Chemical Peels

Before getting a chemical peel, some patients need to follow a pre-peel skin care plan for 2 to 4 weeks. This plan can improve results and reduce potential side effects. Your dermatologist will tell you whether this is necessary.

On the day of your peel, you will first be prepped for the treatment. This includes cleansing your skin thoroughly. If you will have a deep peel, you will receive general anesthesia, which will put you to sleep. A deep peel must be performed in a surgical setting.

After you are prepped, your dermatologist will apply the peel quickly and evenly. Your dermatologist will watch your skin carefully to remove the peel at just the right time. With a deep peel, the skin is treated one small section at a time. This limits the effects on the heart and lungs.

After the peel comes off, your skin will be treated as needed. Patients who get a medium peel may need cool compresses followed by a lotion or cream to soothe their skin. If you have a deep peel, you will have a wound that requires a surgical dressing.

All peels that a dermatologist performs require some at-home care. The following table shows you what you can expect.

• Refreshing or lunchtime peel
  • Healing time: 1 to 7 days. Skin will be red. After the redness disappears, scaling may develop, which lasts 3 to 7 days. 
  • At-home care: Lotion or cream applied until the skin heals, followed by daily use of sunscreen.
  • When to wear makeup: Usually immediately after the peel, but sometimes the next day. 
  • Follow-up visit: No. However, 3 to 5 peels may be necessary to give you the desired results. These peels may be repeated every 2 to 5 weeks. 

• Medium peel
  • Healing time: 7 to 14 days. Skin will be red and swollen. Swelling worsens for 48 hours. Eyelids may swell. Blisters can form and break open. Skin crusts and peels off in 7 to 14 days. 
  • At-home care: Daily soaks for a specified period. Apply ointment after each soak. Take an antiviral medication for 10 to 14 days. Apply lotion or cream. Total avoidance of the sun until skin heals. 
  • When to wear makeup: After 5 to 7 days, you can wear camouflaging makeup. 
  • Follow-up visit: Yes. Follow-up visit required after the procedure. 

• Deep peel
  • Healing time: 14 to 21 days. Area will be bandaged. 
  • At-home care: 4 to 6 daily soaks while healing. For 14 days, apply ointment after each soak. After 14 days, apply thick moisturizer as directed. Take an antiviral medication for 10 to 14 days. Total sun avoidance for 3 to 6 months. 
  • When to wear makeup: At least 14 days before you can apply makeup. 
  • Follow-up visit: Yes. The next day, the dermatologist will want to see you. Several follow-up visits are required during the first week.

To help their patients get the best results, dermatologists also share these tips:

• Use the moisturizer as directed to keep your skin moist and supple. If your skin dries and cracks, it can scar.
• If your skin burns, itches, or swells, contact your dermatologist. Rubbing or scratching skin treated with a chemical peel can cause an infection.  
• Do not use a tanning bed or other type of indoor tanning. Your skin will not heal properly.
• After your skin heals, apply sunscreen every day. This will help you maintain results.

Once your skin heals, you will see the results. Healing time ranges from 1 day for a refreshing or lunchtime peel to 14 days or longer for a deep peel. To get the results you seek from a refreshing peel or lunchtime peel, you may need to have 3 to 5 peels.

Most results are not permanent because our skin continues to age. If you have lots of sun-damaged skin or precancerous skin growths called AKs, you will likely continue to see new spots and growths on your skin.

In the hands of a doctor who has experience with chemical peels, side effects tend to be mild. Some patients develop:

• Persistent redness that may last for months.
• Temporary darkening of the skin. 
• Lighter skin color (medium and deep peels).
• Scarring (very rare when peel performed by a dermatologist). 

If serious side effects occur, it is often because the patient did not follow the dermatologist’s instructions. Your risk for developing an infection or scarring increase dramatically if you: 

• Fail to protect your skin from the sun. 
• Fail to care for your wound as instructed.
• Scratch the treated skin or pick off a scab.
• Apply makeup before your skin heals.
• Don’t heed your dermatologist’s advice and use a tanning bed or other type of indoor tanning.