Chemical peels for acne
Do they work to clear acne?
What are they?
Chemical peels can be administered by doctors in up to 70% strength, or in up to 30% strength by estheticians in spas and salons. Chemical peels are acids which are applied to the skin about once every two weeks.1-2 These acids chemically exfoliate the top layers of skin. This exfoliation signals the cells inside the skin to produce more rapidly, which can help hasten skin turnover and prevent pores from becoming clogged.1,3 At this time there is no evidence showing whether any one type of peel works better than another. From the data we currently have, they all appear to have similar efficacy.1,3,4-7 Chemical peels are also sometimes used to help lessen the appearance of acne scars.
Types of peels
- Glycolic acid
- Salicylic acid
- Lactic acid
- Polyhydroxy acid
- Amino fruit acid
- Pyruvic acid
- Trichloracetic acid (TCA)
- Jessner's peel
Do they work?
Studies show about 45-50% reduction in acne lesions after a series of 4-6 peels.3-5 Most study participants report a "fair" to "good" result.4,8 Results tend to last for 1-2 months, with acne beginning to reassert itself at this time.
Side effectsSkin peeling in days
following a chemical peel
Most people experience a sun burnt look with obvious peeling of the skin in the days after their first peel. This redness and peeling tends to be less pronounced with each consecutive peel.3-5 Temporary darkening of the skin has been reported, and some people with darker skin have experienced skin lightening which can be permanent.1,3 Because people with darker skin and people who are prone to keloid scarring are more likely to experience side effects from chemical peels, it is vital that people with darker skin consult with an experienced dermatologist before embarking on chemical peels. A 2012 article published in the Journal of Cutaneous and Aesthetic Surgery sums it up: "Usually, complications are minor and more common in dark-skinned individuals. They are seen more in medium and deep depth peels."9
Because chemical peels peel away the protective layers of the skin, your skin will be much more sensitive to sunlight and UV rays.2 It is extremely important to keep your skin out of the sun after a peel and to use an adequate SPF.
$100 - $300 per peel, depending on the type of peel and where it is administered.
Most chemical peels appear to help clear most types of acne. However, the dermatological community's consensus is that other medications and treatments must be used in conjunction with peels to achieve a satisfactory level of clearance.
In my 20+ years of experience working with people with acne, chemical peels can be a fun adjunct to an anti-acne regimen for people who enjoy them, but they are unnecessary, somewhat costly, and present major challenges with preventing sun damage. Most people can achieve complete clearing of their acne with a properly applied benzoyl peroxide regimen and do not require the assistance of a peel. If a peel is desired, over-the-counter alpha hydroxy acids provide the same ingredients at more moderate dosages and with less potential for severe side effects."
- Dreno B, et al. "Expert opinion: Efficacy of superficial chemical peels in active acne management – what can we learn from the literature today? Evidence-based recommendations." Journal of the European Academy of Dermatology and Vereneology. 2011; 25(6): 695-704.
- Kornhauser A, Coelho SG and Hearing VJ. "Applications of hydroxy acids: Classification, mechanisms, and photoactivity." Clinical, Cosmetic and Investigational Dermatology. 2010; 3: 135-142.
- Kempiak SJ and Uebelhoer N. "Superficial chemical peels and microdermabrasion for acne vulgaris." Seminars in Cutaneous Medicine and Surgery. 2008; 27(3): 212-220.
- Kessler E, et al. "Comparison of α- and β-hydroxy acid chemical peels in the treatment of mild to moderately severe facial acne vulgaris." Dermatologic Surgery. 2008; 34(1): 45-50.
- Ilknur T, et al. "Glycolic acid peels versus amino fruit acid peels for acne." Journal of Cosmetic and Laser Therapy. 2010; 12(5): 242-245.
- Raone B, et al. "Salicylic Acid peel incorporating triethyl citrate and ethyl linoleate in the treatment of moderate acne: a new therapeutic approach." Dermatologic Surgery. 2013; 39(8): 1243-51.
- Bae BG, et al. "Salicylic acid peels versus Jessner's solution for acne vulgarism: a comparative study." Dermatologic Surgery. 2013; 39(2): 248-53.
- Peric S, et al. "Side effects assessment in glycolic acid peelings in patients with acne type I." Bosnian Journal of Basic Medical Sciences. 2011; 11(1): 52-57.
- Nikalji N, et al. "Complications of Medium Depth and Deep Chemical Peels." Journal of Cutaneous and Aesthetic Surgery. 2012; 5(4): 254-260.