Principles of Treatment
What is a chemical peel?
A chemical peel causes controlled exfoliation of the epidermis, and sometimes the superficial dermis, to stimulate cell renewal and the synthesis of support fibres (collagen, elastin). Agents used include:
- Fruit acids (AHAs: glycolic acid, lactic acid) for superficial peels;
- Salicylic acid (BHA) for acne-prone or oily skin;
- Trichloroacetic acid (TCA) for medium-depth peels;
- Deeper agents (e.g. phenol) for deep peels, used very selectively.
Types of peels
- Superficial peel: improvement of radiance, skin texture, early fine lines.
- Medium peel: correction of pigmentation, moderate wrinkles, superficial scars.
- Deep peel: more significant action on wrinkles and skin laxity, performed under strict conditions and indications.
Personnalisation
The choice of agent, concentration, and depth is personalised based on skin type (phototype, history), expectations, and medical history. Safety and progressiveness of treatment are the priority.
Session Process
A prior medical consultation is required to:
- Assess the skin, the type of lesion (spots, wrinkles, scars), phototype, and history (treatments, isotretinoin, herpes history, hypertrophic scars).
- Explain options, alternatives, and risks.
- Propose an adapted protocol: prior skin preparation (e.g. emollients, sometimes retinoids or depigmenting agents) if indicated.
Session process
- Duration: generally 15–45 minutes depending on the protocol.
- Skin cleansing, application of the chemical solution, neutralisation if necessary.
- Comfort: mild tingling or warmth is common; comfort measures (cooling, local anaesthesia depending on depth) may be offered.
- Information given before discharge: local care, products to use, signs to watch for.
Standard precautions
- Avoid intense sun exposure before and after the peel.
- Follow post-procedure prescriptions and care recommendations.
Post-treatment Course and Results
Immediate post-treatment effects
- Superficial peels: redness, mild flaking for a few days.
- Medium peels: more marked redness, visible flaking for 3–10 days, possibly superficial crusting.
- Deep peels: longer recovery period and close monitoring required.
Onset and duration of effects
- Improvement in radiance and texture is often visible after the initial flaking.
- The effect on wrinkles and collagen stimulation develops over several weeks.
- Duration of results depends on the type of peel, lifestyle (sun exposure, smoking), and maintenance care.
- Results vary from person to person; caution and personalisation are essential.
Maintenance and combinations
Several sessions may be needed for progressive results. Peels can be combined or alternated with other treatments (hyaluronic acid injections, botulinum toxin, laser) based on the medical assessment.
Contraindications and Precautions
Common contraindications
- Pregnancy and breastfeeding.
- Active skin infection or active herpes on the treated area.
- History of hypertrophic or keloid scars.
- Recent isotretinoin use (generally 6 to 12 months depending on the product and peel depth).
- Known allergy to any component of the solution.
- Heavily pigmented or high-phototype skin: heightened attention to the risk of post-inflammatory hyperpigmentation.
Precautions
- Prepare the skin according to recommendations (products prescribed by the physician).
- Avoid sun exposure and UV cabins before and after treatment.
- Inform the physician of all ongoing treatments (medications, active cosmetics).
Risks and Possible Side Effects
Common and expected adverse effects
- Redness, tingling, flaking, skin sensitisation.
- Transient sun sensitivity.
Less frequent or more serious adverse effects
- Post-inflammatory hyperpigmentation or hypopigmentation.
- Secondary infection or herpes reactivation (prevention possible with antiviral treatment if history is present).
- Scar or permanent alteration of skin texture (rare).
- For deep peels, enhanced medical monitoring and higher risk of systemic complications.
Important note
Risks are explained at the consultation and measures are taken to minimise them. In case of doubt or abnormal signs after the session (persistent pain, oozing, fever, spreading redness), prompt medical consultation is necessary.
Yes. Strict sun protection is essential before and after peeling to reduce the risk of hyperpigmentation. Use of sunscreen and a hat is recommended.