When your skin is being treated with acid, knowledge is power.
Many of us are in pursuit of glowing skin.
And lunchtime drop-in chemical peels are becoming the norm for many.
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 skin peeling treatment.
From contraindications, the concentration of the acid used and the number of sessions you have.
Concerned? Don’t panic; we have you covered.
This article will arm you with all the knowledge you need before considering having a chemical peel.
What you need to consider before you commit
We say that knowledge is power, especially if you are considering a peel at any depth.
You are after all using acid on your skin, which can upset your protective barrier.
Questions you should be asking yourself are; Do I have sensitive skin? Is there any pre-existing inflammation?
- if I have sensitive skin 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 suffer from acne and breakouts, what is my degree of sebaceous activity?
- is there any keloid or hypertrophic scars on my skin
- are there any infections or contraindications that could damage my skin if I commit to having such a treatment?
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.
The consultation process
A chemical peel is a five-step procedure and should involve consultation, pre-chemical peel preparation, peeling, all-important maintenance, and recovery.
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 local lesion or your entire face
- the kind of condition you’re chemical peel is treating – acne scarring, photo ageing, melasma, fine lines, wrinkles
- 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, you should not have a peel.
The colour of your skin should also be taken into consideration.
Those with Fitzpatrick skin types IV to VI have an 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 loss of pigmentation at the site of the skin injury.
Ideally, your skincare specialist will look at your complete medical history. A history of systemic disease, particularly cardiac disease, should be contraindicated 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 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 “Chemical Peels 101” article.
Contraindications to peeling
Your skincare specialist will use the consultation process to give you a complete 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 photosensitising 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 six 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 six months
Safety first: The pre chemical peel preparation.
A chemical skin 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 conduct 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 and adverse outcome.
- before your treatment, gentle, hydrating, and skin-strengthening formulae such as DNA Age-Delay Complex will help make your skin more resilient. Afterwards, concentrate on antioxidants and a good SPF to keep your skin protected.
- discontinue Retin A, Retinols, Vitamin A creams, AHAs and BHAs, and other topical medications at least four weeks before 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 four 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 treat for at least two weeks before your peel. Any dense hair in the treatment area should also be removed before your treatment.
- avoid IPL, laser, chemical peels, or microdermabrasion at least four 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 essential 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 on the treated area; this includes tanning beds and self-tanners for at least four weeks after your treatment
- avoid strenuous exercise 3 days after your treatment because it may exacerbate inflammation 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
- skin peeling after retinoid, tretinoin or acne medication can occur, so please stop their use. This includes 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, significantly increasing the likelihood of complications
- please refrain from tweezing, picking, waxing, rubbing, using a depilatory, or undergoing any electrolysis to reduce the risk of scarring. When you are considering treatment for peeling skin, 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 three 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 peel. Please don’t treat it with actives in a bid to hurry up the process; instead, use gentle healing serums on a skin peeling face
- 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 four weeks after your treatment; even then, be cautious.
Remember, 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 is not followed. Risks can include infection, unplanned pigment changes, and scarring.
Skin healing: The recovery stage
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 mild erythema that should subside in at least 24 hours. Slight redness, skin sensitivity, and flaking may occur as your treatment eliminates dead surface skin cells; each treatment varies.
Your skin can take on a rough, patchy, darkened quality for a few days after a peel – don’t panic. It is typical and expected and should resolve naturally, yet it is also possible to not peel.
You will still benefit from the treatment if this occurs because your skin has exfoliated microscopically.
With a higher percentage of acid, your face will initially appear inflamed. However, within a few days, 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 four weeks after treatment. If you need to be outdoors, wear a large-brimmed hat, 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 using 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 have a chemical peel, 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 this 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.