Chemical peeling involves the placement of a chemical exfoliative on the skin surface to treat facial wrinkles, abnormal skin growths or abnormal skin pigmentation. The chemicals used are acids such as phenol, salicylic acid, alpha hydroxy acids,… Some acids are inherently stronger than others & some come in a variety of concentrations (from 10% to 50% or more). All destroy the outermost layer of skin with deeper destruction (peel depth) dependent on type of acid & its concentration. As with lasers & other treatments that damage the outer skin layer alterations in skin pigmentation can arise (especially in darker skinned individuals) or scarring. Prior to the mid 1990s chemical peeling was much more popular. Since then laser and radiofrequency treatments have replaced most of the chemical peels but it is still a valid procedure given the right peel in the right patient.
Very superficial peeling solutions are present in some currently available over the counter cosmetics. These require consistent use over prolonged periods of time in order to have any visible effect. They also have virtually no down time with virtually no chance of complications thus they can be used without physician supervision. The visible effect however is much less than can be attained with a deeper peel.
Different chemicals can preferentially affect different skin elements so the type of chemical applied depends on the desired effect.
Deeper peels should only be performed by qualified physicians as the deeper the peel the greater the potential for scarring & pigmentation changes. Some sedation/anesthesia is required for deeper peels. For the deeper peels the recovery time is about the same as for laser-10 to 21 days before make up can be worn. Depending on the type of chemical and whether it is neutralized shortly after application the outermost layer can turn black and then peel away over the course of a week revealing smooth soft new skin.