Chemical peels use acid to dissolve the uppermost layers of skin, revealing fresher cells below, making the skin appear younger. In general, the higher the concentration of acid in a chemical peel, the deeper into the skin the acid goes. In addition, the higher the concentration of acid, the greater is your risk of experiencing an unwanted side effect.
Redness, Swelling and Itching
Redness, swelling and itching are the most common side effects of a chemical peel. This effect, which looks and feels like a sunburn, can occur regardless of the type of peel given.
Chemical peels generally range from over-the-counter (OTC) home peels to those performed under anesthesia in a medical facility. Although the OTC peels contain very low concentrations of the acid--generally 3 percent to 10 percent of an alpha-hydroxy acid (AHA) such as glycolic acid--those with sensitive skin, or who use the peel too often, can experience these side effects.
Estheticians and physicians offer a variety of AHA peels with higher concentrations of acid than those found in the OTC brands. According to Chemical Peel, these peels contain concentrations of at least 30 percent of the active acid. Because AHA's and beta hydroxyl acid peels usually affect only the outermost layers of skin, and therefore do not structurally alter the skin, these side effects do not last long.
Hyperpigmentation, Cracking and Peeling
Trichloroacetic acid, called TCA, is a common ingredient found in peels that are meant to dissolve sub-surface cells. TCA, usually applied by a physician, helps to correct more noticeable wrinkles and uneven pigmentation. Side effects of this more intense acid include hypopigmentation (loss of skin color), hyperpigmentation (darkening of the skin), cracking and peeling.
Generally, skin will start to darken beginning on the third or fourth day after treatment. As it darkens, skin dries out, cracks and then begins to peel, revealing fresher looking skin beneath. This process can last from 4 to 7 days and can cause irritation. Infection is a possible secondary side effect of the cracking and peeling process.
Infection and Scarring
Infection and scarring can occur with any chemical peel, regardless of whether the peel is meant to treat only the superficial layer of skin or whether it will penetrate more deeply into the epidermis. Because the protective, outer layer of skin dissolves during the peeling process, skin is vulnerable during this process and can more easily become infected. Proper post-peel care can greatly lessen the chance of infection and scarring.
Dr. Eric Bernstein of The Patient's Guide stresses that phenol, the most common ingredient in deep peels, should be used only on very deep wrinkles and hyperpigmented skin. Improper use of phenol can permanently scar the patient. Even under the best of circumstances, Dr. Bernstein notes, patients can expect weeks of downtime after one of these treatments because the acid fully dissolves the uppermost layers of the epidermis.
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