effects of chemical peels?

Swelling - usually lasting up to three days, but it is usually only associated with the deeper peels.

Pain - again, this is only really seen with the deeper peels and may last for a few hours only.

Redness - most superficial peels produce a mild amount of redness that persists for a few days only. Medium to deep peels can cause redness that can persist for up to a month.

Itchiness - This is only common after medium and deep chemical peels.

Ocular injury - Care must be taken during the procedure to avoid the peel from entering the eye.

Allergic reactions - uncommon, although peels such as the Jessner peel have a higher rate of allergy. Anti-histamines may be taken before, if an allergy is known, or after.

Folliculitis /acne - this occurs commonly as a result of the emollient creams used during healing. Antibiotics may be required to heal these eruptions.

Bacterial/fungal infection - is uncommon. It can, however, lead to scarring.

Herpes simplex recurrence - is common and needs to be treated with anti-viral medication to prevent spread and scarring.

Hyperpigmentation - dark patches over the peeled areas. This usually occurs over the deeper parts of the peel and is a result of inflammation causing release of melanin/pigmentation from the skin (post-inflammatory hyperpigmentation). This is usually temporary, although it can last for up to 2 years. Treatment usually involves a lightening agent such as hydroquinone.

Hypopigmentation - is a loss of pigmentation and usually occurs in darker skin types after peeling. This can be permanent sometimes.

Telangiectasia - are small red vessels under the skin and can become more prominent with peeling. The vessels are easily treated with lasers such as the Gemini laser.

Milia - this are small white cysts that form about 2 to 3 weeks after the skin has re-epitheliased (grown over). It can be due to blockage of the skin due to emoillent creams used after chemical peeling. They can be removed with a needle or lancet.

Demarcation lines - this is usually a result of medium to deeper peels, and the line of where the peel was used and the untouched skin is noticeable even after the skin has healed.

Scarring - a very uncommon complication of chemical peels. This is usually associated with a history of poor healing or keloid scarring. Scarring is more likely the deeper the peel. A early sign of scarring is persistent redness and itchiness. This needs to be treated with a topical steroid.

How can I minimise the complication rate from chemical peels?

Patient selection is a very important part of reducing the rate of complications. By choosing the right peel for each particular skin type, whilst considering the needs of the patient, complications can be minimised. Darker skinned patients in particular, especially those of European, Asian, Indian, Sri Lankan, or African backgrounds are more prone to pigmentation problems (either a gain or loss of pigmentation) after a medium to deep chemical peel. It is possible to prepare the skin beforehand with hydroquinone and tretinoin which help to reduce the rate of post-inflammatory hyperpigmentation (dark areas) post peel. This is particularly important for the medium/deep peels and in darker skinned patients. This regime can be continued after the peel (2 weeks after) to further reduce pigmentation problems.

Similarly, sun exposure pre and post peel should be avoided or at least minimised. Sun exposure can lead to an increase in pigmentation problems also.

Decreasing the rate of perceived complications may also be as simple as asking the patient what their requirements are. Some will accept deeper peel side effects with longer recovery times, whereas others will not accept much recovery time and side effects. Also, some are not after a dramatic change, but instead are after a ëfreshen upí only, and a deeper peel in this case is not appropriate.

How much do chemical peels cost?

Why should I choose The Victorian Cosmetic Institute as my provider of chemical peels?

Our doctors specialise in skin treatments and will be able to give you the proper advice on the right treatment for you. We have a wide range of chemical peels available which increases the likelihood of finding the best chemical peel for your skin.

The first step is simply contacting us for your initial consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.

Making that first phone call can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.