Chemical Peels (Deep Peels)

Immediately after treatment:

  • The application of a deep peel will color the skin ivory-white to gray-white. Redness (erythema) may be visible underneath the white.
  • Immediately after the chemical peel treatment, the doctor will cover the skin with a waterproof zinc oxide non-permeable tape, to be removed after 24 hours.
  • At the end of treatment with a deep peel, the skin appears white or gray-white (top row). Immediately after treatment, the face is covered with waterproof zinc oxide nonpermeable tape (bottom).3

Days and weeks after treatment:

  • Once the tape mask is removed 24 hours after treatment, the skin will be cleaned with sterile solution. It will then be covered with an antiseptic powder or antibiotic ointment for the next 7 days to prevent infection.
  • Once antiseptic powder or antibiotic ointment is no longer being applied every day, skin redness (erythema) should begin to gradually decrease over the course of several weeks. During this time, patients are allowed to use make-up to cover up the redness, which will make it easier to resume daily activities.
  • Patients should avoid direct sun exposure and apply sunscreen for 4 weeks after treatment.

Longer term:

  • A treatment with a deep peel can cause long-term skin redness (erythema). For most patients, the redness gradually decreases over the course of 2 months. However, some patients experience persistent redness for 3 months or more after treatment with a deep peel.
  • Darkened skin (hyperpigmentation) may also continue to be present for months after treatment.
References
  1. Levy LL, and Zeichner JA. Management of acne scarring, part II. A comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 13(5), 331-340 (2012).
  2. Uptodate.com. Management of acne scars. Available from: https://eresources.library.mssm.edu:3285/contents/management-of-acne-scars?source=search_result&search=management%20of%20acne%20scars&selectedTitle=1~27#H1673698. Last retrieved on 6 September, 2017.
  3. Landau M. Chemical peels. Clin Dermatol. 26(2), 200-8 (2008).
  4. Garg VK, Sinha S, and Sarkar R. Glycolic acid peels versus salicylic-mandelic acid peels in active acne vulgaris and post-acne scarring and hyperpigmentation: a comparative study. Dermatol Surg. 35(1), 59-65 (2009).
  5. Puri N. Efficacy of Modified Jessner’s Peel and 20% TCA Versus 20% TCA Peel Alone for the Treatment of Acne Scars. J Cutan Aesthet Surg. 8(1), 42-5 (2015).
  6. Al-Waiz MM, and Al-Sharqi A. Medium-depth chemical peels in the treatment of acne scars in dark-skinned individuals. Dermatol Surg. 28(5), 383-7 (2002).
  7. Sachdeva S. Lactic acid peeling in superficial acne scarring in Indian skin. J Cosmet Dermatol. 9(3), 246-8 (2010).
  8. Leheta TM, Abdel Hay RM, and El Garem YF. Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid 20% in atrophic post-acne scars; a randomized controlled trial. J Dermatolog Treat. 25(2), 130-6 (2014).
  9. Park JH, Choi YD, Kim SW, Kim YC, and Park SW. Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients. J Dermatol. 34(1), 17-24 (2007)
  10. Kontochristopoulos G, and Platsidaki E. Chemical peels in active acne and acne scars. Clin Dermatol. 35(2), 179-182 (2017).
  11. Brody HJ. Complications of chemical peeling. J Dermatol Surg Oncol. 15(9), 1010-1019 (1989).
  12. Erbağci Z, and Akçali C. Biweekly serial glycolic acid peels vs. long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars. Int J Dermatol. 39(10), 789-94 (2000).
  13. Mackee GM, and Karp FL. The treatment of post-acne scars with phenol. Br J Dermatol. 64(12), 456-9 (1952).