Chemical peels — the application of chemical agents to the skin to produce controlled exfoliation and regenerative wounding of the epidermis and/or dermis — are among the oldest and best-evidenced cosmetic procedures available. Their clinical applications span acne management, hyperpigmentation, photodamage reversal, acne scarring, and skin texture improvement, with outcome quality directly proportional to peel depth — and depth directly proportional to both efficacy and recovery time and risk. Selecting the appropriate peel for a specific indication and skin type requires understanding the peel classification system, individual skin characteristics, and realistic expectations for results and recovery.
Superficial Peels: Entry-Level Efficacy
Superficial peels — penetrating only to the epidermis — include: glycolic acid (alpha-hydroxy acid, AHA) 20–70%, salicylic acid (beta-hydroxy acid, BHA) 20–30%, lactic acid 30–50%, and Jessner's solution (combination resorcinol, lactic acid, salicylic acid). Recovery: 0–3 days of mild redness and flaking. Clinical results: gradual improvement in skin texture, mild hyperpigmentation reduction, and acne lesion frequency — typically requiring a series of 4–6 peels at 2–4 week intervals for meaningful visible results. Salicylic acid peels have comedolytic and anti-inflammatory properties making them particularly well-suited for acne-prone skin; glycolic acid peels have the most extensive evidence for photodamage and overall skin texture. Both are safe for Fitzpatrick skin types I–IV with appropriate concentration selection; care is required in types V–VI due to post-inflammatory hyperpigmentation risk.
Medium-Depth Peels: The TCA Standard
Trichloroacetic acid (TCA) 15–35% (superficial-medium) and 35–50% (medium depth) penetrates to the papillary dermis, producing "frosting" (protein denaturation) that guides depth of penetration. Recovery: 7–10 days of significant flaking and redness. Clinical results: measurable fine line reduction, more significant hyperpigmentation correction, and improved skin texture versus superficial peels, with results typically maintained for 6–18+ months. The Jessner's/TCA 35% combination (Obagi Modified TCA Peel) provides more uniform penetration than TCA alone. TCA peels are appropriate for Fitzpatrick types I–III; modified protocols and lower concentrations can be considered for types IV–V with careful monitoring. Fitzpatrick type VI skin requires specialist expertise for any TCA work.
Skincare Before and After Peels
Pretreatment: 4–6 weeks of tretinoin priming accelerates healing by normalizing cell turnover before the peel; hydroquinone 4% in darker skin types reduces post-inflammatory hyperpigmentation risk; daily SPF 50 is mandatory. Post-peel care: petrolatum-based emollient (plain Vaseline) 2–3× daily until peeling complete; absolute sun avoidance during healing; SPF 50 starting 3 days post-peel. Proper wound care protocols and skin care supplies are essential for optimal peel outcomes; our skin care catalog and wound care products provide clinical-grade emollients and post-procedure skin support.
