Q&A: Side Effects of Chemical Peels

Q: I have never had a chemical peel and would like to try one, but I am afraid of the thought of acid on my face.

A: Chemical peels can improve and smooth the texture of facial skin by removing damaged outer layers and can be helpful in treating facial blemishes, wrinkles, and uneven pigmentation.  

Your concern about having acid on your face is sensible. While peels offer a far less invasive option to smoother skin than plastic surgery, they are not without some side effects – mostly minor – and a few serious risks. Adverse reactions are rare and include numbness, scarring, and infection. And after any peel, you need to be diligent about using sunscreen to protect the new layers of skin.

The mildest form of chemical peel uses alpha hydroxy acid (AHA) and improves the texture of rough or sun-damaged skin. These mild acids remove only the outermost layers of the skin and can be useful in treating acne. The most likely side effects with these treatments are a temporary stinging sensation and mild irritation or redness that usually subside quickly.

Medium-strength peels use trichloroacetic acid (TCA) to smooth fine surface wrinkles and treat superficial blemishes and pigment problems. A medium peel is the preferred treatment for darker skin. TCA may produce unintended color changes in the skin and involve significant redness and some crusting or peeling for several weeks. 

Stronger chemical peels use phenol acid and generally take more recovery time. Peeling and crusting can be more pronounced. Deep chemical peels are recommended for coarse wrinkles; severely blotchy, sun-damaged skin; and precancerous growths. They can cause permanent darkening or lightening of the skin, so they are not recommended for darker skin tones. Deep peels can pose a pronounced risk for those with a family history of heart disease and usually involve anesthesia, which may have complications.

The vast majority of those who have chemical peels suffer no serious side effects. So, putting first things first – including your fears – you need to be clear about the effect that you are looking for. Then, work with your dermatologist to learn everything you can about the best peel for you and what to expect afterward. Finally, assess your “fear level” from an informed viewpoint to make the best decision for you.

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