Chemical peels have been a cornerstone of aesthetic dermatology for decades. Despite the proliferation of laser and energy-based devices, chemical peels remain one of the most effective, versatile, and cost-efficient treatments available to practitioners. Understanding the science behind them is essential for safe and effective application.
How Chemical Peels Work
At their core, chemical peels work by applying a controlled chemical injury to the skin. The acid solution dissolves the intercellular bonds between corneocytes (dead skin cells) in the stratum corneum, triggering a cascade of biological responses: accelerated cell turnover, increased collagen synthesis, and improved melanin distribution.
The depth of penetration, and therefore the intensity of results, depends on the acid type, concentration, pH, and contact time. Superficial peels affect only the epidermis, medium-depth peels reach the papillary dermis, and deep peels penetrate to the reticular dermis.
Types of Acids Used in Peels
Alpha Hydroxy Acids (AHAs)
AHAs are water-soluble acids derived from natural sources. The most commonly used in professional peels include:
- Glycolic Acid (30-70%): The smallest AHA molecule, offering the deepest penetration. Excellent for photo-aging, hyperpigmentation, and acne scarring. Available in concentrations from 30% to 70%.
- Lactic Acid (30-70%): Gentler than glycolic with additional humectant properties. Ideal for sensitive skin and first-time peel patients. Provides brightening and hydrating benefits.
- Mandelic Acid: Larger molecular size means slower, more even penetration. Excellent for darker skin tones with lower risk of post-inflammatory hyperpigmentation.
Beta Hydroxy Acids (BHAs)
Salicylic Acid (20-30%): Oil-soluble, making it uniquely effective for acne-prone and oily skin. Penetrates into pores to dissolve sebum and dead cells. Anti-inflammatory properties make it well-tolerated even on sensitive skin.
TCA Peels
Trichloroacetic Acid (10-35%): A versatile medium-depth peel acid. At lower concentrations (10-20%), it produces a superficial peel; at 35%, it reaches the papillary dermis. TCA peels produce visible frosting (a white precipitate indicating protein coagulation) that serves as an endpoint indicator.
The Fitzpatrick Scale and Peel Selection
Proper patient assessment is critical. The Fitzpatrick skin typing scale (I-VI) helps practitioners select appropriate acid types and concentrations:
- Types I-III: Generally safe for all peel types and concentrations with standard protocols.
- Types IV-V: Higher risk of post-inflammatory hyperpigmentation. Prefer mandelic acid, lower-concentration lactic acid, or modified Jessner's solution. Avoid high-concentration glycolic acid.
- Type VI: Proceed with extreme caution. Superficial peels only with extended pre-treatment and post-peel pigment management.
Contraindications and Safety
Absolute contraindications include active infections, open wounds, recent isotretinoin use (within 6-12 months), pregnancy, and known hypersensitivity to peel ingredients. Relative contraindications include recent sun exposure, active inflammatory conditions, and use of photosensitizing medications.
Always perform a thorough patient history and conduct a patch test when introducing a new acid or concentration.
Post-Peel Care Protocols
Post-peel care is where your private-label product line becomes invaluable. A well-curated post-procedure regimen should include:
- A gentle, pH-balanced cleanser
- A hydrating serum (hyaluronic acid-based)
- A barrier-repair moisturizer with ceramides
- Broad-spectrum SPF 50 sunscreen
- An anti-bruising arnica cream (for medium-depth peels)
Providing these products under your own brand not only ensures protocol compliance but generates significant retail revenue from every peel treatment.
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