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Chemical peels have been used by dermatologists for over a hundred years to treat various skin complaints. The goal of chemical peeling, or chemoexfoliation, is to destroy the superficial layers of the skin in a controlled manner in order to stimulate regeneration of skin cells. If the peel is strong enough, repair of damaged cells in the deeper layer of the skin may take place, resulting in greater cosmetic improvement.
There are numerous types of chemical peels available, ranging from superficial, medium depth to deep. Most agents used are weak to moderately potent acids, such as alpha-hydroxy or trichloroacetic acid. Only qualified practitioners, such as dermatologists, are allowed to apply medium depth and deep peels, as the risks are greater.
In general, the deeper the peel, the more noticeable the improvement, but the risks, discomfort and recovery time are also greater. Superficial peels will give almost instantaneous improvement in the appearance of the skin, as dull dead skin cells are removed, but the benefits will be short-lived as dead skin cells will soon build up again. Medium and deep peels can address a wider variety of problems, such as brown pigmentation, acne and mild scarring and different types of sun damage including wrinkles.
Depending on the type of peel used, the patient may experience stinging or burning upon application. Shedding of the skin may take place and can persist for days, again, depending on the strength of acid applied. The best candidates for chemical peels are fair-skinned individuals, those with darker skin may have a slightly higher risk of discolouration. Other risks include persistent redness, infection and very rarely scarring.
This depends on the depth of the peel. The benefits of a superficial peel are almost immediate, but the duration of benefit is short. With the medium depth peels, some shedding and redness can be expected but usually subsides after several days, when the benefits then become apparent.
It is vital that patients who under go a chemical peel use adequate UVA/UVB sunprotection after the procedure. By stripping the dead skin cell layer, the skin’s barrier function is compromised which will make it more susceptible to sun-induced damage. By continuing to use photoprotection, the benefits of the peel may last longer. A patient may be advised to prepare the skin by using a skin-care regimen for several weeks before the peel in order to maximise its effectiveness.