Chemical Peels

Medium-Depth Peels Overview

We are all familiar with mechanical exfoliation: using facial scrubs, mitts and facial cleansing brushes to exfoliate the skin.

Proper, regular exfoliation removes the barrier of dead skin cells on the surface of the skin, uncovering the fresh, new cells beneath. This also clears the way for skincare products to penetrate more deeply into the skin, making them more effective.

Chemical peels are also a way of deeply, chemically exfoliating the skin. This is sometimes called chemiexfoliation and it reveals smoother, softer, more even skin.

Chemical peels typically contain acids of varying strengths and types, which remove the dead, dull, outer layers of skin. The depth of the peel depends on the strength and type of acid used.

Deep peels remove the epidermis and the upper dermis. As these are deeper peels, the results are more dramatic and longer lasting.

How do medium-depth chemical peels work?

During medium-depth chemical peels, acids are used to create an intentional, controlled injury to a specific skin depth.

The acid breaks the chemical bonds which hold the skin cells together, causing them to peel off. The acids used in medium-depth peels are able to penetrate the epidermis and a proportion of the dermis.

The aim is to deeply exfoliate the skin which, in turn, stimulates new epidermal and dermal growth, increased collagen production and more evenly distributed melanin. The new skin that grows has improved surface texture and appearance.

Medium -depth peels are usually carried out using trichloroacetic acid (TCA) at concentrations between 35% and 50%. Other acids are sometimes used, including: glycolic, pyruvic and salicylic acid, as well as Jessner’s solution, which is a combination of acids.

Phenol is typically used in deeper peels but may be found in small quantities in medium-depth peels.

Often, higher concentrations are associated with additional risks and complications. For this reason, medium-depth peels should be carried out by an appropriately qualified professional.

Who are medium-depth chemical peels good for?

Medium-depth chemical peels are effective on all skin types and tones. A more aggressive treatment than superficial chemical peels, they are used to improve the appearance of uneven skin, fine lines, acne scarring and sun damaged skin.

Medium-depth chemical peels can be used the face, neck and most places of the body, but are most commonly used on the face and backs of hands.

It’s important to note that the skin on different areas of the body will react differently to the same peel, so a practitioner may advise different peels for different areas.

In general, they are used to:

  • Smooth skin
  • Reduce blemishes
  • Reduce pigmentation
  • Reduce fine lines
  • Improve the appearance of age spots
  • Reduce acne scarring
  • Obviously, the deeper the peel, the more impressive and dramatic the results. But this should be balanced by the risks and side effects of the harsher, deeper peels.

Chemical peels DO NOT reduce pore size or improve saggy, lose skin.

You may not be suitable for a chemical peel if you:

  • have a history of problems with skin scarring, particularly keloid scarring
  • have certain skin pigment issues
  • have facial warts or a facial skin infection
  • have used prescription acne treatments such as isotretinoin
  • clients with darkly pigmented skin may be unsuitable for deeper peels due to the heightened risk of hyperpigmentation
  • extra caution may be required if you have dry skin or conditions like dermatitis and rosacea – your practitioner will advise
  • How do you prepare for a medium-depth chemical peel?
  • 6 weeks prior to your treatment, stop using skin products containing vitamin A derivatives, unless directed by your practitioner.

1-2 weeks prior to your treatment, avoid exfoliating facials, waxing, hair removal creams, laser hair removal, electrolysis and sunbathing/sunbed use.

24 hours prior to your treatment, stop using exfoliating products including those containing alpha and beta hydroxy acids.

What happens during a medium-depth chemical peel treatment?

On arrival at the clinic, your practitioner will complete a detailed personal details and medical history form with you. They will discuss your medical history and clearly highlight the realistic, expected result of the treatment.

Your face is first cleansed thoroughly. It may be degreased with alcohol to maximise the absorption of acid into your skin. The peel is applied to the skin with a soft brush or cotton pads.

It is good practice for your practitioner to offer a free check-up, a few days after your treatment. This allows them to check your progress and recovery. You may be advised to have a course of peels, spaced 10-14 days apart, and to repeat the course every 6 months.

What happens after a medium-depth chemical peel?

It is very important that you carefully follow the advice of your practitioner, following a peel treatment, to help improve the benefit of the procedure and reduce the risk of complications or side effects.

As the chemical peel penetrates deeper layers of skin, you may experience more discomfort and peeling afterwards, compared to a superficial peel.

Do not scratch or pick at your skin as doing this may result in permanent scarring. The peeling skin is a barrier. Your aim is to take care of it, not remove it!

To help avoid infection, follow your practitioner’s advice regarding hygiene, including washing your face gently with a mild cleanser and not wearing make-up.

Ensure you wear a high SPF sunscreen during the course of your treatment and for 4 weeks after. Avoid any direct sun exposure for 6 weeks.

Only use the skincare products advised by your practitioner.

Avoid strenuous activity for 24 hours after your treatment, and avoid saunas, steam rooms and hot showers until your skin is healed.

Do not have any other facial treatments for at least 1 week after the peel.

If, at any point, you experience any unexpected pain or swelling, discolouration, hyperpigmentation, hypopigmentation or infection, consult your practitioner immediately. Please note that prior to the skin peeling away, it may become uniformly darker.

What are the side effects and risks of medium-depth chemical peels?

Your face may swell slightly following a medium-depth peel and your skin may turn dark brown with white streaks. Following this, the skin will peel over 5-7 days, during which time it may be itchy, tight and easily irritated.

Once the skin has peeled, fresh, bright red skin will appear. This will fade to your normal skin tone over 3-6 weeks. Sometimes, skin redness persists for more than 2-3 months, but this also usually disappears in time.

Hyperpigmentation (brown spots on skin) may occur with all peels. To reduce the chance of this, apply high factor sunscreen daily and avoid direct sun exposure for 6 weeks post peel.

Bleaching creams can be used to help minimise the appearance of any hyperpigmentation – these should only be used if prescribed by your practitioner. You should not undertake at-home bleaching without the advice of a medically qualified prescriber.

If you are susceptible to cold sores, you may find you have an outbreak after a chemical peel. To help prevent this, taking a course of antiviral medicine beforehand may be advised by your practitioner.

There is a small chance of developing a localised skin infection following a chemical peel.

Scarring is extremely unlikely with a medium-depth peel if it is done properly, by a medically qualified practitioner, who will advise appropriate before and aftercare ensuring the risk of infection is minimised.