- Light chemical peels
Light chemical peels are used to improve fine wrinkles, uneven pigmentation and mild sun-damaged skin. The solution used as light chemical peels is usually comprised of hydroxy acids (alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs)) in 20-70% concentration. Chemical peeling must be performed by a professional and in clinic; however there are some mild chemical peeling preparations with lower concentration of chemical peels that are available for public application. The best results from light chemical peeling are obtained with repeated procedure, when peeling is performed 4-5 times in a 2-4 week period and then repeated 4 times a year.
AHAs are derived from fruit, sugar, sour milk, and other natural sources and include Glycolic acid (extracted from sugar cane), Lactic acid (extracted from sour milk), Malic acid (extracted from pears and apples), Citric acid (extracted from oranges and lemons) and Tartaric acid (extracted from grapes). BHAs are organic acids which have a slight structural difference with AHAs. The most well-known BHA is salicylic acid which has been used for decades as an acne remedy. BHAs are helpful because they can exfoliate oily skin and deeply penetrate the skin with no irritation.
Light chemical peel’s side effects are few, including mild flaking or slight irritation, and most of the patients can return to work or everyday activities almost immediately after treatment. Nevertheless, sun protection is an important issue in these patients. Mild chemical peels are effective in different skin types but for darker skins (type IV to VI) more attention and care is needed.
- Medium chemical peels
In medium chemical peeling, Trichloroacetic acid (TCA), with moderate concentrations, is used. Other products (like Jessner’s solution) can also be used along with TCA. Medium chemical peels penetrate deeper into the skin compared to light chemical peels and are used to remove wrinkles, superficial blemishes, acne scars, uneven pigmentation and moderate sun damage. Since these peeling agents have moderate skin penetration, they are better to be used only on facial and neck skin.
After medium chemical peeling, a superficial crust forms over the treated area, then flakes off in three to seven days. The newly revealed skin may initially appear reddish and inflamed, which may even last for 2 months. However, usually after 1-2 weeks the skin gets back its normal appearance and the remaining inflammation can be covered by cosmetic products.
In this method, patients do not typically experience much pain, and any discomfort can be controlled by prescribed medications.
- Deep chemical peels
Deep chemical peels are the strongest facial peels, which can be used to treat coarse facial wrinkles, advanced sun-damage, scarring and pre-cancerous growths.
In deep chemical peeling phenolic solution is used. This method is powerful, thus its results last for years. A deep chemical peeling session usually takes from 60 to 90 minutes; in this session the patient is first sedated and then the solution is applied on each part of the facial skin for about 15 minutes. During the session, the patient’s cardiac condition must be controlled and the process must be stopped if there was any cardiac arrhythmia. After the procedure the patient is advised to have a rest for two weeks; however the skin redness may prolong for up to 3 months.
Phenol’s bleaching effect causes the treated and untreated areas to look different in color, thus it is better to have this procedure only be used for people with skin type I to II. Deep chemical peels are not appropriate for application on non-facial areas; In addition, patients with heart conditions are not suitable candidates for this procedure.