Chemical peels

  • Overview

    Chemical peels: Overview

    Also called chemexfoliation, derma peeling

    Do you wish that you could simply peel signs of aging from your skin? Dermatologists use chemical peels to do just this. A chemical peel can diminish many signs of aging on the face as well as the hands, neck, and chest. 

    Chemical peels also treat some skin conditions. Dermatologists use chemical peels to treat some types of acne and conditions that discolor the skin. 

    Whether you receive a chemical peel to diminish signs of aging or treat a skin condition, you can see:

    • Fewer lines and wrinkles.
    • More even skin color.
    • Brighter complexion.
    • Smoother skin. 

     

    Some chemical peels require downtime.              

    Uses: Dermatologists use chemical peels to treat:

    • Acne (some types).
    • Age spots.
    • Discoloration (blotchy complexion, uneven skin tone).
    • Dull complexion.
    • Fine lines (especially under the eyes and around the mouth).
    • Freckles.
    • Melasma.
    • Rough-feeling skin.
    • Sun-damage skin.

     

    Insurance coverage: Chemical peels are considered a cosmetic treatment. Insurance does not cover the cost of cosmetic treatments.

  • FAQs

    Chemical peels: FAQs

    To help you decide whether this treatment is right for you, you should read the following facts. 

    Warning:

    The results you see after getting a chemical peel depend largely on the skill of the person performing the peel. To protect your health and get the results you seek, you should see a dermatologist or dermatologic surgeon. These doctors have in-depth knowledge of the skin.

    What happens during a chemical peel? 

    Before getting a chemical peel, some patients need to follow a pre-peel skin care plan for 2 to 4 weeks. This plan can improve results and reduce potential side effects. Your dermatologist will tell you whether this is necessary.

    On the day of your peel, you will first be prepped for the treatment. This includes cleansing your skin thoroughly. If you will have a deep peel, you will receive general anesthesia, which will put you to sleep. A deep peel must be performed in a surgical setting. 

    After you are prepped, your dermatologist will apply the peel quickly and evenly. Your dermatologist will watch your skin carefully to remove the peel at just the right time. With a deep peel, the skin is treated one small section at a time. This limits the effects on the heart and lungs. 

    After the peel comes off, your skin will be treated as needed. Patients who get a medium peel may need cool compresses followed by a lotion or cream to soothe their skin. If you have a deep peel, you will have a wound that requires a surgical dressing. 

    What must I do after getting a chemical peel?

    All peels that a dermatologist performs require some at-home care. The following table shows you what you can expect.

    What to expect after a chemical peel

    Type of Peel  Healing time At-home care  When to wear makeup  Follow-up visit 
    Refreshing or lunchtime peel 1 to 7 days.

    Skin will be red. After the redness disappears, scaling may develop, which lasts 3 to 7 days. 
    Lotion or cream applied until the skin heals, followed by daily use of sunscreen.  Usually immediately after the peel, but sometimes the next day.  No. However, 3 to 5 peels may be necessary to give you the desired results. These peels may be repeated every 2 to 5 weeks. 
    Medium  7 to 14 days

    Skin will be red and swollen. Swelling worsens for 48 hours. Eyelids may swell. Blisters can form and break open. Skin crusts and peels off in 7 to 14 days. 
    Daily soaks for a specified period.

    Apply ointment after each soak.

    Take an antiviral medication for 10 to 14 days.

    Apply lotion or cream.

    Total avoidance of the sun until skin heals. 
    After 5 to 7 days, you can wear camouflaging makeup.  Yes. Follow-up visit required after the procedure. 
    Deep 14 to 21 days.

    Area will be bandaged. 
    4 to 6 daily soaks while healing.

    For 14 days, apply ointment after each soak. 

    After 14 days, apply thick moisturizer as directed

    Take an antiviral medication for 10 to 14 days.

    Total sun avoidance for 3 to 6 months. 
    At least 14 days before you can apply makeup.  Yes. The next day, the dermatologist will want to see you. Several follow-up visits are required during the first week. 

    To help their patients get the best results, dermatologists also share these tips:

    • Use the moisturizer as directed to keep your skin moist and supple. If your skin dries and cracks, it can scar.
    • If your skin burns, itches, or swells, contact your dermatologist. Rubbing or scratching skin treated with a chemical peel can cause an infection.  
    • Do not use a tanning bed or other type of indoor tanning. Your skin will not heal properly.
    • After your skin heals, apply sunscreen every day. This will help you maintain results. 

     

    Is there downtime?

    After a medium or deep peel, you will have downtime. A deep chemical peel requires recuperation at home for 2 to 3 weeks.

    When will I see the results?

    Once your skin heals, you will see the results. Healing time ranges from 1 day for a refreshing or lunchtime peel to 14 days or longer for a deep peel. To get the results you seek from a refreshing peel or lunchtime peel, you may need to have 3 to 5 peels. 

    How long will the results last?

    Most results are not permanent because our skin continues to age. If you have lots of sun-damaged skin or precancerous skin growths called AKs, you will likely continue to see new spots and growths on your skin. 

    What are the possible side effects?

    In the hands of a doctor who has experience with chemical peels, side effects tend to be mild. Some patients develop:

    • Persistent redness that may last for months.
    • Temporary darkening of the skin. 
    • Lighter skin color (medium and deep peels).
    • Scarring (very rare when peel performed by a dermatologist). 

     

    If serious side effects occur, it is often because the patient did not follow the dermatologist’s instructions. Your risk for developing an infection or scarring increase dramatically if you: 

    • Fail to protect your skin from the sun. 
    • Fail to care for your wound as instructed.
    • Scratch the treated skin or pick off a scab.
    • Apply makeup before your skin heals.
    • Don’t heed your dermatologist’s advice and use a tanning bed or other type of indoor tanning.

     

    When is it safe to have another chemical peel?

    To maintain results, you can repeat mild and medium chemical peels. Your dermatologist can tell you how often you can have a repeat treatment. A person can have only one deep peel. 

    What is the safety record for chemical peels?

    Dermatologists have been performing chemical peels for more than 50 years, with an excellent safety record. 

    Even people who have skin of color can safely have a chemical peel — but they should see a dermatologist who has expertise using chemical peels to treat darker skin tones. Without this knowledge, people who have skin of color (i.e., African American, Asian, Latino) can develop permanent pigment problems. 

  • Preparation

    Chemical peels: Preparation

    To protect your health and find out what results you want, a dermatologist always offers a consultation before performing a chemical peel. To help you get the most benefit from this consultation, dermatologists recommends that you:

    • Ask questions.
    • Gather important information before your consultation.

     

    This page tells you what to ask and what information to gather.

    Questions to ask before getting a chemical peel 

    You should ask the following questions before getting a chemical peel:

    • Will a board-certified dermatologist perform the chemical peel?
    • How many chemical peels has the doctor performed on people with my skin coloring?
    • What will I need to do before and after the peel to get the best results?
    • What results can I expect?
    • What are the potential side effects?
    • Do I have a higher risk for any complications?
    • Will I have downtime?
    • May I see before-and-after photos or speak with patients you treated with a chemical peel?
    • How much will the treatment cost?

     

    During the consultation, your dermatologist also can tell you whether another treatment would be a better option for you. You may find that your dermatologist recommends using more than one treatment. Results from many research studies show that combining treatments can lead to better, longer-lasting results. 

    Information to tell your dermatologist before getting a chemical peel

    Before you get a chemical peel, be sure to tell your dermatologist the following information:

    • If you are taking or have ever taken isotretinoin, a medicine prescribed for severe acne. 
    • All other medicines you take — or have recently taken. Be sure your dermatologist knows about antibiotics, acne medicines, and medicines that you buy without a prescription, such as aspirin. 
    • If you frequently get cold sores or have had cold sores in the past.
    • If your skin scars easily.
    • All herbs, vitamins, and minerals you take. Even if you haven’t taken these for a while, be sure to mention them. 
    • All surgeries and cosmetic treatments you have had. While some patients feel embarrassed talking about this, the information you share can make a difference in the results you see. Don’t omit anything — even if it seems unimportant.