Chemical peels: Celebrities swear by them as the answer to dull and lifeless skin. Zara Kassam explains what’s involved and why they aren’t for the faint hearted.

There’s no doubt about it, an accumulation of dead cells in your skin is going to leave it looking less than glowing, but a spotless, flawless complexion is lying just beneath the surface. So how do you access this inner you? The answer, proponents say is what’s known as a chemical peel, skin peel or lunchtime peel.

There are many different types of chemicals used in skin peels that target different skin concerns from wrinkles and aging to acne and scarring. And with names like ‘lunchtime peel’ being bandied about you’d think it was a walk in the park. It’s true, they are done quickly, but they aren’t all free. And while many some may result in mild temporary redness, others can cause swelling, redness and flaking afterward.

In order to understand which chemical skin peel is best for you and your skin type, you need to understand the condition and tone of your skin. Peels using concentrated forms of acids should only be done by qualified professionals who have completed accredited training in how assess your skin, apply the acid and neutralise it fast.

So, how to they do it? First the skin is cleansed and then the acid solution is applied to the surface with a brush, It’s absorbed into the skin where it releases the active acid component and where it goes to work breaking down the sticky bonds that keep the dead layer of skin attached.

Depending on the type of peel used it can be mildly tingling or quite painful and it is imperative that proceduralist knows what signs to look for on your skin and neutralises it before it become too painful or burns the skin.

Types of peels: the AHA peel

The most common type of chemical peel used is the Alpha hydroxy acid peel (AHAs), typically in concentrations ranging from 30% to 70%. AHAs are naturally occuring components of sugar cane and fruits; the five most common AHAs used in chemical peels are: citric acid, glycolic acid, lactic acid, malic acid and tartaric acid.

Caroline Gwilliam from Aesthetic Source, specialists in skincare and in-clinic/in-salon procedures highlighted the significance of AHAs skin peels says the most commonly used peel involves glycolic acid which penetrates deep beneath the surface of the skin, exfoliating dead skin cells while stimulating cell regeneration and collagen production.

The procedure gives instantaneous results, however produces a light peeling effect Caroline described the skin feeling “dry and mildly irritated almost as if the skin had been sunburned.”

Caroline says there is good evidence supporting the effectiveness of this type of peel for:

• Treating sun spots,
• Acne scars, blemishes
• Fine lines
• Areas of dryness
• Uneven pigmentation.

Skin care products that contain lower levels of AHA can be bought to be used at home. These products contain AHA concentrations of less than 10%. Stronger peels are available in salon and medical clinics and can achieve impressive results in reducing photo-damage, fine lines, pigmentation and treating acne.

Caroline warns however that peels with 30-70% AHAs can only be used by a trained professional as there are risk such as burning the skin if they are administered incorrectly.

Before peel (NeoStrata ProSystem Peel – Alpha Hydroxy Acid)

After NeoStrata ProSystem Peel – Alpha Hydroxy Acid

She adds that it’s important not to overdo it though as using peels to frequently can make the skin irritated and inflamed. Depending on the skin condition one treatment every 4-6 weeks is usually sufficient.

So can everyone have one? No, says Caroline.  She warns that AHA peels are not suitable for those using the acne medication Accutane or who have active cold sores, as well as women who are pregnant.

Beta hydroxyl acids peels (BHA)

Beta hydroxyl acids peels (BHA), otherwise known as Salicylic acid peels, are used in concentrations between 20-30%. They work in a similar manner to AHA peels and can have advantages for those suffering from acne or if they have sensitive skin.

The benefit of using BHA peels rather than AHAs is that irritation will be reduced due to the anti-inflammatory properties of Salicylic acids. A deep BHA peel can be beneficial for many skin types because the irritation and inflammation are kept to a minimum as it also has antiseptic properties. As salicylic acid is lipid of fat soluble it’s a good peeling agent for blemish-prone skin with blackheads.

The Blue Peel or TCA peel

Another peel in is the Blue Peel otherwise known as the Trichloroacetic acid (TCA) peel which can be used in concentrations up to 50% and is more commonly used to treat:

• Sun damage
• Fine lines
• Wrinkles
• Age spots
• Acne and scaring
• pigmentation spots and melasma.

TCA chemical peels are referred to as “medium depth peels” this means that it penetrates further into the skin than AHA peels resulting in more striking results. TCA peels remove the upper layers of the skin thereby eliminating superficial wrinkles, spots and pigmentation.

TCA peels are effective on all skin tones however those with darker complexions may need to follow a pre-treatment protocol that treats the skin with AHAs.

TCA peels ultimately are used as a skin resurfacing treatment, like many other peels it removes the dead skin allowing the growth of new skin cells thereby the skin appearing smoother and more vibrant. It is a very popular treatment for diminishing the appearance of acne scars and it can be done on not just the face and neck but other parts of the body too including the back, chest or legs.

If you are considering a TCA peel you probably want to set aside several days to recover; skin irritation, redness and swelling will occur almost immediately after the procedure. Usually the skin will tighten and darken within a few days, followed by cracking and peeling for approximately 4-7 days. The end result is that the skin will look tighter and smoother.

The Jessner Peel

Another form of peel is Coombe’s formula which is also known as the Jessner Peel. It is the most uncomfortable of the peels, and consists of salicylic acid, lactic acid and resorcinol in an ethanol base in a combined concentration of around 14%. Resorcinol is used to treat callouses, warts, acne, psoriasis and other forms of rough, hard or scaly skin.

This type of peel is excellent for targeting concerns such as:

• Mild to severe acne and blackheads
• Skin discolouration/pigmentation issues
• Moderate wrinkling
• Sun damage

Due to the mild acid percentages used in the Jessner peel it does not penetrate the skin as deeply as many other chemical peels.  It breaks down only the outermost layer of the skin so it’s not likely to over peel the skin. But don’t let that make you think it’s an easy option. On application this peel can be very uncomfortable and may feel as if the skin is heating up as the acid is applied.

The Jessner peel encourages the natural peeling to start several days after the chemical treatment. For desired results the it can be repeated every four weeks until the anticipated results are achieved; however, for most patients, only one treatment is required. On the downside, if you opt for this peel it does mean you’re stuck indoor for 8-10 days as your skin sheds. If you do venture outside it’s recommended that you use a sunscreen.

Retinoic Acid Peels

Retinoic acid peels are the ideal treatment for those looking for the deepest level of chemical peeling; this peel penetrates the skin deeper than BHAs and targets skin concerns such as:

• Acne
• Scars
• Wrinkles and pigmentation.
• Lack of collagen production
• Loss of elasticity
• Hyperkeratosis
• Skin aging

The Retinoic acid peel is can be used in combination with the Jessner peel so that the retinoic acid can work at a deeper level. However the main difference with this type of peel is that the doctor leaves the patient with the chemical peel solution on the face. The peeling process itself begins on the third day onward. There are usual problems visible during the first two days.

In order to really see a difference to your skin, you may have to have a series of these peels. It is often recommended to have a three retinoic acid peels done once every three weeks but sometimes more may be needed over time.

The main advantages of this treatment is that there is minimal skin damage but when a retinoic acid peel treatment is over special skin care regimen is required for a period of time. The use of cosmetic products containing retinoids and AHAs are not advised for up to two weeks after treatment. The peel helps to slow down the skin’s ageing process, improves skin texture and remodels its contour, and achieves a pronounced rejuvenating and whitening effect. There is also a strong antioxidant effect.

However, you must remember that even though this procedure is there, it isn’t for everyone. These chemical peels cannot be used in conjunction with radiotherapy, as well as those suffering from severe aspirin allergy and rosacea or are pregnant.

In general any skin peel should be avoided if you have active cold sores or open damaged skin. After care is important too. As skin peels work by removing dead skin cells and encouraging new ones to grow, leading to a fresher, more glowing you, the skin is susceptible to sun damage so a good sunscreen should be worn every day for at least a month after the treatment.

And, as Caroline reminds us, stronger peels should applied be done by trained professionals who have a neutralising solution on hand to deactivate the solution once they can see the skin reacting or if you’re finding it too uncomfortable. Scarring, buring and infection – although rare is a possibility if your in the wrong hands.

The cost – milder peels can between £60-100 and deeper once can cost more than £500 according to the NHS.