Many of us are searching for instant gratification in the form of luminous, healthy skin.
It seems that a chemical peel could be the answer to your prayers for treating an array of skin conditions that boost that ‘lit from within’ glow, and if the Google gods are to be believed, it’s minimal risk for big payoffs.
Whilst it’s true a safely performed peel administered by a professional can make your complexion look fabulous, administered in the wrong hands, the complications that can arise when you paint something as corrosive as lye on your face can have disastrous consequences.
Even when performed correctly, chemical peels aren’t quick and easy makeovers.
If you’ve had a peel and are worried about chemical burns, this article will help you connect the dots and arm you with the knowledge to begin to repair your skin.
Having a chemical peel should be taken seriously
You are essentially causing an inflammatory response with an acid, and in reality, that can lead to problems. Not only that, but after the treatment, you are often applying active products on your skin that can penetrate at a depth where they should not go – certainly not on compromised skin which can lead to infections and irreparable damage. Not everyone’s skin is ideal for peels. A lot depends on your skin’s characteristics, making chemical peels ineffective and increasing the risk of adverse effects, which we discuss in greater detail below.
Bottom line: If your skin is impaired, it requires a super-healthy skin response, and if your skin is stressed at all, you are almost certainly at risk of damage. If you are concerned, follow the link to find out how to best treat your skin. Whilst that is mostly about microneedling, it is still the same concept because essentially, your barrier function has been compromised. We are recommending you only use a high molecular weight hyaluronic acid such as H₂O complex on your skin in the first few days of the treatment to ensure your skin repairs and heals correctly. Otherwise, you may be at risk of a granulosum infection, which can have long-term devastating consequences.
Lately, we have received an overwhelming amount of emails from readers who have experienced chemical peel burns or damaged skin due to poorly-performed peels, with side-effect concerns ranging from infection, orange peel texture, scarring, and pigmentation issues, to name but a few.
Little do consumers know that professional-grade peels can, in some cases, do more harm than good. Mid to high-strength chemical peel treatments should only be carried out in a medical setting by an appropriately-trained professional such as a qualified aesthetician, nurse, or doctor.
Peter from Canada wrote: I purchased a chemical peel online; I’d had a few facials in the past and was pretty confident it was something I could perform on myself at home. I wanted to treat some marks left behind by hormonal spots, which wouldn’t fade. Upon application, the product started to sting almost immediately. My skin was burning; the pain was so unbearable I started panicking and I quickly rinsed it off, but my skin remained red and blotchy for days afterwards. The area around my eyes was super sensitive as well and I couldn’t apply anything to my skin. It really hurt.
Di from Malta wrote: I had a VI PEEL chemical six months ago and it has completely ruined my skin. A week after I had the peel, my skin texture starting deteriorating rapidly. I am 35 years old, and my skin now resembles someone who looks more like 60. My whole face is filled with lines, and my inner cheeks have pores that have stretched and I had no pores before this chemical peel; My skin now has a very shiny texture, but not in a good way. It’s raised and bumpy in some areas, and it almost looks like tiny pimples in between my pores. My face texture is thick and leathery and resembles someone who has had very severe sun damage. I have lost my youthful skin and am at my wit’s end; please help.
Jasmine from New Zealand wrote: Samantha, I really want my experience to be a warning to all of those considering having a chemical peel. I had a light peel at 12% TCA performed on me around 2 months ago to remove some minor scarring. But now my skin has been destroyed its constantly inflamed, very red, crepe and with small red spots all over it and lots of thin horizontal lines and the scars are worse? It has completely affected my mental health, and I am constantly reduced to tears. I did everything by the book and am at a loss, can you help? I really hope this is a lesson to anyone considering having a chemical peel.
Suzy from Australia wrote: Pre peel, my skin was generally smooth with a few shallow soft rolling scars on my cheek because I suffered from acne breakouts as a child. Post peel, I now have massive pores, Horrible orange peel texture, and it made my existing scars DEEPER?
Everything looks so uneven now and destroyed. The peel gave me broken capillaries all over my cheeks, I can’t go outside for 5 minutes without my whole face turning red, and it’s as though everything irritates it. Before, a pimple would heal with a red mark yet it now ‘heals with a dent or shallow indentation left behind, regardless of how tiny the pimple is? So not only am I suffering the scars from the peel itself, any small breakouts I get since continues to make matters worse. In your experience, has anyone ever had this after a peel and later recovered? I wouldn’t be so devastated if I didn’t think it was permanent; I would love it if you could shed some light on this for me please.
Elizabeth from Australia wrote: I had a deep peel, and when I came around, I was groggy from the pain and medication. After 48 hours the tape came off, and I had a thick scab over my entire face; this was apparently normal but hadn’t been clearly explained to me, so understandably, I was extremely alarmed, and by this time, I realised I hadn’t thought this procedure through very clearly beforehand. My face was burned, red, and so swollen to the point I could hardly open my eyes, and I couldn’t open my mouth to talk, my skin formed a thick crust, and when the dressing came off I could not recognise myself. Finally, after three months the swelling has gone down, but I am experiencing terrible skin which has really scared me.
First and fast: Understanding chemical peel
These treatments are acid solutions that have a much lower pH level than your skin’s natural pH, which is usually around pH 5.0 (4.5 – 5.5).
Chemical peeling accelerates exfoliation, induced by caustic agents; when they are applied to your skin, they have the ability to dissolve the “desmosome connections” – adhesive cell junctions that hold the build-up of dead skin on your face. Depending on the peel depth, within 2-5 days of having a chemical peel, this dead skin dries and thus begins the process of peeling off your face. That’s why it is called a “peel”. Essentially what they do is cause controlled damage within your skin. The following release of cytokines and inflammatory mediators results in the thickening of your epidermis. In turn, this boosts collagen deposition and reorganises structural elements in your skin, giving your skin volume and bounce. The result is an improved clinical appearance of your skin, fewer lines, decreased pigmentary dyschromia, reduced scarring, and a brighter, more youthful appearance.
To find out more, the article, “Chemical Peels 101” is a complete guide on the subject.
Know before you go: Chemical peels can penetrate deep
This is a big concern when trying to fix certain skin conditions, especially when considering performing them at home.
Take pigmentation, for example – this runs very, very deep into your skin, way down into the dermis. Acne also runs quite deep as well, and different acids and layers of acids penetrate at different depths into your skin.
This is why it is important to understand where your skin conditions are sitting within the layers of your skin when choosing an acid, something your skincare specialist will be able to advise you on.
Here is an indication of the depth of peels:
If you have just mild hyperpigmentation, you can use pretty much any hydroxy acids, from superficial peels like glycolic, mandelic, and salicylic to very superficial like lactic, which is very hydrating.
However, if you have dermal melasma that has been very problematic and unyielding, you will need to use a multi-layered peel and most likely combine it with other modalities such as melanin inhibitors to reach the depths where it lies. C+ complex is a good example of a melanin inhibitor.
Medium-depth peels are best for stubborn pigmentation problems and may include TCA at 13%, 20% and 30% at multiple layers. Deep peels may contain TCA 50% or higher, and intense phenol peels.
Complications you need to be aware of before a peel
In our clinic, we have seen several troubling conditions as a result of this treatment being poorly performed, including:
Allergic reactions and recurrent inflammation
Permanent textural changes: This is a common problem that we have seen in our client’s skin, including lines of demarcation.
Scarring: Persistent erythema that continues for more than four weeks after a peel indicates early scarring – you should see a dermatologist and ensure you are treated with potent topical corticosteroids to prevent scarring and infection.
Pigmentary changes: Postinflammatory hyperpigmentation and even hyperpigmentation are conditions that can be very persistent and often difficult to treat.
Bacterial infections: These include bacterial infections such as staphylococcus, streptococcus, and pseudomonas.
Viral infections include herpes simplex and fungal infections like candida, which all need to be treated aggressively and appropriately.
Toxicity: Although this is rare, these reactions can occur with resorcinol, salicylic acid, and phenol peels.
It’s a serious procedure and not for everyone
As a general rule, most reasonably healthy people can have chemical peels; however, there are some health conditions and skin characteristics that make chemical peels less effective and increase the risk of adverse effects, including:
- if you have an aspirin allergy
- if you suffer from any autoimmune diseases
- if you have diabetes, your skin will be thin
- if you have had any prior chemical peel sensitivities
- women who are actively trying to get pregnant or breastfeeding
- if you have undergone any recent facial surgical procedures
- if you spend a lot of time outdoors and have direct sun exposure
- if you have had any recent radioactive or chemotherapy treatments
- if you suffer from seborrheic dermatitis, collagen disease, atopic, eczema, or rosacea
- if you have warts, an active Herpes lesion, or a history of keloidal scarring
- if you have any broken skin, have recently waxed, or have recently used a depilatory cream like Nair
- if you have a naturally darker skin tone, you may be at an increased risk for pigmentation concerns related to peels
- if you have poorly-managed chronic skin conditions, you should avoid chemical peel treatment
- if you are on or have in the last 6 months received acne treatment like Accutane, it can increase your risk of scarring
What are the dangers of a chemical peel?
Inflammation, scabbing and swelling: Normal healing from a chemical peel involves your skin being inflamed after treatment which can last a few months.
Changes in skin colour: A chemical peel can cause treated skin to become darker than normal, known as hyperpigmentation. In some cases, it may also cause your skin to go lighter than normal (referred to as hypopigmentation). This is more common after a deep peel.
Infection: A chemical peel can lead to a bacterial, fungal, or viral infection, such as a flare-up of the herpes virus — the virus that can cause cold sores to occur. The compromised state of your skin’s barrier function after a chemical peel may contribute to the spread of infection to the area that has been treated.
Heart, kidney or liver damage: In extreme cases, deep chemical peels that traditionally use phenol can damage the heart muscle and cause your heart to beat irregularly. Phenol peels have also been known to harm the kidneys and liver. To limit this exposure to phenol, deep chemical peels are usually carried out a portion at a time, in 10 to 20-minute intervals.
Increased risk for pigmentation: The major risk factor for pigmentation problems is high in moderate to highly pigmented skin types (skin phototypes III to VI ).
Increased risk for poor wound healing: Caution is necessary for medium-depth or deep chemical peeling if you have medical conditions that may inhibit normal wound healing after the procedure. Contraindications include other factors that may also impede healing. These include Accutane®, Retin-A®, or other medications within the last 6 months that could potentially exfoliate or thin your skin, a history of radiation therapy in the treated area, or certain medications like systemic glucocorticoids or other diseases that impair wound healing (such as diabetes).
Increased risk for hypertrophic or keloidal scarring: Those with a history of keloidal or hypertrophic scarring may risk such scars following a peel. We consider a history of keloidal scarring on the face a contraindication for those having a chemical peel treatment.
Pre-existing skin disease: Relative contraindications include active inflammatory skin conditions such as rosacea, eczema, and acne vulgaris in the treatment area and skin disorders including flat warts, lichen planus, psoriasis, and vitiligo.
This is why we can’t stress enough the importance of only having peels administered by a professional and not performing them at home by yourself.
Professional only VS at-home peels – Is there a difference?
When you have your peel performed by professionals, they will carry out a pre and post-consultation to ensure everything is thoroughly sterilised to prevent infection. They will constantly monitor your skin for any unusual rashes, swelling, erythema, or frosting, and any other tell-tale signs that the acid may need to be neutralised, or the chemical peel could be progressing too deeply. They will also provide you with the correct home care, which in our opinion, is keeping everything to a minimum and not applying anything topical which could harm your skin. Instead, opt for a product like our H₂O complex, which contains high molecular weight hyaluronic acid.
When you are in the privacy of your own home, you do not have the luxury of having a professional standing by making sure that you do not damage your skin. It is true, however, that “At-home” chemical peels of good quality are usually buffered with slightly higher pH levels to give you the extra time and safety that you need. This does not necessarily mean that “buffered peels” with slightly higher pH levels are not powerful; remember that chemical peels are based on unnatural pH levels and can harm your skin if you are not careful.
As we can see, chemical peeling is a serious procedure used to treat pigmentation, photo ageing, superficial scarring, premature ageing and more.
Before embarking upon such a treatment, we recommend doing your research thoroughly because there are so many reasons why you should NOT have a chemical peel, including; Infections, inflammation, redness, scarring, and pigmentation.
Various depths of peels, superficial and medium-depth, are by far the safest. Still, the type, depth, and concentration of peel being used on your skin will be selected according to the pathology of your particular skin condition, which your treatment provider will determine.
They will provide you with a thorough consultation and advice on pre-treatment procedures to prime your skin whilst giving you supportive medical therapy and thorough postoperative home care, all of which must be considered to guarantee a safe and satisfactory outcome.