Everything To Know About Medical-Grade Chemical Peels Before You Get One
From the types available to what you should be asking your physician beforehand
By now, we're well aware of the glorious glow-inducing, skin-improving effects of exfoliating skin care acids such as AHAs and BHAs, which we've welcomed into our at-home routines with open arms. But what about their big (acid) sister: the physician-administered medical-grade chemical peel?
Chemical peels can definitely seem intimidating, especially for those of us with more sensitive complexions. Throw in the term "medical," and, well, they can sound flat-out terrifying—we get it. However, we're here to vanquish that stigma.
There are multiple levels of treatments that exist when it comes to chemical peels, and when administered by a professional, even those with the most sensitive of skin can experience their remarkably radiant, damage-reversing results. And now that spring is here? Well, we could all afford to lose some of that leftover winter roughness.
We caught up with Gabrielle Garritano, PA-C and founder-CEO of medical skin-care clinic JECT NYC, to get the scoop behind all things chemical peels and the acids involved: What to know, what to expect, and how to ensure your face is in the right hands.
What is a medical-grade chemical peel?
As Garritano explains, chemical peels are "the controlled removal of the uppermost layers of skin by exfoliation" by means of various acids. When it's medical-grade, it's of the much stronger variety, and can only be administered by a licensed professional, which can be a physician or an aesthetician, depending on the intensity.
While, yes, it's called a peel, it doesn't necessarily mean your whole face is going to peel off in sheets (though, it can). It also doesn't mean your entire face is going to (temporarily) end up a red, irritated disaster à la Samantha in Sex and the City—though, again, it (temporarily) can.
While a treatment typically takes about 15 minutes to perform, depending on the intensity of the treatment you get, you can experience downtime effects of up to two weeks post-peel.
How could a peel benefit your complexion?
There are a number of reasons why someone may choose to get a chemical peel. According to Garritano, they have been clinically proven to: help treat acne, minimize the appearance of pores, diminish the appearance of unwanted pigmentation issues such as sun damage and age spots, diminish the appearance of fine lines and wrinkles, improve persistent skin redness, as well as provide an immediate boost to skin's clarity, radiance, brightness, tone, and texture. They can also provide a number of preventative benefits, like improving cell turnover rates, preventing future breakouts, and enhancing the penetration (and, thus, results) of active ingredients applied along with the peel.
With that said, not all peels do the same things. There are different levels of treatments, explained in-depth below, differentiated by the specific acids used and their strength, as well as other complementary ingredients.
What kinds of peels exist?
There are a number of medical-grade peels out there which range in level of intensity. Garritano categorizes them by three types:
Very superficial: This type of treatment typically involves mandelic acid and lower strength salicylic and glycolic acids. It is ideal for someone totally new to peels, or someone who deals with sensitive skin, facial redness, or light skin discoloration, as these affect only the outmost layers of the skin. In terms of downtime, a seasoned peel-er or someone with normal or resilient skin will notice skin clarity and increased glow without much redness at all. However, newbies and those with more sensitive skin will often experience a bit of redness and flaking post-treatment.
Superficial: Superficial peels involve salicylic acid, resorcinol, and lactic acid, and extend deeper throughout the epidermis, or the top layers of the skin. As this peel works deeper than the previous, they can address skin texture, blemish concerns, superficial pigmentation, as well as fine lines and wrinkles. This also means that they're a bit more intense, resulting in visible redness and flaking on the surface of the skin, as well as sensitivity, for the first few days. Most patients will experience peak results on day seven, while some may not experience peeling or redness at all.
For very superficial and superficial peels, you can expect your skin to feel a little dry and tight for 24 hours post-peel, and maybe be a bit tender or pink. Light flaking to full-on peeling (depending on the intensity and how much excess dead skin you have) typically begins on the second day and can last until the fifth. Within a week, your skin should return to normal with noticeable improvements.
Medium depth: Medium depth peels extend beyond the epidermis, penetrating the lower layer of the skin, or the papillary dermis, through TCA, or trichloroacetic acid. If you're looking for dramatic results, this is the peel for you—but do expect more serious downtime, including increased sensitivity, redness, darkened patches, rough texture, plenty of peeling, and even mild swelling—which can begin as early as the second day and last up to two weeks. "Your skin will look worse before it looks better," says Garritano, but you can expect the most dramatic improvements for skin issues involving age spots and sun damage, acne scars, and deeper lines and wrinkles.
What about at-home peels?
While there are plenty of at-home peels on the market today, they are not as effective as medical-grade treatments performed by professionals—though, these still have noticeable benefits, and can be a great way to prep your skin for a more intense treatment. "At-home peels are formulated to stay on the very most outer layers of the skin," says Garritano. "A home peel is a great way to give your home care regimen a little boost, make home care easier if you are not good at daily skin care, prep the skin for a medical peel, or provide instant radiance to the skin. However, if you're looking to address a skin concern, you need a chemical peel powerful enough to penetrate to the lower layers of the skin."
What if your skin is sensitive?
As explained above, just because your skin is sensitive doesn't mean you need to shy away from a chemical peel. Garritano suggests easing your way into it by beginning chemical exfoliation with gentler at-home products, such as a glycolic cleanser or pads. "When patients are able to tolerate this, they can upgrade to a very superficial peel, such as mandelic acid peel, low strength glycolic, or low strength salicylic acid." She highly recommends a mandelic peel for those with sensitivities, as it was specifically developed for those with sensitive and redness-prone skin.
However, pre-treating the skin with an at-home glycolic acid product doesn't need to just be reserved for sensitive skin types. Garritano explains that, because it lowers and balances the pH of the skin, it helps deliver a more even and efficacious peel result for all chemical peels.
How often should you get a peel?
Very superficial to superficial peels can be performed every two to three weeks, while more aggressive treatments can be performed every one to two months. However, how often you should get a peel totally depends on your unique skin type. "There is no one size fits all solution, as it will depend on the skin condition you are trying to correct, the depth of the damage, and your tolerability," says Garritano. "Talking with your medical professional about your goals and your timing desires will help create a customized recommendation of specific peel and timing that can help achieve your skin care goals."
Once you've reached the desired results you were hoping to get out of your peels, Garritano suggests going back for maintenance peels every month, every other month, or every quarter.
Chemical peels aren't just for your face
That's right—you can experience the benefits of a chemical peel on other areas of the body. Glytone, the professional brand used at JECT NYC, creates medical-grade peels for the neck, chest, eyelids, hands, and back, as well.
What should you look for in a clinic or physician?
Possibly the most important thing to keep in mind when considering a chemical peel is making sure you go to a physician you can trust. Chances are, you may have heard a horror story or two about someone who got a peel and ended up with some not-so-great results, beyond the expected one- to two-week long recovery time. So, how do you know where, and who, is best to turn to?
Garritano feels that a successful peel really depends on the relationship between you and the potential practitioner—and being sure you ask all of the questions. "Because everyone's skin is different, and there are many peels out there, it's important to make sure your provider is choosing a treatment specifically for you," she says. "Find a provider who is ready to go on that journey with you." Garritano suggests asking them these 15—yes, 15—questions before deciding to go through with any treatment:
- What type of peel do you recommend for me?
- Why am I a good candidate for that peel?
- What are the side effects I might experience?
- How long will the side effects last?
- What will I look like right after the peel?
- What ingredients are in the peel?
- What products should I use to prep the skin before the peel?
- Are there any products I should stop using before my peel?
- What products should I use immediately after the peel?
- What results can I expect from my peel?
- Will one peel be enough, or will I need more?
- How much experience do you have performing this peel?
- Are you licensed by the state to perform this peel?
- Is this a medical-grade or esthetician-grade peel?
- What are your recommendations for maintaining the results?
Comfortable with the answers? Consider yourself ready to peel!