Last updated February 2022
What are chemical peels?
Chemical peels are a method of regenerating and resurfacing the skin by inducing a controlled wound to the skin. They remove the top layer’s skin to help induce collagen remodelling and therefore improve sun-damaged skin, skin pigmentation problems, wrinkles, skin texture, and the overall appearance of the skin. The strength of the chemical peel will determine its depth. A deep peel will have a greater number of possible complications and a longer recovery, but also will result in a greater improvement in the skin.
What are the benefits of a chemical peel?
There are many benefits to receiving a chemical peel. Aside from revealing a brighter and smoother complexion, they also improve the appearance and texture of the skin. Some other benefits of a chemical peel include:
- Improving uneven skin tone and texture
- Stimulating the production of new collagen and skin cell growth
- Reducing discolouration caused by sun damage
- Helping clear up breakouts
- Smoothing wrinkles and fine lines
- Increasing hydration of the skin
- Addressing visible signs of imperfections and superficial scars
- Allowing skincare products to penetrate deeper into the skin
What types of chemical peels are there?
There are several types of chemical peels each suited to different skin problems and types. Chemical peels are classified as a superficial, medium or deep chemical peel, according to the level of skin they reach. Below is an example of some of the peels available at Victorian Cosmetic Institute.
Alpha-hydroxy acid (AHA) peels
Lactic acid peels are best for exfoliation and hydration. Lactic acid is a naturally occurring acid in the body. These peels can be performed at various concentrations to vary the strength of the peel. Its main role is to remove the top layers of the skin and induce new collagen formation. Because lactic acid is a natural human metabolite, there is less chance of an allergic reaction with this type of peel. Alpha-hydroxy acid peels work by removing the top layer of skin cells. These cells often hold surface pigmentation, are responsible for uneven skin tone and contribute to fine lines. Each time a patient has a lactic peel these cells are exfoliated away and the skin is forced to generate new cells. A series of these peels increase the efficiency of cell regeneration and remove rough surface cells.
Beta-hydroxy acid (BHA) peels
Salicylic acid is the main ingredient found in these peels. These peels are generally used to treat acne prone, oily or blemished skin as they are oil soluble and penetrate deeper in this type of skin environment. Beta-hydroxy acids are generally larger molecules than alpha-hydroxy acids and therefore may not penetrate as deeply in a normal (non-oily) skin environment. For active acne, there may be some post peel purging. As the acid exfoliates away the surface of your skin, it brings clogged pores you have underneath, closer to the top, which may erupt as more active pimples. Salicylic acid works by penetrating the follicles removing trapped oils, dead cells and reducing inflammation within the skin. Read here for more information on which skin care products are suitable for oily skin.
Retinoic acid peels
Our cell turnover in our skin slows as we age. Retinoic acid helps to increase the turnover rate of the skin and make it behave more like ‘younger skin’. They can also help to reduce DNA mutations caused by UV exposure on the skin. It stimulates collagen production, inhibiting the growth of harmful bacteria, restoring the immune system, improving circulation, and sealing in moisture deep within the skin. Due to its many benefits, Retinoic acid peels are used for resurfacing, to treat sun damage, acne, wrinkles and skin texture. For more information on the benefits of Vitamin A for the skin.
This peel is a little different to the others in the fact that the peel is left in situ on the skin for the next 6 – 10 hours. The peel will have a mild yellow tinge on the skin, which is hardly noticeable on many skins. The peel feels slightly tingly and a little itchy but very comfortable. The patient will rinse the peel from the skin with warm water themselves at home. A delay of 2 – 3 days will occur before the skin starts to peel. The peeling usually lasts for 4 – 5 days.
Modified Jessner’s peel
The Modified Jessner’s peel is a combination of Salicylic acid, Resorcinol, Lactic acid and Kojic acid. Resorcinol is a derivative of phenol (a very deep peeling agent) and is good for resurfacing the skin. The depth of the peel, which in most cases is superficial, is determined by the number of layers placed on the skin. The skin turns a frosty white colour after treatment for a short time. Kojic acid is a lightener/brightener used to reduce pigmentation in the skin. This peel stimulates the deeper dermis level of the skin and causes new fibroblasts and collagen to develop, puffing out lines and wrinkles caused by ageing. It is also used to treat sun-damaged skin, hyperpigmentation (melasma) and contributes to the healing of acne. Read our article for more information on how to treat pigmentation with skin care.
Trichloroacetic acid (TCA) peel 10-20%
Commonly referred to as TCA peels, these peels have been performed for many years. A TCA peel exfoliates the skin at a dermal level, improving skin texture, wrinkles and pigmentation. It is also suitable for treating enlarged pores and acne scars. Due to the nature of the treatment, clients may require 7-10 days of downtime. Most clients only require 1 treatment, however for more problematic skin, it is recommended to do 2-4 peels over 12 months. As the formation of new collagen requires time, the results will continue to improve for 6 to 12 months after the treatments.
Medium depth chemical peels
Trichloroacetic acid (TCA) 35%
Medium chemical peels with 35% Trichloroacetic acid is an effective treatment that targets skin texture, fine lines, wrinkles and pigmentation. A medium depth TCA peel exfoliates superficial wrinkles, and also works well on depressed scars. The procedure stimulates the production of new skin cells and reveals healthier looking skin. TCA peels are a cost effective alternative to laser resurfacing.
Deep chemical peels
Laser skin resurfacing
At the Victorian Cosmetic Institute, deep chemical peels have been replaced with laser skin resurfacing which can achieve better results with more control over the depth of treatment and can cause more collagen remodelling.
Which chemical peel is right for me?
Chemical peels induce a controlled wound to the skin, and can replace part or all of the top layers of skin. The key determinants to which chemical peel is right for you are:
- Degree of the skin problem
- Sun damage
- Skin type/colour
- Amount of improvement you would like to achieve
- Amount of recovery or downtime that is acceptable by you
Darker skin types
As a rule, the deeper the peel, the more side effects, potential 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, especially problems such as post-inflammatory hyperpigmentation where the treated skin may become darker than the untreated skin. Therefore, deeper peels in darker skin tones must be considered with caution and sometimes it may be better to perform a series of more superficial chemical peels rather than one deep peel.
Skin ageing concerns
The degree of skin ageing will also determine which peel to use. For younger patients with less sun-damage, pigmentation and wrinkles, a superficial peel may be required. The opposite is also true.
Acne skin types
Different skin problems also respond to particular peels. Acne, for example, responds well to Jessner’s peel and salicylic (beta-hydroxy acid) peels. BHA peels and Jessner’s peels are very oil soluble and are able to penetrate deeper into pores and remove oil and sebum and are anti-inflammatory. Both alpha-hydroxy acid and beta-hydroxy acid peels help exfoliate the skin.
Pigmentation and sun damage concerns
TCA peels, alpha-hydroxy acid peels, and Jessner’s peels are suited to pigmentation problems and severe sun damage.
Wrinkles and fine lines
Wrinkles can be best treated with TCA peels, or any medium to deep chemical peel. These peels can be a cost effective alternative to laser resurfacing. A course of Retinoic peels to complement other skin treatments is also a common treatment plan.
For the body
Parts of the body other than the face can be peeled also. For example, you can have chemical peels on the chest and back for acne, or on the neck and décolletage to help reduce sun damage.
How to prepare for a chemical peel
It is recommended to use medical grade skincare at least 3-4 weeks before your first chemical peel, to prepare your skin, discourage the production of post-peel hyperpigmentation and accelerate healing.
Skin priming can be achieved by commencement of a skin care products containing retinoic acid such as Cosmedix Refine or Retin-A/Stieve-A (available by prescription only), as well as a topical lightening agents such as hydroquinone, kojic acid or arbutin.
Use of alpha-hydroxy acid cleansers/exfoliants in the weeks prior to chemical peeling can also help the peeling agent (especially in evenness of penetration), but do not reduce the risk of post-peel inflammatory hyperpigmentation. Your Skin Therapist will advise which products are best to prepare your skin prior to treatment.
What to expect during a chemical peel
In our opinion, chemical peels are best performed by an experienced Skin Therapist. The skin is thoroughly cleansed with an appropriate cleanser first. A masking agent 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. Depending on the peel that is used, neutralisation of the peel may occur at the end of the treatment. This ensures the chemical peel does not stay active on the skin for longer than necessary.
The chemical peel is completed usually by placing sunscreen and a soothing balm on the face.
What will my skin look like after the treatment?
After the chemical peel, your skin will look glowing and refined, making lower strength peels an ideal treatment for the day before an event. After day 3, you may experience some flaking or skin peeling, which is normal after a chemical peel. This can be gently exfoliated with an enzyme cleanser like the Osmosis MD Purify to remove dead skin cells.
How to care for my skin after a chemical peel
After a chemical peel, there are a few ways you can care for your skin, to give you the best results from your treatment.
Don’t touch your face
As your dead skin may shed and flake after your treatment, try to avoid peeling this off with your fingers, as it can lead to possible scarring. Let the dead skin shed naturally.
Pull your hair back
Keeping your hair out of your face can limit touching and breakouts. It’s important to allow the skin to heal naturally, without accidentally touching your skin when brushing your hair back. Touching the skin with dirty hands and fingers can affect the development of new skin and may also lead to breakouts. If breakouts do occur, see a skin specialist to treat them for you, alternatively, do not touch the breakouts.
Cleanse with cool water
Using hot water after your treatment can cause inflammation. Use cool water to cleanse your face and gently pat your skin dry afterwards – avoiding rubbing the face.
Moisturise your skin and limit sun exposure
After a chemical peel, your skin will be sensitive. There may be some products in your skincare routine that you will want to avoid, as they have active ingredients that may irritate the skin during its healing process. Two products that you will want to use during the healing process are sunscreen and a basic moisturiser.
It is recommended to limit sun exposure post-treatment and practice sun safety when outdoors. This includes wearing a hat, wearing protective clothing and using sunscreen. We recommend the Dermaceutic K Ceutic SPF50, to hydrate and repair the skin post-treatment.
We also recommend the Aspect Dr Soothing Balm, to soothe and hydrate the skin. When applying your moisturiser, be careful not to rub it in, instead gently apply a thin layer all over your face when needed, throughout the day. Once the peeling process is complete and your skin no longer feels sensitive, you can go back to your usual skincare routine.
Your Skin Therapist will advise you of which products you should use and avoid post treatment.
Let the skin peel
Do not forcibly remove the dead skin, refrain from rubbing, pulling or peeling the skin during the healing process. As the skin is very sensitive in the healing process, it is best to stop exfoliation, until the skin is healed.
Facial scrubs, skin resurfacing acids, retinol and cleansing brushes should not be used, until the skin has stopped shedding – this may take up to a week or more post-treatment.
Who is a suitable candidate for a chemical peel?
A consultation with a Skin Therapist can determine if you are a suitable candidate for a chemical peel. The Skin Therapist will assess your skin and whether you have any pigmentation issues and ask if you have any allergies to the chemicals used. The Skin Therapist will also check if you have any untreated skin infections, enquire about your goals and optimal outcome.
Based on the consultation, the Skin Therapist will determine whether a chemical peel or a combination of treatments are best suited for your aesthetic goals, and create a customised treatment plan.
Who is not a suitable candidate for a chemical peel?
Patients with a history of, or a current infection of herpes simplex virus (cold sores) should ensure that their Skin Therapist 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, your Skin Therapist may request for you to see a doctor to be put on antiviral 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 brow lift should wait at least 6 months.
What are the risks associated with chemical peels?
As a rule, the deeper the peel, the higher the rate of complications and the longer the recovery. Most superficial peels are safe and effective, where medium and deep peels require more experience from the operator and more careful pre-peel preparation and post-peel care. For medium peels like the 20% TCA peel, the downtime can vary from a few hours to a week.
The risks associated with chemical peels include:
- Swelling – Usually lasting up to three days, but it is usually only associated with the deeper peels.
- Pain – This is only 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 – An uncommon reaction, although peels such as the Jessner peel have a higher rate of allergy. Antihistamines 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 – Though uncommon, it can, however, lead to scarring. This is usually only associated with medium to deep peels.
- Herpes simplex recurrence – This is a common reaction and needs to be treated with antiviral medication to prevent spread and scarring.
- Hyperpigmentation – Dark patches may form over the deeper parts of the peel and is a result of inflammation causing release of melanin/pigmentation from the skin. This is usually temporary, although it can last for up to 2 years. Treatment usually involves a lightening agent such as hydroquinone.
- Hypopigmentation – A loss of pigmentation can occur in darker skin types after peeling. This can be permanent sometimes.
- Telangiectasia – Small red vessels under the skin can form and become more prominent with peeling. The vessels are easily treated with lasers such as the Gemini laser.
- Milia – Small white cysts that form about 2 to 3 weeks after the skin has re-epitheliased (grown over) can manifest. It can be due to blockage of the skin due to emollient 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 that is usually associated with a history of poor healing or keloid scarring. Scarring is more likely the deeper the peel. An 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, 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.
Chemical Peels Case Studies
This patient presented to the Victorian Cosmetic Institute with a long standing history of acne. After a course of Chemical Peels and the Synergie Blemish Control at home skin care kit he has been able to stop his breakouts and can now begin repairing his acne scars.
4 BHA chemical peels were performed spaced 4 weeks apart.
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 scarring, 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.
What do each of the different depths of chemical peel achieve?
Superficial peels remove the upper layers of the skin and can help smooth and revitalise the skin.
Medium-depth peels are ideal for those with sun damaged skin or premature signs of ageing. They can also improve superficial wrinkles, remove wrinkles, uneven pigmentation, sunspots and brown spots.
Deep peels can also help with sun damaged skin and wrinkles, but have been replaced with laser skin resurfacing, which offers similar results but with better safety and control.
How many sessions do I need?
This will depend on your aesthetic goals, treatment and your treatment plan. If you have concerns of acne or sun damaged skin, multiple sessions may be required.
Is downtime required for a chemical peel?
This will depend on the type of chemical peel, as each differs in strength and will have different downtimes. Everyone’s skin will respond differently to the chemical peels. Generally, your skin starts to flake and peel a few days after the treatment, but it can take up to 7 days before the new skin develops. Within 7 to 14 days, the skin should be fully healed.
Is a chemical peel painful?
Generally, a chemical peel is not painful, but you may experience a slight tingling sensation, a change in temperature or skin tightness. You may also experience slight sensitivity post-treatment.
How much does a chemical peel cost?
This will depend on the type of chemical peel.
To see the current pricing for a chemical peel, click here.
Is it safe to get a chemical peel during pregnancy?
There are a limited number of peels that are safe to have during pregnancy. Although your peel options are limited, we do have a number of facial options available.
Why should I choose the Victorian Cosmetic Institute as my provider of chemical peels?
At Victorian Cosmetic Institute, our team of Skin Therapists have many years of success in treating various skin types and skin concerns using chemical peels.
If you are requiring deeper treatment using the TCA chemical peel or skin lasers you will require a consultation with one of our Cosmetic Doctors or Cosmetic Nurses. Our Cosmetic Doctors and Cosmetic Nurses are highly skilled in skin treatments and will be able to give you the proper advice on the right treatment for you.
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 to book their consultation online. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate prior to booking your consultation appointment. You can book online here or phone our Customer Care team directly on 1300 863 824.