Chemical Peels- a scientific miracle that comes with a toll by Asma Ferdoes

There is a famous saying “Beauty is only skin-deep.” Though this is a very deep and multi-layered saying in itself, what it aims at is there is more to a person than mere appearance.

For me, the definition of beauty goes beyond the colour and texture of skin or the shape of a person. Our attitude, confidence and character too exert such charisma and appeal that they bring alive our external beauty as well. Yet, there is no denying that how we appear too goes a long way in captivating our audience and creating impressions in every area of life. So, it is as important to maintain our skin and its appearance as it is to maintain our physical health and a humane nature.

Here is where the scientific miracle of “Chemical Peels” comes to our aid. It is a modern day cosmetic surgical treatment performed using certain chemicals and acids by certified professionals and registered skin specialists on the face, hands, and neck of a patient to improve our skin’s texture and appearance, and reduce topical imperfections. This procedure causes the skin to exfoliate and peel off resulting in the new skin underneath to be often softer; less blemished, and regain its smoothness and flawlessness.

Chemical peels are often opted to treat problems that are often the result of our lifestyle choices and the natural process of ageing, and exposure to environmental factors.  Problems every one of us would relate to, such as

Wrinkles and fine lines

Acne scars

Hyper pigmentation

Scars from minor accidents or heedlessness


Sun damage

Uneven skin tone or redness

There are innumerous other treatments too that address these problems, but it is our individual choice, lifestyle demands, and the degree of the problem that decide our course of action. A thorough consultation and in-depth analysis of the problem with the professional will help us decide in choosing this option over others.

For the record:

Chemical peels have been performed by experts for more than 50 years now and with a relatively impressive safety record. 

Though famous among Europeans and Americans (who tend to have naturally lighter skin tones) people of colour like African American, Asian, and Latino, etc too can opt for this treatment. But they must be cautious in choosing their doctor and need to be handled by someone who has expertise in handling darker skin tones, else there is a huge risk of developing permanent pigmentation problems and a failed treatment.

Though the history of chemical peel technique can be traced to early Egyptians and Romans, they used natural products containing certain acids like lactic acid, tartaric acid, and such; we can credit the modern method for skin treatment to surgeons and dermatologists of late 19th century and of early 20th century. 

According to a report published in PMFA Journal, “In 1874a Viennese dermatologist, Ferdinand von Hebra used peeling techniques to treat pigmentation conditions such as Melasma, freckles and Addison’s disease. In 1882 in Germany, Paul G Unna described the use of salicylic acid, resorcinol, trichloroacetic acid (TCA) and phenol on the skin. It was following his reports that other authors started publishing their work.

In 1917, during World War I, Douglass Montgomery made reference to his use of phenol under bandages for healing and ‘beautifying’ the skin. However it was not until 1952 that George MacKee published his results in England, using phenol for the treatment of scarring. Interestingly, despite this publication date, he had actually been using phenol peels since 1903. It is not surprising that these doctors used phenol in the early days of skin peels, particularly in patients with scarring, as in current day practice this is classed as a ‘deep peel’.

The use of chemical peels really started to gain momentum in the 1960s as modified solutions of phenol were developed and histological assessment comparisons were drawn between phenol and TCA. Scientific work continued into the 70s and 80s and at the same time, the use of alpha hydroxy acids (AHAs) was developed by Van Scott and Yu for more superficial treatment.”

Understanding different types of chemical peels:

There are three different types of chemical peels that we can get. These include:

Superficial Peels or better known as light-peels or lunch-time peels: It uses mild acids like alpha-hydroxy acid. It is gentle on the skin and only penetrates the outermost layer of skin. It might need to be repeated for up to 3 to 5 sessions every 2 to 5 weeks to get the desired results. Follow up visit is usually not necessary but sometimes may be requested depending on individual case.

Medium peels: It uses trichloroacetic or glycolic acid, and penetrates to the middle and outer layer of skin. It is more effective for removing damaged skin cells and scars. This peel can be repeated 3-4 times over a span of few months until desired result is achieved. It needs little precautions during recovery to protect the healing skin like At-home care which may involve daily soaks for a specified period, applying prescribed ointment after each soak, taking an antiviral medication for 10 to 14 days, and applying moisturizing and soothing lotion or cream. Total avoidance of the sun might also be recommended until skin heals. Follow-up visit is usually required after the procedure.

Deep peels: These peels often use phenol or trichloroacetic acid, and penetrate to the middle layer of the skin to remove damaged skin cells. It should only be performed in a surgical setting and may even require local anesthesia as it might be a painful procedure and need us to be completely relaxed. The procedure is a delicate one and done under careful scrutiny and clarity. Also it can be done only once in a lifetime. 

Deep peels also require an extensive at-home care. We might be advised 4 to 6 daily soaks while healing, along with thick moisturizers and healing ointments. We might also be prescribed anti-viral medication for 10 to 14 days, and may have to observe total sun avoidance for 3 to 6 months. We might even need to avoid wearing makeup for at least a fortnight or a month. Several follow-up visits are usually required during the first week.

According to a Medical review published by Dr. Cynthia Cobb and Ana Gotter, there are a number of factors which have to be considered in choosing the type of chemical peel.

Before you drop the sail

Now that we have decided to embark on the journey towards a clearer skin through this channel there is always a necessity to be fully prepared and know the pros and cons. It is always wise to know a few things beforehand, therefore do ask about:

  • The performing professional’s experience and qualifications

  • The type of chemical peel they would recommend and why

  • Any risks or possible side effects

  • What aftercare will be provided

  • What will happen if things go wrong

  • What insurance cover do they have

Also, it is important that we inform the staff:

  • About our medical history

  • All or any underlying health conditions

  • Any known medicinal allergy or reactions

  • Any former treatment done

  • Our expectations with the treatment

  • Our lifestyle requisites that might interfere with the treatment or recovery.

Safety comes first. There are also some precautions we must or may have to take under the recommendation of our specialist:

  • Do not use any type of retinol or retin-A topical medication for at least 48 hours prior to our appointment

  • Disclose about the use of all or any medications we take

  • Should not have been on Accutane for at least six months

  • Take an antiviral medication if we have a history of fever, blisters or cold sores to prevent a breakout around the mouth

  • Use special lotions to improve treatment, like glycolic acid lotion

  • Use a retinoid cream to prevent skin darkening

  • Stop waxing, epilating, or using depilatory hair removal products the week before the peel. 

  • Avoid hair bleaching.

  • Stop using facial scrubs and exfoliants the week before the peel.

  • Arrange for a ride home, especially for medium or deep chemical peels, which will require us to be sedated.

On aboard! The journey into the dreaded water.

So, the big day has arrived. On the day of the treatment, we will first be prepped for the treatment by cleansing our skin thoroughly. As stated earlier, if we have a deep peel scheduled, we might probably receive general anesthesia. After the peel comes off, the 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. For a deep peel, we might have some wounds that will require a surgical dressing. It is also a good advice to have a friend or close relative accompany us for medium or deep peel sessions as their aid and care might be handy at times.

The possible Risks and Side effects of a chemical peel

Common side effects are temporary, and generally include redness, dryness, stinging or burning sensation on the treated area, and sometimes slight swelling. With deep peels, we may permanently lose the ability to tan.

Chemical peels can, however, can have more serious risks and dangerous side effects that can be permanent and we will be informed of their possibility beforehand. Therefore, the risks and side-effects are ours at our own peril. These might include:

  • Darkening or lightening of the skin color. These can be more common in people with darker skin.

  • Scarring which can be permanent.

  • Infections. People with herpes simplex have reported to experience flares following a treatment. Very rarely, chemical peels can cause fungal or bacterial infections.

  • Heart, liver, or kidney damage. The phenol used in deep peels can actually damage the heart muscle, kidneys, and liver, and cause irregular heartbeats. That is the reason it is used only in a surgical setting under careful scrutiny and precision.

What to expect after

Recovery time varies depending on which chemical peel we have received.

Light chemical peels: Recovery time is about four to seven days. Our skin may temporarily be lighter or darker.

Medium chemical peels: The skin will generally recover in about five to seven days after a medium chemical peel, though we may have redness that persists for months. Our skin might initially swell, and then form crusts and brown blotches before revealing the new skin.

Deep chemical peels: It will take about two weeks for the new skin to develop, though white spots or cysts may last several weeks. Also it is common for redness to last for several months.

During recovery, following the doctor’s post operation instructions faithfully is crucial. So, do follow the specific instructions for how often to wash the face and moisturize, and which products to use diligently. We must also try to stay out of the sun until the skin has healed, and avoid using makeup or other cosmetics until the doctor gives us the go-ahead. We might be advised to use ice packs for 20 minutes at a time, or a cool fan, to help relieve discomfort at home.

We might be allowed to wear certain makeup products immediately after the peel, but sometimes we might be asked to defer till the next day or a few days depending on our skin condition and the type of peel we have opted for.  

Home at last! What now? 

So, now that we have gone through fire and deep waters to get a flawless skin, what can we expect of it and how long will this dream last?

As we would have been informed before the treatment, most results are not permanent because our skin continues to age. If we have lots of sun-damaged skin or precancerous skin growths called as actinic keratoses (AKs) or solar keratoses we will likely continue to see new spots and growths on our skin as time passes and the effects of the treatment wear off. To maintain the results, we will be required to repeat light and medium chemical peels every few months.

After everything is said and done:

Ultimately, it is our life choices and decisions that define who we are and what we sow we will have to reap. Though chemical peel treatments are generally safe when done under right conditions by certified professionals, it is a serious treatment and needs thorough planning and analysis. Our life-style demands, desired beauty expectations and social pressure can heavily influence us in this decision and it is a boon of science that can make our lives better, our appearance attractive and help achieve better objectives in a more effective way. There are billions of ways to achieve the end result, but if we are willing to go through hell and wish to bypass the perseverance the other methods usually call for, chemical peel is the answer for us. 

It is a boon of science that can make our lives better, our appearance attractive and help achieve better objectives in a more effective way.

But what we always need to remember is that external beauty can aid us only so far. It needs to be well supported by our overall health and mental well being that will guide us in life and most important of all is to have a strong character and a noble heart to win in every walk of life.