Why women get confused about chemical peels
The peel market in Israel is saturated. Every clinic offers something called a "peel," every pharmacy sells acids for home use, and every Instagram feed shows women with flaking faces in flattering light. The vocabulary is one. The results, the risks, and the depth of action are entirely different.
When a new client sits across from me and says "I had a peel a month ago at another clinic," I ask her four questions. Which acid. At what concentration. How long it was left on the skin. And what the state of your skin barrier was that day. In most cases she cannot answer a single one of them. That is not her fault. Nobody explained.
That is what this article is. Not a treatment. Not a protocol. A map. So that you know to ask the right questions, understand what you are getting, and recognize when something is wrong. And there is one question that decides everything that follows, and I will get to it in the middle.
Five peel levels, from the most superficial to the deepest
The accepted medical classification divides peels by the depth of penetration into the layers of the skin. The layers themselves are anatomy, not opinion. Epidermis on the outside, dermis on the inside, and several intermediate strata between them. Each level of peel reaches a different depth, and that is what determines the risk, the recovery, and the result.
Level 1: action on the stratum corneum only (Very Superficial)
This is the lightest level. Action only on the upper layer of dead cells. Lactic acid serums at 5 to 10 percent, mandelic acid 5 to 10 percent, or papaya and papain enzymes. The sensation: a gentle tingle, sometimes nothing at all. The recovery: minutes to hours. There is no real redness, no visible flaking.
When this is the right treatment: sensitive skin that needs gentle stimulation, a new client who has never been exposed to acids, the "peel before an event" I do 5 days before the event to bring radiance back at low risk.
What it will not do: it will not shift pigmentation, it will not soften wrinkles, it will not resolve acne. If someone promised you that it would shift dark spots, she sold you an illusion.
Level 2: superficial peel (Superficial)
The most common peel in clinics in Israel. Glycolic acid 20 to 30 percent, mandelic acid 20 percent, lactic acid 15 to 20 percent. The action: the upper cell layer (stratum corneum) and down to the upper part of the epidermis.
The recovery: redness for 24 hours, mild dryness for 3 days, minimal and sometimes invisible flaking. You leave the clinic with a pink face and a soothing mask, and the next day you can go back to work.
When this is the right treatment: texture improvement, slight unevenness of color, a tired tone after summer, the beginning of a series for soft pigmentation, maintenance after a deeper treatment.
What it will not do: it will not address acne scarring, it will not shift deep melasma, it will not close prominent pores. A revolutionary result from a single treatment? It does not exist. A series of 4 to 6 treatments? Yes, meaningful improvement.
Level 3: superficial-medium peel (Medium-Superficial)
This is where the real clinical work begins. Glycolic acid 50 to 70 percent (with controlled contact time), mandelic acid 40 percent, salicylic acid 20 to 30 percent, or combinations such as the Jessner peel (salicylic + lactic + resorcinol). The action: to the middle of the epidermis, and sometimes to the boundary between the epidermis and the dermis.
The recovery: redness for 2 to 3 days, visible flaking that starts on the third day and continues for 5 to 7 days. Never pull the flaking off by force. You carry on with your routine but you do not go out to events in the first week.
When this is the right treatment: stubborn surface pigmentation, acne with clogged pores, coarse texture, fine surface lines that insist on staying, very shallow acne scarring.
What it will not do: it will not give the result of a true medium peel. If a dramatic change is required, you have to go up to the next level.
Level 4: medium peel (Medium)
The level I respect the most, because it demands real experience. TCA 15 to 25 percent, or TCA 10 percent combined with glycolic acid as a combination peel. The action: through the epidermis in full, and down to the upper part of the papillary dermis.
The recovery: redness for 5 to 7 days, significant flaking from the second or third day that continues up to 10 days. You barely leave the house in the first week. SPF 50 constantly. Do not scratch. Do not wear makeup. Do not heat the face.
When this is the right treatment: shallow to moderate acne scarring, resistant pigmentation that did not respond to a series of superficial peels, moderate wrinkles, multiple solar spots (Solar Lentigines). This is the peel that genuinely works, and not only "refreshes."
What it will not do: it will not shift deep wrinkles that require filler or injections. It will not replace RF microneedling for deep scarring. A client who expects a medium peel to replace every other treatment will be disappointed.
Level 5: deep peel (Deep)
The most aggressive level. TCA 35 percent and above, or phenol (Phenol-Croton Oil). The action: down to the depth of the reticular dermis. The recovery: two to three weeks of intense redness, aggressive flaking, residual redness lasting months. Revolutionary results, but also a risk of scarring, reactive pigmentation, and in the case of phenol even systemic effects on the heart and kidneys.
This is not a treatment I do at my clinic. A deep peel is a treatment that should be performed under medical supervision, in most countries by a dermatologist only, and sometimes under anesthesia. A client who comes to me and asks to "make wrinkles disappear in one treatment" is someone I refer to a specialist physician. And I tell her honestly that in 2026 most dermatologists in the Western world no longer do phenol, because the alternatives (CO2 fractional laser, combined RF microneedling) deliver 80 percent of the result at 20 percent of the risk.
The three acid families, and how different they really are
Beneath the 5 levels there are 3 chemical families. They are not interchangeable. Each one does something different at the molecular level.
AHA, alpha hydroxy acids
Alpha hydroxy acids are water-soluble acids. They act on the outer cell layer of the epidermis, break down the bonds between the corneocytes, and speed up cell turnover. The members of the family: glycolic (from sugar cane), lactic (from milk), mandelic (from bitter almonds), tartaric (from grapes), malic (from apples), citric (from citrus).
The difference between the members is mainly the size of the molecule. Glycolic is the smallest molecule in the family, and it penetrates fast and deep. Mandelic is the largest, and it penetrates slowly and gently. That means mandelic 40 percent may be less aggressive than glycolic 20 percent, and that changes the calculation.
AHA suits mainly: uneven tone, the appearance of surface spots, texture improvement, fine surface lines, overall radiance. AHA is the first acid in most of the series I run. Which member of the family I choose depends on the skin: for Fitzpatrick 4 and above with a tendency toward melasma, mandelic. For more resilient skin, glycolic.
BHA, beta hydroxy acids
The only member of this family in use is salicylic acid (Salicylic Acid). Unlike the water-soluble AHAs, BHA is oil-soluble. That changes everything. Salicylic does not stay on the surface of the skin: it penetrates into the pores, which hold oily sebum, and breaks down the buildup from within.
BHA suits mainly: skin prone to active breakouts, clogged pores, oily skin with blackheads, post-breakout marks, and superficial darkening after breakouts. Salicylic also shows soothing properties, which is a contribution for skin prone to inflammation.
Salicylic is an excellent choice for oily skin, for adolescence, and for age 30+ with hormonal acne. At a concentration of 20 to 30 percent it becomes a level 3 peel, and at 2 percent it is an everyday ingredient in home serums.
TCA, trichloroacetic acid
The only family that works at levels 4 and 5, and that is no accident. TCA belongs neither to the AHAs nor to the BHAs. It is a chlorinated acid that creates coagulation (Coagulation) of the skin proteins, detaches the epidermal layer in its entirety, and obliges the skin to build it again from scratch.
This is not a treatment that refreshes. This is a treatment that renovates. The new collagen formed after TCA is of higher quality, better organized, and more durable than the collagen it replaced. The difference in how the skin looks 8 weeks after TCA 20 percent is not subtle. It is visible to everyone.
TCA suits mainly: post-breakout scarring, the appearance of deeper spots, moderate wrinkles, accumulated sun marks, skin with scattered solar spots. This is not a peel you start with. Most of my clients reach TCA after a series of AHA or BHA peels that prepared the skin.
The acid is not the decision. The level is not the decision. The state of the skin barrier on that day is the decision.
The one question you have to ask before any peel
Now to the part nobody explains. Everything I have written so far is worthless if the practitioner does not ask the following question: "What is the state of your skin barrier right now?"
The skin barrier (Skin Barrier) is the outer layer of the epidermis, made up of corneocytes and the lipids between them. It is responsible for holding moisture in the skin, for keeping bacteria and pollutants from entering, and for regulating the inflammatory response. When the barrier is in good condition, it allows the peel to work predictably. When the barrier is compromised, that same peel can cause a chemical burn, reactive pigmentation, or inflammation that persists for months.
How the state of the barrier is checked. Advanced clinics have devices that measure TEWL (Transepidermal Water Loss), that is, the rate of water loss through the skin. A high TEWL value means a compromised barrier. At my clinic I use a device, and alongside it a manual assessment: checking whether there are areas of residual redness, localized dryness, fine flaking, or a pain response to substances that usually do not sting.
Four signs that the barrier is compromised and that a peel must not be done now:
First, if you have used retinoids, strong acids, or home peels in the last two weeks. Second, if you have a certain redness across the cheek areas that was not there a month ago. Third, if you feel stinging when a plain moisturizer is applied to the skin. Fourth, if you are back from tanning or a sun holiday within the last four weeks.
This is not a matter of caution. It is a prohibition. In that state, a peel at level 2 and above can cause what is known as an "Acid Burn," a chemical burn, which can leave pigmentation that stays for months. At my clinic, if I identify a compromised barrier, I postpone the treatment. Two weeks of barrier repair with basic ingredients (niacinamide, peptides, hyaluronic acid, ceramides, panthenol), and then we return to the question of whether the peel is still appropriate.
This is an essential part of every Bright & Glow protocol I run: we do not begin without assessing the barrier. Even if the client promises she is ready.
By concern, which peel
Given that the skin barrier is sound, here is how I choose the acid.
Hormonal pigmentation (melasma). Mandelic 20 to 40 percent or lactic, and nothing else. Glycolic at a high concentration is liable to irritate the melanocytes, and TCA is not suitable for melasma at my clinic because of the risk of worsening and of post-inflammatory pigmentation. If there is a hormonal background, I work alongside the treating physician. For a deeper look at melasma in women in Ashdod, I have a separate article on pigmentation in women in Ashdod.
Active acne and post-acne. Salicylic 20 to 30 percent. The penetration into the pores, the anti-inflammatory properties, and the effect on sebum production, all three together. Usually a series of 6 treatments 2 weeks apart.
Fine surface lines and general skin fatigue. Glycolic 30 to 50 percent. A series of 4 to 6 treatments 3 weeks apart. Result: radiance, improved texture, a reduced look of superficial expression lines.
Shallow acne scarring. TCA 15 to 20 percent. A series of 3 to 4 treatments 6 weeks apart, usually combined with microneedling, which deepens the effect.
General radiance, a refresh before an event. Mandelic 20 percent or lactic 10 percent. Twice during the month before the event. Result: radiance, but without any aggressive risk.
Before, during, after: what to expect
Two weeks before
Stopping retinoids, acids, and home peels. Daily SPF 50, in winter too. No direct tanning. A full health declaration: medications, conditions, pregnancy, allergies.
The day of the treatment
Arriving with a clean face, without makeup. With me the treatment begins with deep cleansing and preparing the skin. Applying the acid in layers, according to protocol. The time the acid stays on the skin is critical, seconds to minutes, depending on the concentration and on the acid. Neutralization when needed, a soothing mask, an active serum to finish.
With TCA at level 4 I follow the Frost, the whitening that clinically signals that the acid has reached the intended depth. This is not something a client sees for herself. It is something the practitioner has to know how to recognize.
The first 24 hours
Redness, a sensation of heat, dryness. No touching the face. No makeup. No sun. Washing with lukewarm water only, with the gentle cleanser I supply. Sleeping on your back.
Days 2 to 7
At levels 2 and 3: the redness comes down, flaking is minimal. At levels 4 and above: visible flaking starts on day 2 or 3 and continues 7 to 10 days. Never pull the flaking off by force. Do not scratch. The ingredients I send home are basic only: ceramides, panthenol, peptides, niacinamide, hyaluronic acid. SPF 50 every time you go out.
Two weeks after
A gradual return to routine. Vitamin C in the morning if the barrier has restored itself. Retinoids, not before 4 weeks from a level 4 treatment.
When not to do a peel
There are situations in which the treatment is not permitted, full stop.
Accutane (isotretinoin) within the last six months. The medication changes the skin's capacity to recover. A peel in that state raises the risk of scarring significantly.
Active rosacea. Inflamed skin cannot take additional acid stimulation. Even a level 2 peel can provoke an acute flare.
Active herpes in the facial area. Requires postponement until full recovery and sometimes antiviral prophylaxis before the treatment.
A fresh tan. For four weeks after significant exposure, no peel. The skin is still in a state of subclinical inflammation.
Pregnancy and breastfeeding. Levels 1 and 2 with certain acids (lactic, mandelic at a low concentration) are possible with some practitioners. Most of the stronger acids are not permitted.
Clotting disorders or treatment with anticoagulants. Requires a physician's approval.
Active pigmentation disorders. Melasma in an active and worsening state requires stabilization before any strong peel.
Prices in Israel 2026
The peel market in Israel is wide open and varied. Here are the real ranges, based on a survey of about 30 clinics in Tel Aviv, Herzliya, Jerusalem, Ashdod, and Beer Sheva:
Level 1, a basic light peel: 250 to 400 shekels for a single treatment. A series of 6 usually at 1,200 to 2,000 shekels.
Level 2, a superficial peel (glycolic 20 to 30 percent, mandelic, lactic): 350 to 600 shekels for a single treatment. A series of 6 usually at 1,800 to 3,200 shekels.
Level 3, a superficial-medium peel (glycolic 50 percent and above, salicylic 20 percent, Jessner): 500 to 850 shekels for a single treatment.
Level 4, a medium peel (TCA 15 to 25 percent): 800 to 1,500 shekels for a single treatment. A series of 3 usually at 2,200 to 4,000 shekels.
Level 5, a deep peel (TCA 35 percent and above, phenol): 2,000 to 4,000 shekels per treatment. Performed under medical supervision, usually once and not as a series.
What affects the price. The practitioner's experience. The quality of the acids (pharmaceutical-grade acids versus aesthetic-grade acids). The accompanying materials: masks, serums, a home kit. The initial assessment (with me the assessment is included in the price of the series). Follow-up between treatments.
A price below 300 shekels for a genuine superficial peel is a red flag. Either the acid was diluted to a concentration with no meaning, or the practitioner is cutting the treatment time short, or there is no preliminary assessment. When what is at stake is the meeting of an acid with your skin, the cheapest options are usually the most expensive in the long run.
How to know whether a peel is the right treatment for you
I ask a new client for four things before I approve the start of a peel series.
First, a skin assessment that clarifies what the real concern is, what the medication history is, and what you have tried in the past. Second, a 20-minute face-to-face assessment in which I examine the skin barrier, the skin type (Fitzpatrick), and the existing level of pigmentation. Third, a Baseline photograph in standard lighting before the series begins. Fourth, an agreed understanding of what the treatment will do and what it will not do.
If one of those four does not happen, you are not in a serious clinic.
When to come to me
- You are considering a peel and are not sure which level or which acid suits you
- You tried a peel at another clinic and the result was partial or negative
- You have melasma, hormonal pigmentation, or acne scarring and you are looking for a long-term protocol
- You are planning a significant event and want genuine radiance within 8 to 12 weeks
Not a fit if
- You are taking Accutane (isotretinoin) or stopped taking it within the last six months
- You are pregnant or breastfeeding (for most of the acids)
- You are back from a fresh tan within the last four weeks
- You have active herpes, active rosacea, or dermatitis in the facial area
- Your skin barrier is compromised right now and needs repair before any active
- You have a history of keloid or hypertrophic scarring
- You take anticoagulants or antiplatelet medication, or you have a clotting disorder
- You have an active autoimmune condition or are on immunosuppressive therapy
- You take photosensitizing medication without your doctor's clearance
- You have a known sensitivity to salicylates
