Chemical peeling

What it is

Chemical peeling is an office procedure where a chemical agent is applied to the skin in a controlled fashion, speeding up the exfoliation — the peeling — of the skin. The skin then regenerates from below, and in most people looks smoother and finer afterwards.

What it treats

Chemical peeling may help acne, and the superficial marks and scars caused by acne. It is used in disorders of increased pigmentation such as chloasma and post-inflammatory hyperpigmentation, and may also help fine wrinkles, oily skin and sun-damaged skin.

The agent and the course

The most common peeling agent used is glycolic acid, an alpha-hydroxy acid derived from fruits, so these are often referred to as fruit acids. Peeling needs to be done once every two to four weeks, for four to five sittings. Your doctor will generally start with 20% glycolic acid and gradually increase the strength to 35%, 50% and 70% for later peels. It will be either a full face peel or spot peeling, depending on what is being treated.

Before the peel

Your dermatologist will prescribe creams or lotions for a few weeks beforehand — alpha-hydroxy acids or bleaching agents such as hydroquinone or azelaic acid. This is called priming the skin, and generally gives a better result. Tell your doctor if you have a history of cold sores, an allergy to any medication, or neck or facial surgery in the previous three months. Come without make-up, and bring a hat to avoid sun on the way home.

During and after

The face is cleaned and glycolic acid applied for one to two minutes. You will experience redness, burning and stinging during and after. The area is then cleaned and a mild cortisone cream applied.

Expect redness for 12 to 24 hours and superficial peeling for one to three days. Apply moisturisers liberally and use a broad-spectrum sunscreen. Do not pick or scratch the skin, and do not schedule a peel just before an important social event.

Safety

Chemical peeling is an established procedure, and whether it suits your skin is assessed before treatment. Rarely, secondary infection or a change in skin colour can occur; this is usually reversible with treatment over a few months.

“Never hesitate to clear your doubts with your doctor.” — Dr. D. A. Satish, patient leaflet