Chemical Peels

Dermatologists, Plastic Surgeons, even some Estheticians and cosmetologists are now proudly advertising various methods to rejuvenate the skin or improve one’s appearance with chemical peels, moisturizers, creams, potions and lotions. There is no question that appropriate use of vitamin A cream or Retin-A®, chronic use of weak acids, such as glycolic acid creams and serial chemical peels can improve the ravages of the sun. These sorts of regimes will improve fine wrinkles and brown or age spots on the face at the risk of some redness, peeling and irritation but little other known risks. Deeper peels can cause scarring and color changes.

No specific peeling agent has been shown to be better than another. The mechanism of action is simply peeling off the skin to varying depths. This seems to stimulate the skin to produce some new collagen which is probably responsible for improvement in some fine wrinkles. Superficial chemical peels when done in a serial fashion can also improve the patient’s appearance and remove age spots, particularly when combined with vitamin A cream (Retin-A® or Renova®) and weak acid-containing creams (glycolic acid, lactic acid, etc.). Vitamin A cream is not a peeling agent but has many powerful effects on the skin.

Medium depth peels can be done with numerous agents, usually a combination of Jessner’s which is lactic acid 14%, salicylic acid 14%, and resorcinol 14% followed by trichloroacetic acid 30- 40%. This usually gives, in experienced hands, a uniform medium depth peel which will improve brown spots and fine wrinkles and minimize some acne scars, but to really produce a dramatic change, a deeper injury is needed, such as a deep peel using phenol or a laser resurfacing procedure.