While many people are starting to understand that chemical peels are just another (often mild!) form of exfoliation, others hear the phrase and immediately panic. We get it – the mere category sounds like something a masochistic mad scientist would cook up in a lab. It also doesn’t help that a wide population of people was exposed to chemical peels via that infamous Sex and the City® scene, where Samantha impulsively indulges in a deep chemical peel and has to walk around red-faced for the remainder of the episode.
It’s this painful, splotchy, tomato-y visage that we tend to conjure up at the thought of a chemical peel, but the truth is that peels are a spectrum, and many don’t result in those gnarly side effects.
“We generally classify chemical peels as a superficial, medium, and deep,” says Rosalyn George, MD, a board-certified dermatologist at North Carolina’s Wilmington Dermatology Centersm. According to Dr. George, superficial peels remove parts of the top layer of skin (the epidermis) to help correct minor skin imperfections, like congested pores, dullness, and rough texture. Medium depth peels remove the epidermis and some of the tops of the next layer of skin, called the dermis, for more advanced treatment of texture and tone. Deep peels go through to the deeper portion of the dermis to help address issues like scarring, major sun damage, wrinkles, and areas of hyperpigmentation.
Most peels offered fall into the superficial and medium categories. This is because there are higher rates of complications from deep peels, says Dr. George. No matter what type of peel you’re getting, though, it’s imperative that you find an experienced practitioner to perform the treatment. With all that in mind, we’ve outlined the four primary types of peels below.
Alpha Hydroxy Acid Peels (AHA)
Sometimes referred to as fruit acid peels, AHA peels are water-soluble peels that tend to be superficial, though they do come in varying strengths. The most commonly used AHA is glycolic acid, but other forms include lactic, citric, and mandelic acids.
“I find AHA peels to be very beneficial in photoaging, discoloration like melasma, as well as for fine lines and wrinkles,” explains Dr. George. “Additionally, AHAs have been shown to increase collagen production, so I tend to pick these types of peels for my patients who are more concerned about texture and lines.”
Regardless of what peel you get, you’ll find that preparation and application are pretty similar across the board. First, your skin is cleansed, then it’s quickly swabbed with acetone or alcohol to remove any lingering oil, which could interfere with the acid. Lastly, the peel is applied in even layers to cover the entire treatment area. (You may feel a tingling or burning sensation as the acids work their way into your skin, but not all peels cause discomfort or irritation.) That’s it!
“If using glycolic acid, the peel needs to be neutralized with water or a neutralizing solution to avoid deeper penetration,” notes Dr. George. You’ll be done with your treatment quite quickly, and after a few minutes, your provider will likely slick a gentle, chemical-free sunscreen onto your skin and send you on your way. As with any chemical peel, AHA treatments can increase your sensitivity to the sun, so be religious about applying SPF in the days after your appointment (and every day, right?).
All peels have possible side effects, but again, AHA peels tend to be more superficial, so you can expect minimal downtime, including some facial redness immediately post-treatment and possible mild peeling over the following week. Consult with your dermatologist, who can help you find the right treatment for your needs.
Beta Hydroxy Acid Peels (BHA)
The most common beta hydroxy acid is salicylic acid, which is an oil-soluble ingredient that penetrates pores more effectively than AHAs. Dr. George says, “BHA peels are also usually superficial peels.”
Since BHAs are oil-soluble, and because salicylic acid is a known acne-buster, this type of peel is best for those with acne-prone or oily skin. Dr. George says she tends to use them more on younger patients, who deal with these skin issues more frequently. Preparation and application are the same as above, though BHAs do not require neutralization.
A Jessner Peel is a medium peel that often falls into the BHA category, though it does use a combination of AHA (lactic acid), BHA (salicylic acid), and resorcinol (a chemical compound). Consider it a slightly more aggressive, one-two-three punch against acne and dull skin. The salicylic acid helps break down sebum, dirt, and gunk that clog pores and lead to blackheads and acne; lactic acid exfoliates, brightens, and refines skin texture, and resorcinol targets acne specifically.
A word of praise in particular for BHA peels: they’re less likely to cause irritation than AHA peels. That’s because salicylic acid is a known anti-inflammatory — it’s related to aspirin, after all! – and can help soothe the skin as it treats it. That said, consult with your dermatologist before booking a BHA peel to ensure it’s the right treatment for you.
Trichloroacetic Acid Peels (TCA)
Trichloroacetic acid is a much stronger peeling agent that results in a medium-depth peel. While you can find gentle, easy-to-use versions of AHA and BHA peels at Sephora®, a TCA peel should always be administered in a clinical setting.
“Since these peels are more aggressive, they can be useful for pigment abnormalities, fine lines, and texture, and can have some benefit for deeper lines, as well,” says Dr. George. “These are for the patient that is motivated to see results more quickly and has the time to peel for seven to 10 days following their treatment.” On that note, a TCA peel does cause that post-treatment redness and sensitivity à la Samantha Jones. Your skin will likely feel tight and tender in the days that follow, and a constant flurry of dead skin cells will flutter off your face for the next week to a week and a half.
As Dr. George said, it’s effective, but it does come with some downtime. Along with your favorite non-chemical sunscreen, apply a gentle moisturizer several times a day to keep your skin nourished (we like the soothing Avène® Skin Recovery Cream), and wash your face twice daily with a non-irritating formula, such as Cetaphil® Gentle Cleanser for All Skin Types.
Some offices, Dr. George’s included, will actually use a combination of AHA/BHA and TCA in order to get a deeper peel effect. This helps target more significant skin issues, including deep wrinkles, melasma, and notable hyperpigmentation.
Phenol Peels
Phenol peels are the most aggressive form of chemical peels, using carbolic acid to penetrate into the deep layers of the dermis. Given their potency, they’re reserved only for patients who need a very deep treatment. That includes those with very deep and/or numerous wrinkles, scarring, severe photodamage, and even people who have skin abnormalities as a result of precancerous growths. If, like us, you are excited by the potential of such a powerful treatment, hold your horses: the average person really only needs a superficial or medium peel to get the skin-smoothing, radiance-revealing results they want.
If your dermatologist has declared you a candidate for a phenol peel, know that the application process is largely the same, but there’s one more step before the actual treatment: you’ll likely receive a sedative and/or anesthetic to help reduce pain and discomfort. (We told you this procedure was aggressive!) Once applied, the phenol peel is allowed to set, and then it is neutralized with water. Afterward, a coat of thick ointment or medicated gauze is applied to help soothe and protect your skin.
[Editor’s note: Keep in mind, downtime from this type of chemical peel can be up to two weeks, so be sure to plan accordingly.]
Perhaps unsurprisingly, the sensitivity, redness, and peeling post-procedure tend to be more severe than what you’d experience even with a medium-depth TCA peel, so plan your appointment carefully. You might want to consider scheduling a phenol peel ahead of a week that you can spend indoors watching Netflix®, shedding your skin in private. Phenol peels can be a very effective option for those who want to target the issues we outlined above, but really should be approached with caution and care.
Want to learn more about chemical peels? Visit our chemical peel treatment guide, then discover which treatments are right for skin of color here.
