Chemical Peels: Skin Renewal with Medical Criteria
What is a chemical peel?
A chemical peel is a dermatological procedure that applies a controlled acidic solution to the skin to induce a regulated exfoliation of its most superficial layers. The goal is not to “burn” the skin, but to stimulate its natural renewal: damaged cells slough off and the body responds by regenerating fresh, more even and functional skin.
There are three depths of peeling, each designed for a different objective:
- Superficial: acts on the stratum corneum and superficial epidermis. Renews tone, refines texture and improves luminosity. Recovery of 2-5 days.
- Medium: reaches the deep epidermis and papillary dermis. Treats pigmentation, superficial marks and fine lines. Recovery of 7-14 days.
- Deep: penetrates the reticular dermis. Reserved for severe damage and always in a medical setting. Recovery of several weeks.
Why does skin benefit from controlled renewal?
Over time, the skin’s cell renewal cycle slows down. In young skin, cells take about 28 days to migrate from the basal layer to the surface and shed. After age 40, this cycle can extend to 40-50 days, causing a buildup of dead cells, dull appearance, uneven texture and increased pigment retention.
Chemical peeling intervenes in this process in two ways:
- Direct removal: dissolves the bonds between corneocytes, accelerating the shedding of cells damaged by sun, pollution or chronological aging.
- Regenerative stimulus: the controlled injury activates dermal fibroblasts, increasing collagen production and improving the quality of the extracellular matrix.
What concerns can it address?
Peeling is not a universal treatment, but it is effective in specific situations:
- Photoaging: sun spots, rough texture, loss of luminosity
- Melasma and post-inflammatory hyperpigmentation (peels with glycolic, mandelic or tranexamic acid)
- Fine lines and superficial wrinkles
- Mild active acne and post-acne marks
- Enlarged pores and excess sebum
- Keratosis pilaris and uneven texture on neck or hands
Most commonly used acids
1. Glycolic acid
The most studied and versatile. It belongs to the alpha-hydroxy acid (AHA) family and is derived from sugar cane. Its molecule is the smallest of all AHAs, giving it deep penetration capacity. It renews, hydrates and stimulates collagen. Ideal for skin without particular sensitivity.
2. Mandelic acid
An AHA derived from almonds. Its molecule is larger than glycolic, so it penetrates more slowly. It is the choice for sensitive skin, melasma and darker skin tones, where efficacy is needed with minimal risk of post-inflammatory hyperpigmentation.
3. Salicylic acid
A beta-hydroxy acid (BHA) that is lipid-soluble. Unlike water-soluble AHAs, salicylic acid penetrates sebum, making it ideal for oily skin, acne and enlarged pores. It also has anti-inflammatory properties.
4. Trichloroacetic acid (TCA)
Reserved for medium and deep peels. Its depth depends on concentration and the number of layers applied. It requires prior medical assessment and a specific post-care protocol.
The Skin Esthetic approach: barrier first, anti-aging after
At our clinic we apply a guiding principle: not everything that can be done should be done. The most powerful peel is not necessarily the most appropriate. The skin barrier must be intact before any procedure. If a patient presents dysbiosis, severe dehydration or a compromised barrier, we first restore barrier function and only then schedule the peel.
Skin does not need rushing, it needs criteria. A well-indicated peel renews without aggression; a poorly indicated peel causes inflammation, hyperpigmentation and lasting sensitivity.
When to consult a professional
Chemical peeling is a medical act when it exceeds superficial depth. Before starting any skin renewal protocol, a medical assessment is recommended to evaluate:
- Skin type and phototype (Fitzpatrick)
- Skin barrier status
- History of herpes, dermatitis or adverse reactions
- Use of retinoids, isotretinoin or photosensitizing agents
- Realistic expectations and sun exposure calendar
During the summer season, medium and deep peels are postponed. Superficial peels with mild acids can be maintained, but always with strict photoprotection.
