One of the most effective skin care modalities at our disposal is the chemical peel. Professional and at home chemical peel formulations continue to improve; their increased safety and efficacy help provide consistent results when applied correctly. Here is a quick overview of how to use this modality successfully.
The challenge to providing measurable results for your client is choosing the correct chemical peel for their skin type and condition(s), while achieving marked improvement in the skin. Sometimes the reality of what can be improved and what the client is focusing on are in conflict. An example of this would be a client with sensitive skin who is focused on addressing their hyperpigmentation or melasma. Do you treat the sensitivity first then work on hyperpigmentation? The client may want to see results right away, but being too aggressive without first addressing skin type and conditions can lead you down a dangerous path.
Understanding how to correctly choose the right peel for each skin type is essential to becoming an expert in the application of chemical peels.
ANALYZE THE SKIN
The first and most important step in a chemical peel process is assessing your client. Analyzing the client’s skin is critical to a successful treatment. Here are six basic issues to address:
- Identify the client’s correct skin type.
- Identify the client’s current skin conditions. Conditions could be dehydration, sun damage, lost elasticity, acneic lesions, open sores, etc.
- Identify the client’s response to UV exposure; Fitzpatrick type is the most commonly accepted classification.
- Identify the client’s healing response time. Many estheticians use the Lancer Ethnicity Scale or Roberts Skin Type Classification System. Ask the client about their recent healing response: Do they scar easily? Does the scar discolor and stay that way or does it fade in six months, a year, longer? Do they form keloid scars?
- Identify the client’s sensitivity level. Are they currently experiencing environmental allergies? Do they react to cosmetic products? Have they been diagnosed with rosacea?
- Identify the client’s concerns. What improvement(s) do they want to see? What is most important to them?
PERFORM A PROPER PEEL
Any time you bring in a new chemical treatment it is important you get training by the manufacturer, even if you are a veteran esthetician with many hours of practice. Each formulation is different and can have different protocols. For liability reasons, you need to provide documentation that you have been trained in the safe use of that formulation. Here are some basic steps to performing a safe and effective chemical peel technique:
- Cleanse the skin with a basic cleanser, using a cleansing massage to relax the client, as well as emulsify and remove any makeup.
- Cleanse further with a deep cleansing gel formulated for oily skin. This starts the degreasing process.
- Cover the eyes with eye pads to protect them from drips, spills, and fumes; if you are working close to the eye area, eye pads or tanning goggles are very helpful.
- Use a degreasing or pre-peel prepping solution to further degrease the skin. Most product lines have formulas that work with their peels. Apply with non-woven gauze or esthetic wipes, starting at the forehead and working to the jawline.
- Blot the skin with a tissue or towel; make sure all areas are dry.
- Apply the chemical peel with a cotton tipped applicator or small fan brush designed for acid application according to the manufacturer’s instructions.
- Check in with your client to be sure they’re feeling OK and keep a close eye on the skin for any signs of trauma or stress. Use a fan to reduce any discomfort.
- Remove the peel according to the protocol. Most AHA peels are neutralized with tepid to cold water, while some can be neutralized with an alkaline solution provided by manufacturers. Other peels simply self-neutralize when they are no longer able to penetrate, such as TCAs and Jessner’s. Depending on the peel, apply a soothing mask afterward to encourage healing. Leave on up to 10 minutes; remove with a cool towel.
- Apply a serum with a blend of growth factors designed to aid healing, such as stem cell extracts and hyaluronic acid. A cold jade roller or other cold device can be used over the application to soothe the skin.
- Apply a moisturizer formulated for post-peel skin and a physical SPF.
THE FINAL TOUCH
Send your client home with clear post-care directions, including explicit instructions on what to avoid, such as direct sunlight, tanning beds, sweating, and heating up the skin. Let them know if they should expect the skin to peel (and for how long!). Also include a copy of their consent form, and information on how to contact you if there are any problems.
Chemical peels are the mainstay of an esthetician’s practice. When performed correctly, improvement can be seen after the first peel, with continued improvement coming after multiple treatments are performed no closer than 14 days apart.
Guidelines for Chemical Peeling:
|Skincare Goals / Intended Outcome||Best Types of Peels||Best for:|
|Brightening, hydrating, texture improvement||AHA light/superficial peel (lactic, mandelic, glycolic acid peels less than 30 percent, formulation designed for sensitive skin no lower than 1.5 pH); enzyme peels||Skin type: Dry, dehydrated, and combination skin |
UV response: Fitzgerald 1, 4–6 Healing response: Scars easily, heals slowly
Sensitivity: Reactive skin, rosacea 1–2 (not in active symptom flare), active environmental allergies (e.g., hay fever). Mild or no prepping of skin
Conditions: First-time chemical peel
|Acne and comedone reduction, oily skin texture improvement||BHA (salicylic acid) superficial peel; formulation designed for oily, acneic skin; Jessner’s peel (1–2 layers)||Skin type: Oily, combination skin |
UV response: All Fitzgerald types (4–6 requires longer pretreatment and post-care management)
Healing response: Heals easily, post-inflammatory hyperpigmentation (PIH) is transient
Sensitivity: Nonreactive skin
Conditions: Comedones, acne grades 1–2, hyperkeratinized skin
|Fine-line reduction, pigmentation improvement, increased hydration, improved texture and tone||Glycolic acid peel up to 50 percent, lactic acid, Jessner’s peel up to four layers; formulations designed for sun damage, wrinkles, and poor texture; vitamin A||Skin type: Dry, combination, oily skin |
UV response: Fitzgerald types 1–4 (5–6 requires pretreatment and a reaction test to be safe)
Healing response: Heals easily, transient post-inflammatory pigmentation, no keloids
Sensitivity: Nonreactive skin
Conditions: Dehydrated (lactic recommended), hyperpigmentation, hyperkeratinized, fine lines, loss of elasticity