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The Ultimate Guide to Peels

Chemical peels are one of the oldest known cosmetic treatments, their history dates back to ancient Egypt when natural fruit acids and milk were applied to purify and nourish the skin.

Nowadays, science has moved on and modern-day peels are highly effective in treating a number of skin issues including pigmentation, ageing skin, blocked pores and acne.

Our team of Save Face accredited practitioners have provided a comprehensive guide to this popular treatment.

About peels

What are peels?

Peel treatment works through the application of specially formulated natural acids to the skin – these have the effect of deeply exfoliating the skin to give a rejuvenated appearance. There are three main types of peel:

  1. Superficial or light peels – these use milder acids, usually alpha hydroxyl acids or AHAs. These include glycolic acid (from sugar cane), citric acid (from citrus fruits), lactic acid (from sour milk), malic acid (from apples) and salicylic acid (from the bark of the willow tree). These penetrate only the outer layer of the skin and the results are significant, but more temporary and can be regularly repeated.
  2. Medium peels – these use trichloroacetic acid or TCA, which is related to vinegar, or glycolic acid. This type of peel reaches the middle and outer layers of the skin to effectively remove damaged cells.
  3. Deep peels – these peels are used to treat more problematic skin issues as they fully penetrate the middle layer of the skin to remove damaged cells. The acids are used in higher concentrations and can include TCA and phenol, they require medical monitoring during treatment and are only administered once.
Before and after peel treatment for skin ageing.

How do peels work?

The alpha hydroxyl acids, or AHAs, exfoliate the upper most layer of the skin allowing healthier cells to come to the fore to improve the texture and feel of the skin.

Salicylic acid also exfoliates the skin, plus it can unblock pores by breaking down oils. It has antibacterial and anti-inflammatory properties, so is particularly appropriate for acne prone skin. It is also suitable for the back and chest areas.

Trichloroacetic acid or TCA, depending on the concentration, has the capacity to penetrate the top five layers of the epidermis to the upper most layer of the dermis. Unlike the more superficial peels, the skin can become dry and tight and may darken before peeling. The peeling usually begins on day 3 and continues for 2 or 3 days. It is suitable for use on darker skin types.

Peels using phenol are the deepest of peels and are usually only performed once. They are used for the face only and are not suitable for darker skin types. Sedatives and anaesthetics are required for this treatment and also heart monitoring is used if the entire face is treated. Dramatic results can be achieved on lines and wrinkles but there is a higher risk of hyper or hypopigmentation (skin darkening or lightening), infection and scarring.

When were acid peels first used?

The resurfacing of the skin with peel treatment was introduced in the second half of the 19th century by the Austrian dermatologist, Ferdinand Ritter von Hebra (1816–1880), who was the founder of the Vienna School of Dermatology. He carefully combined exfoliative agents, such as phenol and nitric acid to treat pigmentation issues and skin irregularities.

Are the peel acids kosher?

Yes, as the acids used are not consumed, they are, strictly speaking, kosher.

What it’s like to have peel treatment

What should I ask before I have peel treatment?

There are a few things you should check before you go ahead with your treatment:

  • Find out the name of your practitioner and look up their qualifications and experience. Ensure that they are accredited by appropriate medical and aesthetic registers.
  • Find out how many treatments they expect you to need for the outcome you want and the cost of the treatments.
  • Ask what they will do to minimise pain or discomfort during the treatment.
  • Ask about any risks or side effects of the treatment.
  • Find out whether you will have a follow-up appointment.
  • Ask what they will do if something goes wrong or if you’re not happy with the results.
  • Ask what aftercare is recommended.
  • If you are in any doubt about the safety of your treatment or the abilities of the practitioner, do not proceed with treatment.

What should I expect to be asked at the consultation?

Your practitioner should ask you for details of your medical history and any medication you are taking. They should discuss the outcome you’re looking for and why you want to have peel treatment, to ensure that it is the right choice for you.

If they don’t believe that peel treatment is right for you, then they should explain why and, if appropriate, discuss alternatives.

What should I expect during treatment?

During a superficial or light peel, your practitioner will use a brush or sponge to apply the solution. The treated skin begins to whiten and there can be a mild stinging sensation, which passes after a few minutes. A wash is then used to remove the solution from the skin.

With a medium peel, your practitioner will use a cotton-tipped applicator or gauze to apply the solution, again the treated skin whitens. A cool compress and, often, a fan are used to soothe the skin. The stinging or burning sensation can last up to 20 minutes.

A deep peel requires intravenous fluids and heart rate monitoring. A cotton-tipped applicator is used to apply the solution, which is done in carefully timed sections to allow monitoring of exposure to the particular chemical solution. The procedure lasts around 90 minutes.

How many peel treatments will I need?

Depending on the particular reason the peel is required along with your desired outcome, your practitioner will recommend which type of peel is best for your specific needs. This will also determine the frequency of treatment. You might, for example, receive an initial treatment of three peels with one month between each. Then be recommended a “maintenance” peel every few months.

How much do peels cost?

Single peel treatments start at £120.

How long should a peel treatment take?

Depending on the particular peel chosen, the treatment can last from 30 to 90 minutes.

How quickly will I see results?

After around 7 to 14 days, you’ll see the formation of healthy, new skin.

How long do the results of a peel last?

A combination of the particular skin issue that you would like to address, and the peel treatment that is chosen will dictate how long results last and the need for any further treatment.

In general terms, results tend to last 3-4 months.

Can I have a peel in conjunction with other treatments?

Your practitioner will recommend the best treatment plan and approach for your specific desired outcome – this will include the order in which treatment should be undertaken if several different procedures are required.

Do peels hurt?

Superficial peels may sting, prickle of feel hot for a few minutes, but are not usually painful.

Medium peels do feel hot, but a cool fan can help to manage this and it only lasts for around 20 minutes.

Deep peels are more painful because of the nature of their more penetrative action. They will require prescribed medication to help manage any pain, both during and after treatment.

Will I be sore after my peel treatment?

After most peels, skin will be red, tight, and slightly irritated for a short period. There are exceptions – for example very light peels can deliver results with virtually no ‘down-time’. Makeup can be worn the following day.

It’s important to follow your practitioner’s advice regarding sun protection, cleansing and moisturising. You should avoid picking, rubbing or scratching your skin. It may take a few weeks before you can see the full results of the peel.

The deeper the peel, the longer the time to full recovery. Over-the-counter pain relief can be used to manage any discomfort. It is usually necessary to avoid makeup for 1-2 weeks after treatment.

What are the side effects of peels?

As with any treatment, there are possible risks with peels, these include:

  • Redness, scabbing and swelling – normal healing from a peel involves redness of the treated skin. After a medium or deep peel, redness might last for a few months.
  • Darkening (hyperpigmentation) or lightening (hypopigmentation) of the skin – this can be permanent and is more common with daker skin.
  • Cold sores can return in patients who’ve had them previously.
  • Scarring or an infection – this is very rare.

Skin will be more sensitive to the sun as it is healing, therefore sunscreen should be used for at least a month after treatment.

Your practitioner will give you advice about how to reduce your risk of getting side effects and complications.

What precautions should I take after having a peel?

Your practitioner will advise you about the best way to care for your skin following treatment. This will include advice about cleansing, moisturising and using any particular soothing ointments. They will also advise about wearing makeup.

With all peels, the new skin is temporarily more sensitive to the sun. Your practitioner will advise about protecting your skin.

Are peel results permanent?

A light peel improves skin texture and tone and lessens the appearance of fine lines. Results are subtle and increase with repeated treatments.

With a medium peel, treated skin will be noticeably smoother for several months.

A deep peel gives dramatic improvement to the look and feel of treated areas.

Over time, age and new sun damage will still lead to new lines and pigmentation changes.

What should I do if I’m not happy with my peel treatment?

So long as you felt that your treatment was administered safely, you should speak to your practitioner if you are at all unhappy with the outcome.

If you weren’t happy with how the original treatment was administered or felt at all unsafe in the clinic, then we would recommend visiting an alternative practitioner to resolve any issues. While this may not be the most cost-effective route, your safety should be your primary concern. Use a register such as Save Face to ensure that you select an accredited practitioner.

What are peels used to treat?

Where on the body can peels be used?

Peels are most commonly used to exfoliate and rejuvenate facial skin, but some peels can also be used to treat the skin on the chest, hands, shoulders and back. Your practitioner will advise you about the best treatment for the area of the skin you would like to improve.

What do chemical peels treat?

Peels can achieve significant improvements in a variety of skin issues and can be used to:

  • Smooth fine lines
  • Rejuvenate and improve skin radiance
  • Improve oily or dry skin conditions
  • Reduce deeper wrinkles
  • Even out skin tone
  • Improve skin texture
  • Reduce acne and acne scarring
  • Lessen sun damage
  • Correct hyperpigmentation
  • Stimulate collagen production
  • Hydrate and brighten

Peels can also help to boost collagen and elastin to improve skin elasticity. Peels are non-invasive and patients often see early improvements such as tighter feeling skin and a brighter complexion.

Can peels help with scarring?

Peels are very effective in improving the appearance of mild scarring – the new skin that replaces the damaged skin cells is usually smoother and less irregular in appearance. Peels are particularly helpful in treating acne scarring.

Before and after peel treatment for acne scarring.

Will people know that I’ve had a peel?

Peels create very natural skin improvements – people may notice you look great, but they won’t realise why!

Having peel treatments in the UK

Who can carry out peels?

There are currently no regulations in the UK controlling who can carry out non-surgical cosmetic treatments such as peels.

We would strongly recommend that you only allow a fully trained and experienced healthcare professional to administer the treatment.

How do I find a safe and experienced practitioner?

Save Face is a national register of accredited practitioners who provide non-surgical cosmetic treatments. The register is accredited by Professional Standards Authority and is recognised by the Government, The Department of Health, NHS England and The Care Quality Commission.

Save Face practitioners have been individually assessed on-site by a Save Face Clinical Assessor, using a stringent set of standards for accreditation.

All Melior Clinics clinics are Save Face accredited. Find out more about Save Face.

How old do I have to be to have a peel?

There are no age restrictions for having a chemical peel. However, a reputable practitioner will not treat anyone who they feel is too young or not suitable for any other reason.

Where peels are used to improve acne scarring for example, it may be appropriate for a patient in their late teens or early twenties to have the treatment, so long as the relevant parental/guardian approvals are obtained.

Safe use of peels

Are peels safe?

All treatments carry a degree of risk. These risks will be discussed with you at your consultation prior to any treatment.

Medical expertise is required to assess skin type and identify any contraindications such as medical conditions or medication. The practitioner will recommend the appropriate peel according to skin condition and type, skin can then be prepared appropriately and the correct aftercare prescribed. This approach minimises risk to ensure good results are achieved, safely.

Can I have a peel if I’m pregnant?

No. You should not have a peel if you are pregnant. The risks are not known and, therefore, no reputable practitioner will treat a pregnant woman.

Can I have a peel if I’m breast feeding?

No. It is not known whether there is any potential risk in having a chemical peel when you are breast feeding, therefore you should not have the treatment.

Can I have a peel if I have an infection?

Treatment is not recommended if you are suffering from any skin infection in or near the treatment area or are unwell in any way (even a cold).

If you have a cold or any other illness, you should tell your practitioner. They can then judge whether treatment will be safe for you.

Can I have a peel if I’m on antibiotics?

If these are for a skin infection in the area to be treated or if they are for an ear, sinus, nose, throat or dental infection, then you are unlikely to be suitable for a peel until the infection has fully cleared up.

If you are on antibiotics for another reason, you should discuss this with your practitioner before your treatment to ascertain if you can go ahead.

Are there any other factors that may prevent me from having a peel?

You should discuss any medical conditions you have and any medication you are taking with your practitioner before the treatment goes ahead.

In some cases, patients with scar formations known as keloids may be advised to seek alternative treatment.

You may not be able to have a peel if you have previously experienced allergic reactions to any ingredients in the peel solution, if you are taking any medications that cause photosensitivity or if you are currently or have recently completed a course of Roacutane (acne treatment) in the last 18 months.

Can you be allergic to a chemical peel?

Yes, it is possible to have an allergic reaction to a peel. If you have any history of allergic reactions, you should discuss this with your practitioner before your treatment.

What are the risks of having a chemical peel?

When peels are administered by someone who is appropriately qualified, trained and experienced the risks of something going wrong are very low. To ensure your safety, you should consider the following:

  • Do not proceed with treatment if you do not feel comfortable with the practitioner.
  • Do not proceed with treatment if you do not fully understand the information you are given.
  • Take the necessary time to make your decisions.
  • Ask the practitioner to show you the product in its unopened package prior to treatment.
  • Make a note of the practitioner’s name and product used for future reference.
  • Ask for copies of before and after photographs for your reference.
  • Do not have treatment in your home, at parties or exhibitions or in environments that are clearly not clean or appropriate.

Can I use a chemical peel solution on myself?

There are a variety of peels available for purchase online of varying strengths and quality. You should be very cautious when using them because misuse of peels risks permanent skin damage, increased and long-term sensitivity, altered pigmentation, infection and scarring.