Chemical peels can help lessen the appearance of superficial scars on the skin, particularly those caused by acne. Despite their name, most chemical peel treatments in use today don’t really peel the skin. Instead, they exfoliate, or slough off, the top layer of dead cells. In doing so, the treatments not only even out the skin’s tone and texture, but also lift and lighten superficial scars. Peels are not effective, however, on deep “ice-pick” acne scars. Nor do they help with thick, raised hypertrophic scars.
Types of Chemical Peels
Three general categories of peel agents are used to remove acne scars. Light peels are most commonly done with glycolic acid, an alpha hydroxy acid (AHA) derived from sugar cane. Other agents used for light peels include lactic acid (from milk), citric acid (from oranges and lemons), malic acid (from pears and apples), and tartaric acid (from grapes).
Medium peels-ones that penetrate the skin a bit more-are usually done with trichloroacetic acid (TCA). These peels produce a second-degree burn-similar to a severe sunburn. Like sunburns, these peels can cause temporary swelling and blistering. Most people take a week off before returning to their regular activities.
Deep peels are usually done with a chemical called phenol. Although the effects of this treatment can be dramatic, recovery is long-sometimes up to 2 months. Phenol peels also carry the risk of bleaching the skin, particularly when used on darker skin tones. For these reasons-and because newer laser therapies can produce many of the same results with fewer risks and a shorter downtime-phenol peels are rarely used anymore.
Who’s a Good Candidate for Chemical Peels?
Light and medium chemical peels can help almost anyone reduce the appearance of superficial scars. But some people may not be good candidates for these treatments. If you intend to keep tanning, chemical peels are not for you.
Also, be sure to tell your doctor if you have a history of cold sores or if you have taken any acne medications during the past year. A cold sore outbreak during the chemical peel healing process could result in severe scarring. Taking an anti-viral medication before the treatment can significantly reduce this risk. People who have used Accutane (isotretinoin) within the previous 12 months are also at increased risk of scarring from a chemical peel. Your doctor will discuss all these issues with you at your consultation.