Chemical Peels

At UT Southwestern Medical Center, our plastic surgeons and dermatologists are skilled in advanced therapies to improve skin appearance. We offer multiple options for chemical peels, based on the latest research, to help our patients look their best.

What Is a Chemical Peel?

A chemical peel is a cosmetic procedure that can improve the appearance of skin on the face, neck, and hands. A solution applied to the skin causes it to peel off. The new skin that regenerates is smoother, less wrinkled, and often more even in color.

As one of the premier cosmetic surgery clinics and research centers in the country, UT Southwestern leads the way in discovering new applications for chemical peels to attain a natural look. This includes determining options that work best to meet our patient’s needs.

Our specialists have completed extensive training in plastic surgery or dermatology after completing their medical residencies. Both types of physicians have earned board certifications from either the American Board of Plastic Surgery or the American Board of Dermatology.

What Types of Chemical Peels Does UT Southwestern Offer?

Chemical peels are effective options for many patients, but they’re not for everyone. Our skilled plastic surgeons and dermatologists can determine if the results will be successful based on a patient’s skin type, gender, ethnicity, and other factors, as well as their goals.

After an evaluation, our specialists recommend safe, effective options to meet each patient’s goals. This may include combining treatments to achieve the most natural, refreshed look. UT Southwestern offers chemical peels that include:

• Light (superficial): A superficial peel uses alpha hydroxy acid (such as lactic acid) or other mild acids to gently exfoliate the outer layer of skin. Patients can have a light peel as often as every two to five weeks. They often require one to two days of peeling.
• Medium: This peel uses trichloroacetic or glycolic acid to reach the middle layer of skin to remove damaged cells. To maintain results, patients can repeat a medium peel after three to nine months. Many patients peel over three to five days.
• Deep: Using carbolic acid (phenol) or trichloroacetic acid, a deep peel fully penetrates the middle layer to remove damaged skin. Patients can have a deep chemical peel only once a year on a particular area. Most patients require five to seven days to complete the peeling process.

What Can Patients Expect During a Chemical Peel?

Preparation

Before a chemical peel, patients should inform their doctor if they have any history of keloids, recurring cold sores (oral herpes), or unusual scarring tendencies. We can then decide on the depth of the peel based on their skin concerns and treatment goals. Patients often require pretreatment with certain products, such as hydroquinone or tretinoin, prior to their peel.

Our team will tell patients whether they need to:

• Stop taking certain medications before the procedure
• Use special lotions before the procedure to prepare the skin
• Have someone drive them home after the peel

Procedure

We perform chemical peels in our offices.

Light chemical peel:

• The specialist applies a chemical solution that might contain glycolic or salicylic acid. The treated skin will begin to whiten.
• Patients might feel mild stinging while the chemical solution is on the skin.
• The specialist then applies a neutralizing solution or wash to remove the chemical solution.

Medium chemical peel:

• The specialist applies a chemical solution containing trichloroacetic acid, sometimes in combination with glycolic acid. The treated skin will begin to whiten.
• After a few minutes, the specialist applies cool compresses to soothe treated skin. No neutralizing solution is needed.
• Patients might feel stinging and burning for up to 20 minutes.

Deep chemical peel:

• Patients receive intravenous (IV) sedation or an oral analgesic, and their heart rate will be closely monitored.
• The specialist applies phenol or trichloroacetic acid (TCA) to the skin, which begins to turn white or gray.

To limit exposure to phenol, the specialist will do the procedure in 15-minute portions.

Recovery

Each patient’s recovery time and the effects experienced vary depending on the depth of the peel.

Light chemical peel:

• The skin will be dry, red, and mildly irritated.
• Treated areas can take one to two days to peel, and new skin might temporarily be lighter or darker than before treatment.
• Results include improved skin texture and tone and reduced appearance of fine lines.

Medium chemical peel:

• The skin will be red, tight, and swollen, and patients will feel stinging. Over-the-counter pain relievers help reduce discomfort.
• Treated skin typically forms crusts and brown patches, then peels off over several days.
• Treated areas take about three to five days to heal, and redness might last for several weeks.
• Noticeably smoother skin is the main result.

Deep chemical peel:

• The skin will be severely swollen and red, and patients will feel burning.
• Patients typically need dressings, ointment, and prescription pain relievers during the first two weeks.
• New skin begins to develop within two weeks, but cysts or white spots might occur for several weeks. Redness might last several months.
• Treated areas show a dramatic improvement in skin texture and appearance.

Our specialists provide each patient with instructions for skin care during recovery and afterward to maintain results. The main recommendation is to avoid sun exposure and wear sunscreen. Applying a gentle moisturizer can also help soothe and hydrate the skin.

Can Chemical Peels Help Reduce Acne Scars?

Chemical peels are a promising treatment for acne scars, particularly for patients with mild to moderate scarring. Depending on someone’s skin type and the severity of scarring, our physicians may recommend different types of peels.

Light peels can improve minor discoloration and fine lines, while medium-depth peels, which involve glycolic acid or TCA, can address deeper pigmentation issues and more pronounced texture irregularities. Using dermabrasion on specific areas alongside chemical peels can effectively treat medium-depth acne scars.

For those with more significant acne scars, a deep chemical peel could be an effective option, especially solutions that combine phenol and croton oil, known for maximizing collagen production. This intense treatment reaches deeper into the skin, promoting substantial skin cell turnover and collagen production. The potential side effects, such as redness, swelling, and a longer recovery period, make it crucial for patients to follow a dermatologist’s guidance carefully.

Medium and deep phenol peels are not recommended for patients with darker skin types due to a high risk of permanent pigmentary changes.

Are Chemical Peels Good for the Skin?

When a chemical peel is tailored to the patient’s individual needs, it’s safe and effective. However, they also come with potential drawbacks. The deeper the peel, the more significant the changes and potential for side effects. This includes the potential of prolonged healing times and risks of complications such as scarring and changes in skin pigmentation, especially in darker skin tones.

Patients can rely on the expertise of UT Southwestern specialists to help them choose the appropriate type of peel.