Chemical Peels

Chemical peels are typically done in a medical setting under the supervision of a dermatologist, or in a skincare clinic by a licensed esthetician. In many states, including California, estheticians are only allowed to perform light AHA / BHA chemical peels. 

• Available in these doses:
  
  
  • Salicylic acid: 5-30% 
  • Glycolic acid: 20-70%
  • Trichloracetic acid (TCA): 15-50% 
  • Citric acid: 10-50%
  • Salicylic acid (20%) / Mandelic acid (10%) 
  • Salicylic acid (20%) / Azelaic acid (20%) 
  • Jessner’s solution: combination of 14% salicylic acid, 14% lactic acid, and 15% resorcinol 
    
    Also sometimes used alone or in combination with other acids: Lactic acid, polyhydroxy acid, amino fruit acid, pyruvic acid

Dosing information:

Chemical peels are often performed in a series of 4 to 10 sessions, one session every other week.

• Who is it for?
  
  
  • Gender:
    • Males and females
  • Severity of acne:
    • Mild-to-moderate
  • Age:
    • Children of 12 years and older, adolescents, and adults

How to use it: 

Chemical peels are usually performed at a doctor’s office by a doctor or trained nurse, or at a skincare salon by a licensed esthetician.

First, your skin will be cleansed carefully. After, the peel will be applied over the area to be treated and left on the skin for 3 to 5 minutes or so before it will be washed off. 

Chemical peels can be done at different depths–light, medium, or deep, but, usually, only light and medium peels are done for acne. 

Light chemical peel: After the procedure, the treated area will be red, dry, and irritated. These signs are particularly noticeable after the first procedure but usually less so after the ensuing ones. Some people develop scaling after redness goes away. 

It takes 1 to 7 days for the skin to regenerate after a light chemical peel. New skin may be lighter or darker than normal, but that is only temporary.

Use a cream or lotion to take care of your skin until it heals, then switch to sunscreen with an SPF of at least 15.

Typically, you can start wearing makeup right after the procedure but sometimes not until the next day.

Medium chemical peel: The treated area will be red, irritated, and swollen. Swelling gets worse for the first two days, after which it gradually dissipates. Blisters can develop and crack. When swelling dissipates, the skin might crust and darken temporarily. Usually, the skin heals in about seven days to two weeks, but redness might linger for a couple more months.

Applying a protective ointment, such as petrolatum, right after the procedure may help soothe your skin. Some simple use-at-home remedies to relieve discomfort also include applying ice or exposing the treated skin to the cool breeze from a fan. Moisturize your skin daily. Get an over-the-counter painkiller, such as ibuprofen or naproxen sodium if you feel you need it. 

Avoid the sun completely until the skin heals. Use a sunscreen with an SPF of at least 15 for as long as your doctor recommends.

Do not apply makeup for at least 5-7 days after the procedure.

Be aware of: 

• Before starting chemical peels, let your physician or pharmacist know if you are allergic to any of the acids or other ingredients in the chemical peel. 
• Before starting chemical peels, inform your physician about any prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products you are using/taking or have used/taken. Mention them even if it seems irrelevant to you and even if you haven’t taken these for a while.
• Before starting chemical peels, tell your physician if you have ever developed scars or cold sores. 
• If you consider chemical peels and are pregnant or are planning to become pregnant, talk to your physician about chemical peels during pregnancy.
• If you consider chemical peels and are breastfeeding, talk to your physician about chemical peels during this period.
• You can continue your regular diet unless your physician advises otherwise.
• Chemical peels are considered a cosmetic treatment and, usually, are not covered by insurance. 

Drug interactions: 

Do not use alcohol-containing or abrasive skin care products, or peel-off products (including facial masks) simultaneously with chemical peels. Inform your physician or pharmacist about all the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before your first chemical peeling procedure. Tell your doctor if you have taken isotretinoin, oral antibiotics, oral contraceptives, steroids, or NSAIDs within the last several months. Also, inform your physician or pharmacist of the skin products you use including soaps, cleansers, moisturizers, and cosmetics.

What if I overdose?

In case of overdose, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or cannot be awakened, call 911 at once.

Information can also be found online at https://www.poisonhelp.org/help

Symptoms of overdose may include:

• Nausea
• Vomiting

Storage:

Store your medication in the provided container and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze salicylic acid.

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)