About Chemical Peels

The choice of the appropriate peel depends on the specific indications, the depth of the desired peeling, your skin phototype and your expectations.

Chemical peeling is a very popular treatment for skin rejuvenation.

Chemical peels induce injury to the epidermis and the superficial dermis resulting in elastotic, aged and photo damaged skin being removed and replaced with a new collagen-rich layer.

Skin peeling dates back to ancient Egypt where Egyptian royalty used to bathe in sour milk to brighten their complexion. Over the years the use of chemical peels has been well established as a potent corrective and anti-ageing weapon against sun damaged skin, age-related skin changes such as fine lines and wrinkles, freckles, skin blemishes, pigmentation disorders, uneven skin tone, dilated pores, greasy and acne-prone skin, and acne scarring.

Various chemicals have been used as peeling agents. Some of the most commonly used ones include:

  • Resorcinol (antiseptic and astringent)
  • Phenol (also called carbolic acid, very deep penetration into the skin)
  • Tricholoracetic acid (is used as an intermediate to deep peeling agent in concentrations ranging from 20-70%)
  • Alpha-hydroxy acids (AHA) such as
    • Glycolic acid (derived from sugar cane)
    • Citric acid (citrus-derived)
    • Lactic acid (found naturally in the body and fermented milk)
    • Malic acid (derived from apples)
    • Tartaric acid (derived from grapes), etc
  • Beta-hydroxy acid (BHA) such as
    • Salicylic acid (closely related to aspirin, which is acetyl-salicylic acid)

Hydroxy acids are naturally occurring organic carboxylic acids classified alpha or beta according to their molecular structure. Both alpha- and beta- hydroxy acids encourage sloughing of old epithelium and epithelial renewal by acting on the intercellular linkages (desmosomes) between keratinocytes.

Dr S. Foutsizoglou will offer you a complete Skin Analysis which will be used as a guidance for the formulation of your individualised treatment. To learn more about your skin type please download the Skin Analysis Chart.

The choice of the appropriate peel depends on the specific indications, the depth of the desired peeling, your skin phototype and your expectations. Multiple compounds may also be used depending on the targeted problem. An example of a combined peel is Jessner's peel (i.e. 14% salicylic acid, lactic acid, and resorcinol in an ethanol base).

The Fitzpatrick phototype scale
Type Skin type Sensitivity Characteristics
Type I Blond or red hair, freckles, fair skin, blue eyes Very sensitive Always burns easily, never tans; very fair skin tone
Type II Blond, fair skin, blue eyes or green eyes Very sensitive Usually burns easily, tans with difficulty; fair skin tone
Type III Darker caucasian, Mediterrainean Sensitive Burns moderately, tans gradually; fair to medium skin tone
Type IV Darker Mediterranean, Asian, Hispanic Moderately sensitive Rarely burns, always tans well; olive skin tone
Type V Middle eastern, Latin, light-skinned black, Asian Minimally sensitive Very rarely burns, tans very easily; dark skin tone
Type VI Dark-skinned black Least sensitive Never burns, deeply pigmented; very dark skin tone

There is a multitude of peeling agents on the market with some of them either being associated with significant side effects and complications or not being effective enough to deliver a satisfactory result. Please also remember that the right chemical peel for the right indications should be used for optimal results.

Experienced doctors such as plastic surgeons or dermatologists are the most likely to give you the range of options available and help you form an individualised treatment course for a skin improvement you can be really happy with. In addition, only doctors are allowed to use high concentration peels which are usually very effective for severe problems such as significant photo damage or acne scarring.

Dr S. Foutsizoglou's vast experience assures the right choice of the chemical peel or combination of peels that will target the root of your skin problem giving you the healthy skin and glamour you have always dreamt of.

In addition to AHA’s and BHA’s some of the highly effective chemical peels our SFMedica doctors use include:

  • SkinMedica VITALIZE Peel – A unique blend of Alpha- and Beta- Hydroxy Acids, Resorcinol and Retinoic Acid.
  • SkinMedica Illuminize Peel – non invasive, indicated for mild skin problems.
  • SkinMedica Rejuvenize Peel – Indicated for moderate to severe skin conditions (e.g. acne, acne scarring, melasma, sun damage, etc). For more information on SkinMedica peels please download the SkinMedica peel PDF.
  • Neostrata AHA’s
  • Mesoestetic Combined Peels
  • Innovation Concept Peel (a combination of Hydroquinone, Kojic acid, Salicylic acid, Phytonadione and Retinoic acid) – ideal for hyperpigmentation and photodamaged skin
  • SkinTech TCA Peels
  • Derma Peel for those who can afford Zero downtime
  • Medik8 Peel and Medik8 Eye Peel for the delicate under-eye, neck and décolleté areas
  • Obagi Blue Peel
  • DermaCeutic Professional Peels
  • INNO-PEEL – A range of chemical peels producing a controlled chemical dermabrasion at epidermal level.
  • Agera Rx
  • PRIORI FORTE Professional Skin Renewal System – Lactic Acid peels designed to treat all skin types. They are particularly indicated for premature ageing, rejuvenation and adult acne.

Mechanism of skin peeling

Chemical peeling is an accelerated form of exfoliation created by the chemical agent. Light peeling agents induce a faster sloughing of the cell in the epidermis (i.e. superficial layer of the skin), whereas deeper peeling agents create inflammation in the dermis (i.e. middle skin layer). Following the controlled chemical burn to the skin, the wound healing process results in skin regeneration and new collagen formation along with deposition of glycosaminoglycans such as hyaluronic acid. Collagen remodelling is the main reason chemical peels decrease sun damage and reduce wrinkles. After healing the skin acquires an improved appearance, more even skin colour, smoother texture and a healthier glow.

Peel depth

Depth of the chemical peel describes the level of penetration and inflammation of the skin produced by the chemical agents. The depth of the peel depends on many variables, including:

  • Peeling agent
  • Concentration of the peeling agent
  • How many coats of the agent are applied
  • Technique of application
  • How the skin was cleaned and degreased before the peel
  • Patient skin type
  • Anatomical location of the peel
  • Duration of contact with the skin (particularly AHAs)