A chemical peel uses a chemical solution to smooth the texture of your skin by removing the damaged outer layers.

Although chemical peels are used mostly on the face, they can also be used to improve the skin on your neck and hands.

A chemical peel is one of the least invasive ways to improve the appearance of your skin. Sun exposure, acne, or just getting older can leave your skin tone uneven, wrinkled, spotted or scarred.

A chemical peel can help improve:

• Acne or acne scars
• Age and liver spots
• Fine lines and wrinkles
• Freckles
• Irregular skin pigmentation
• Rough skin and scaly patches
• Scars
• Sun-damaged skin

• Treat deep facial lines
• Tighten loose or sagging skin
• Remove broken capillaries
• Change pore size
• Remove deep scars

You may not be a good candidate for chemical peeling if you have:

• A history of abnormal skin scarring
• Abnormal pigmentation
• Afro-Caribbean or Asian skin
• Facial warts
• Red hair and pale freckled skin
• Used certain acne treatments within the last year

Chemical solutions are carefully applied to your skin to improve the texture by removing damaged outer layers.

The chemicals used are phenol, trichloroacetic acid, and alphahydroxy acids. The formula used by your doctor will be adjusted to meet your particular needs.

There are three types of chemical peels:

• Light chemical peel - Subtle improvements at first, but that healthy glow will increase with more treatments
• Medium chemical peel - Your skin will be noticeably smoother and fresher looking
• Deep chemical peel - Results are dramatic, but recovery takes the longest

A light chemical peel might be the right choice if you have uneven pigment, dryness, acne or fine wrinkling. This kind of peel removes just the outer layer of skin (epidermis) in a light exfoliation and results in a healthier glow.

Your health care provider will use a combination of alphahydroxy acids and beta hydroxy acids, such as glycolic acid, lactic acid, salicylic acid and maleic acid. All of these chemicals are the mildest choices. You can repeat these treatments to achieve your desired results.

Light chemical peel procedure steps

• Your face will be cleansed.
• The chemical solution is brushed onto your skin and left on for a few minutes. You may feel some mild stinging.
• The chemical peel is then washed off and neutralized.

Light chemical peel risks and recovery

You are likely to experience some redness, stinging, skin flaking, and irritation from a light chemical peel.

After repeated treatments, these side effects will likely subside.

Other light chemical peel risks include:

• Hyperpigmentation (when too much pigment occurs, causing brown blotches). Avoid this by always using a high-factor sunscreen.
• Infection.

Acne scars, deeper wrinkles and uneven skin color can all be treated with a medium chemical peel. The chemicals used for this type of peel will remove skin cells from both the outer layer of skin (epidermis) and upper part of your middle layer of skin (dermis). Your health care provider will use trichloroacetic acid, sometimes used in combination with glycolic acid.

Medium chemical peel procedure steps

• Your face will be cleansed.
• The chemical solution is brushed onto your skin and left for just a few minutes. You may feel some burning or stinging.
• The treated area may turn a whitish grey color.
• The chemicals are neutralized with a cool saline compress.
• Your skin may turn red or brown in the days just after the peel. It may take up to six weeks for your skin to look normal.

You may repeat a medium chemical peel every few months to maintain your new glowing skin.

Medium chemical peel risks and recovery

When trichloroacetic acid is used in a medium chemical peel, you'll experience some redness, stinging and skin crusting just like a light chemical peel.

Although these chemicals won't bleach your skin, you may see some color changes. You're advised to avoid the sun for several months to protect that fresh new layer of skin.

Other medium chemical peel risks include:

• Hyperpigmentation (when too much pigment occurs, causing brown blotches) may result even if you use sunscreen.
• Permanent scarring is another infrequent risk.
• Redness, which occurs in everyone after the peel, may last longer than a few months for some people.

If you have deeper facial wrinkles, skin that's damaged by the sun, scars, areas that appear blotchy, or even pre-cancerous growths, deep facial chemical peels might be the right choice for you.

Your physician will use the strongest chemical called phenol to penetrate down to the lower dermal layer of your skin. For this type of peel, you may need a local anesthetic and a sedative to manage any discomfort.

A deep chemical peel usually involves some sort of pretreatment for up to eight weeks. This will prepare your skin for the peel and speed the healing process.

Pretreatment may include use of a retinoic acid cream or gel – a prescription medication that's derived from vitamin A. This works to thin out the skin's surface layer, allowing the chemical solution to penetrate more evenly and deeply.

Deep chemical peel procedure steps

• You will be given a sedative to relax along with a local anesthetic to numb your face.
• Your face will be cleansed.
• Phenol is brushed onto the area after an appropriate time interval.
• The chemical is neutralized with water.
• A thick coat of ointment is smoothed over your skin, to prevent dryness and pain. The ointment must stay in place. Sometimes your surgeon will cover your skin with strips of tape or medicated gauze rather than ointment.

Deep chemical peel risks

The chemical used in a deep chemical peel, phenol, can lighten the skin that's treated. With this kind of peel, your new skin often loses its ability to make pigment, meaning to tan. You will always need to protect your skin from the sun.

Phenol also can pose a special risk for people with heart disease. Be sure to tell your surgeon about any heart problems and include it in your medical history.

Deep chemical peel recovery

A deep chemical peel requires that you have an adequate recovery time.

You may return to work and some of your normal activities two weeks after treatment. At that point, your skin will be healed enough for you to wear makeup.

Deep chemical facial peels will result in peeling, crusting, skin redness and discomfort for several days.

Your doctor will provide painkillers to keep you comfortable. Although the swelling is likely to disappear in about two weeks, your skin may remain red for up to three months.

One treatment with a deep chemical peel will produce long-lasting and dramatic results that can last up to 10 years.

Chemical peel recovery can vary depending on the type of peel you receive:

• Light chemical peel recovery
• Medium chemical peel recovery
• Deep chemical peel recovery

You should understand that all chemical peels carry some risks and uncertainties.

A chemical peel is usually a very safe procedure when performed by a qualified and experienced plastic surgeon.

It happens infrequently, but you could develop an infection or scarring from chemical peels.

For people with certain skin types, there is a risk of developing a temporary or permanent color change in the skin either lightening or darkening.

Use of hormone medications or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

If you have suffered from cold sores (herpes) in the past, there is a risk of reactivation. Be sure to ask your doctor to prescribe medication to try and avoid an outbreak.

Inform your physician if you have a history of keloids (scar tissue overgrowth) or any unusual scarring tendencies

During your chemical peel consultation be prepared to discuss:

• Your goals
• Medical conditions, drug allergies, medical treatments and smoking history
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
• Previous surgeries

Your surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Discuss likely outcomes and any risks or potential complications

It's very important to understand all aspects of your chemical peel. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of stress. Don't be shy about discussing these feelings with your plastic surgeon.

During your chemical peel consultation be prepared to discuss:

• Am I a good candidate for a chemical peel?
• What will be expected of me to get the best results?
• Who will perform the chemical peel?
• Have they been specifically trained in this procedure?
• Where and how will you perform my procedure or treatment?
• How long of a recovery period can I expect?
• What are the risks and possible complications associated with my procedure?
• How can I expect to look over time?
• Do you have before-and-after photos I can look at for this procedure?
• What results are reasonable for me?