Why "Chemical Peel" Is Not One Word
The term "chemical peel" is an enormous umbrella covering dozens of different acids and concentrations, at different depths, with recovery times ranging from an hour to two weeks. When a client tells me she wants a peel, my first question is always the same question: toward what goal.
Choosing the wrong acid can waste money in the best case, or cause burns, post-inflammatory pigmentation, and scarring in the worst. This is not a field worth experimenting with at home using a kit ordered on Amazon.
The Four Families of Acids I Work With
Mandelic acid (Mandelic Acid) is a relatively large alpha hydroxy acid derived from bitter almonds. The large molecule size means slow, gentle penetration into the skin. This is the first acid I consider for sensitive skin, for skin with a tendency toward melasma, and for clients who have never had a peel before. Common concentrations: 10 to 40 percent.
Glycolic acid (Glycolic Acid) is a small alpha hydroxy acid, derived from sugar cane. Penetration is faster and deeper. It suits skin already accustomed to acids, fine surface lines, pigmentation linked to sun exposure, and stimulating collagen production. Concentrations: 20 to 70 percent, but never at the highest concentration with a new client.
Salicylic acid (Salicylic Acid) is a beta hydroxy acid, fundamentally different. Unlike the AHAs, which work on the upper cell layer, salicylic is oil-soluble and penetrates into the pores themselves. This is the acid of choice for blemish-prone skin, congested pores, and oily skin.
TCA (trichloroacetic acid) is the next tier in strength. At 10 to 20 percent it is a medium-depth peel suited to working on moderate fine lines, shallow post-blemish scarring, and the appearance of deeper spots. At higher concentrations it becomes a deep peel, which I do not work with in the clinic. When a deep peel is called for, I refer to a dermatologist.
The acid matches the concern. The concentration matches the skin. The protocol matches the specific woman.
How I Choose Which Acid for Each Client
The choice begins with three questions. What your skin color is on the Fitzpatrick scale. Whether you have a tendency toward post-inflammatory pigmentation. And what you have been through in the past.
Fitzpatrick 4 to 6 skin (that is, skin that tans easily and almost never burns, through to deep skin tones) calls for particular caution. My first acid is almost always mandelic at 20 percent, because the risk of post-inflammatory pigmentation is significantly higher. Only after several successful sessions do I consider moving to a gentle glycolic.
Fitzpatrick 1 to 3 skin (that is, skin that burns easily and tans only slightly) copes better with more aggressive peels from the first stage. But even here, we begin at the lower concentration.
Skin with a tendency toward melasma always receives a mandelic or lactic peel from me, and nothing else. Glycolic may irritate the melanocytes, and TCA almost always makes the situation worse.
A Full Course of Treatment
A single peel session with me runs 45 to 60 minutes. Deep cleansing of the skin, application of the acid in layers, neutralization if required, a calming mask, and SPF 50 sun protection.
A peel series is generally built from 4 to 6 sessions at intervals of 2 to 3 weeks. The concentration rises gradually. Sun protection between sessions is not a recommendation, it is a precondition for the whole thing. Without daily SPF, the likelihood of pigmentation rises significantly.
What to Expect and What Not to Expect
What will happen: redness on the day of the treatment, mild dryness for 2 to 4 days, partial flaking 3 to 5 days after a stronger session. After 4 to 6 weeks the skin looks more radiant, more even in tone, smoother.
What will not happen: dramatic peeling like in the movies. With me, deep peeling is usually a sign that the concentration was too high. We are after gradual improvement, not trauma.
When to Come to Me
- You want to work on the appearance of superficial spots or uneven skin tone
- You have enlarged pores or coarse skin texture
- You are coming out of summer and feel the skin has lost its freshness
- You are planning an event and want radiance within 4 to 6 weeks
Not Suitable If
- You are taking Accutane (isotretinoin), or you stopped taking it within the past six months
- You are pregnant or breastfeeding (some of the acids are not permitted)
- You have come back with a fresh tan (you need to wait 4 weeks)
- You have active herpes in the facial area
- You are taking photosensitizing medication without your doctor's approval
- 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 have a known sensitivity to salicylates
For details on chemical peels in Ashdod.
