When your skin is being treated with acid, knowledge is power.
It seems many of us are in pursuit of glorious, glowing skin, especially if the rise in clinics offering ‘lunchtime drop-in chemical peeling’ is anything to go by.
Results-wise, you can expect smoother skin texture, more even skin tone, a reduction in the appearance of wrinkles and fine lines, and revved-up collagen production.
But a lot is involved when navigating the vast world of chemical peel treatments, from the concentration of the acid used and the number of sessions you have.
In reality, you’re unlikely to suffer a reaction if you go to a professional. Still, possible side effects can occur, including swelling, flaking, sensitivity, redness, or an absolute worst-case scenario, scarring, which we discuss in greater detail in the article, “Chemical Peel Burns: The Ugly Side of Beauty“.
What you need to consider
We appreciate we are taking a hard line in this article when it comes to chemical peels, but let’s not forget you are using acid on your skin, which at the very least is going to upset your protective barrier and knock the delicate microflora that makes up your acid mantle out of balance. This is why we say knowledge is power if you are considering a peel at any depth.
Questions you should be asking yourself are; is there any pre-existing inflammation? If so, do I really need to be putting such a formula on my already-delicate skin? If I am treating pigmentation, what degree of photo ageing do I have and is postinflammatory hyperpigmentation present?
If I am suffering from acne and breakouts, what is my degree of sebaceous activity? Are there any keloid or hypertrophic scars on my skin, or any other infections or contraindications that could damage my skin further if I commit to having such a treatment?
Concerned? Don’t panic; we have you covered. In this article, we arm you with all the knowledge you need before considering having a chemical peel.
The consultation process
A chemical peel is a five-step procedure and should involve a consultation, pre-chemical peel preparation, the peeling procedure, the all-important maintenance phase, and the recovery phase.
As a skincare company, we can not stress enough the importance of the consultation process. A detailed medical examination of your skin should include a general physical and cutaneous examination which will help to determine the following:
- the type of peel to be used on your skin
- the depth of penetration of the acid to be used
- the types of products used on your skin pre-treatment
- the experience of the person who will be performing your treatment
- your skin type and any contraindications you may have on your skin
- whether the peel is required for a focal lesion or the entire face
- the type of condition you’re chemical peel is treating – acne scarring, photo ageing, melasma, fine lines, wrinkles
- the colour of your skin; those with Fitzpatrick skin types IV to VI have increased risk of pigmentation, hypertrophic, and keloid scarring. Lighter peels are undertaken in darker skin because of the risk of post-inflammatory pigmentation and the tendency for the skin to develop increased and/or loss of pigmentation at the site of the skin injury
- whether anything will contra-indicate your treatment; for instance, if you are prone to keloid scarring, have open wounds on your face, have an active infection, or are otherwise not in good health, then you should not have a peel.
Ideally, your specialist should look at your full medical history. A history of systemic disease, particularly cardiac disease, should be considered for those who plan to receive a deep phenol peel.
Pre-procedure treatment recommendations (Priming): Many people recommend priming the skin with mild topical peeling agents for at least 2-4 weeks before the procedure. The idea of priming is to help reduce wound healing time, facilitate uniform penetration of the peeling agents to be used on your skin, and detect intolerance to any ingredients you may have, which reduces the risk of complications. More information on this can be found in the article, “Chemical Peels 101“.
Contraindications to peeling
Your skin care specialist will use the consultation process to give you a full facial analysis and discuss any contraindications that may prevent you from having the treatment, such as:
- heart disease
- infectious disease
- active herpes simplex
- severe acne or rosacea
- open wounds or sores
- high blood pressure
- pregnancy and breastfeeding
- deficient immune system
- sunburn or irritated, inflamed skin
- bacterial, viral, bacterial, fungal infection
- facial cancers, especially facial melanoma
- history of drugs that have a photosensitizing potential
- if you easily scar or if you have hyper-pigmentation tendencies
- pre-existing inflammatory dermatoses including, psoriasis and eczema
- any use of Accutane®, Retin-A®, or other medications within the last 6 months that could exfoliate or thin your skin
- if you have had cosmetic surgery, such as laser resurfacing, deep or medium depth chemical peels, or dermabrasion within the last 6 months
Safety first: Pre-chemical peel preparation
A chemical peel is a treatment that should be taken seriously and you will have a much higher chance of success if your skin is prepared correctly.
If you were to step into a dermatologist’s office and ask for a peel then and there, you would be refused. First, they will carry out a thorough consultation and put you on a pre-peel routine to prepare your skin. Then you would be scheduled to come back in a couple of weeks to have the peel applied. For this reason, we do not recommend having an at-home peel.
- What you use on your skin pre, during, and post-treatment will mean all the differences between a good outcome and a negative one. Gentle, hydrating, and skin-strengthening formulae such as DNA Age-Delay Complex before your treatment will help make your skin more resilient. Afterwards, concentrate on antioxidants and a good SPF to keep your skin protected.
- Discontinue the use of Retin A, Retinols, Vitamin A creams, AHAs and BHAs, and other topical medications at least 4 weeks prior to beginning your treatment.
- Begin to use internal supplements such as Zinc, Magnesium, and Vitamin C in your daily regime, which will strengthen your skin.
- Use a broad-spectrum SPF 50+ sunscreen before your treatment, and stay out of the sun for at least 4 weeks before beginning your treatment sessions. Avoid treatments if you have any sunburn or inflammation.
- Do not wax or use depilatory creams or electrolysis on any area you are treating for at least 2 weeks prior to your peel. Any dense hair present in the treatment area should also be removed before your treatment.
- Avoid IPL, laser, chemical peels, or microdermabrasion at least 4 weeks before your peel, as they can compromise the integrity of your skin.
- Stop taking any medications that will thin your blood during the two weeks leading up to your procedure. They will interfere with the natural inflammatory process of your skin, which is vital for rejuvenation and may increase the risk of bruising.
Aftercare – the maintenance phase
As with any skin treatment, it’s important to look after your skin following a peel. For best results, follow these aftercare instructions:
- apply a cold compress to the treated area as required for any burning or irritation associated with your treatment
- avoid any excessive heat and direct sun exposure of any kind on the treated area; this includes tanning beds and self-tanners for at least 4 weeks after your treatment
- please avoid strenuous exercise 3 days after your treatment because it may exacerbate inflammation and cause your skin to become inflamed. Sweating excessively after treatment can also irritate your skin or cause blistering, due to the sweat being unable to escape through the top layer of dead skin. Try to avoid sweaty situations; this includes staying out of the sun until after you have stopped peeling. Essentially, you want to avoid lifting your skin prematurely, as this can lead to scarring
- do not use any retinoids or tretinoins, or any acne medication products, including the following: Retin-AⓇ, AtralinⓇ, RenovaⓇ, ZianaⓇ, VeltinⓇ, TazoracⓇ, DifferinⓇ, or antibiotics such as Doxycycline
- do not be tempted to use AHAs (lactic, glycolic, mandelic), BHAs (salicylic), Benzoyl Peroxide, Vitamin C, or any other exfoliating products including coarse sponges or brushes. Avoid lightening agents, as these medications and products will increase your photosensitivity, which can significantly increase the likelihood of complications
- please refrain from tweezing, picking, waxing, rubbing, using a depilatory, or undergoing any electrolysis, to reduce the risk of scarring. You do not want to remove the dry, rough, dead skin faster than your body naturally wants to shed it
- avoid getting your hair dyed until a week after you have finished peeling if your treatment was performed on the face or neck. For most, week 3 post-peel is the best time to have your hair colour-treated
- avoid taking any anti-inflammatory medication for several days, as this could interfere with your body’s natural healing process
- be kind and give your skin time to heal; dryness, scaling, redness, and swelling may last for several days, depending on the penetration depth of the needles. Please do not be tempted to treat it with actives in a bid to hurry up the process; instead, use gentle healing serum-like Bio and Fortify
- your barrier function has been impaired, so post-procedure, you may experience conditions like mild erythema, bruising, and even some mild oedema, all of which should subside within the next 48 hours.
- do not be tempted to wash your face – leave it for at least 48 hours
- do not schedule a facial or cosmetic service such as laser resurfacing or IPL on a treated area(s) for at least 4 weeks after your treatment; even then, be cautious.
Remember, though, no matter what you have done to prepare your skin or how many times you have had a peel – things can still go wrong, especially when the correct protocol has not been followed. Risks can include infection, unplanned pigment changes, and scarring.
Skin healing – the recovery phase
The peeling may take anywhere from 7-10 days on average or longer, depending on internal and external factors such as skin type, age, weather, lifestyle, and hormones. However, as a rule of thumb, with a low percentage of acid, you should only experience some mild erythema which should subside in at least 24 hours. Slight redness and skin sensitivity and flaking may occur as your treatment eliminates dead surface skin cells; each treatment can vary.
Your skin can take on a rough, patchy, darkened quality for a few days after a peel – don’t panic. This is normal, and expected, and should resolve naturally, yet it is also possible to not peel. If this occurs, you will still benefit from the treatment because your skin has exfoliated microscopically. With a higher percentage of acid, your face will initially appear inflamed. Within a few days, however, the stratum corneum (your outermost layer of skin) will turn dark and start to peel. This flaking is usually complete in four to seven days but may continue longer, in line with your natural cellular turnover. Any post-procedural “flushed” appearance will fade slowly over several weeks.
How to treat your skin
Cleanse Gently: Your skin may be fragile for at least 5-7 days. Cleanse your skin with COOL water (hot water will cause inflammation to the skin) using only your fingertips – avoid any harsh rubbing with washcloths, loofahs, buff puffs, sponges, ClarisonicⓇ, or scrubs. We recommend using Miracle Cleanse, which protects as it polishes and is gentle on even the most sensitive skin types.
Moisturising: Letting your skin dry out may cause you discomfort. We recommend using Bio Lipid Complex and Fortify barrier repair cream to help your skin recover. You can find these in our Barrier Repair Kit; they both contain skin-identical ingredients that will help your skin begin to heal and quickly return it to health.
Hydration: For strong peels, you may use the H₂O Hydrating Complex for the first few days or as needed on peeling sensitive areas; this can be layered with Quench for an added boost.
Protecting your Skin: Heat and sun exposure can cause inflammation within your skin. Avoid excessive heat on the treated area, direct sun exposure, tanning beds, and self-tanners to the treatment area for 4 weeks after treatment. If you need to be outdoors, make sure to use a large-brimmed hat, a pair of sunglasses, and use a physical sunblock.
Makeup: Once your skin has finished peeling, you can begin wearing makeup, but even then, only use mineral makeup and ensure you use very clean, sterilised makeup brushes. If you notice your skin becomes sensitive to application, we recommend avoiding the use of that product.
As you can see, there is a lot to consider before you commit to a chemical peel, including knowing your skin type, the degree of photo ageing you have on your skin, your degree of sebaceous activity (whether your skin is oily or dry), whether there is the presence of postinflammatory hyperpigmentation, scarring, any infections, and pre-existing inflammation.
If you do commit to a chemical peel, then your skin’s barrier function is instantly compromised, and you are very limited to what you use on your skin during the wound-healing process; We recommend reading this article to understand more about why you need to keep what you use on your skin to a minimum. Whilst we appreciate the article is based on microneedling treatment, it is relevant for anyone who has received a rejuvenating treatment and whose skin is going through the wound-healing process.