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Chemical peels in acne - Scientific answer to all your questions

Chemical peeling is an opd procedure performed by a certified dermatologist for the treatment of acne and various other disorders. In this question asnwer session, we provide you answer to your most common questions related to chemical peeling in acne.

Author : , MD (dermatology),Consultant, The Derma Clinic, Ludhiana, Ex-consultant at Max smart speciality hospital,Saket, Delhi.
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Acne is one of the most common skin diseases among adolescents and young adults today. It has a significant psychological impact on the minds of young patients who can experience high levels of anxiety, depression, and low self-esteem.(1)

There is a wide range of treatment available for acne, including topical and systemic therapies. Cosmetic procedures such as chemical peeling is a simple and cost-effective treatment that can be combined with various other topical treatments, making it convenient and effective. 

Chemical peel is an OPD procedure performed by a certified dermatologist or plastic surgeon where a chemical exfoliant, of variable strength is applied on the skin which works by removing the top layer of the skin, allowing new, healthy fresher looking skin to present.(2,3) It smoothens the texture of the skin, lightens dark spots and unclogs the pores to prevent future breakouts.

Chemical peels have gained popularity in the treatment of acne as they can target and treat most of the causes of acne at once. They exfoliate the skin, decrease the oil production, reduce pore size and have anti-bacterial and anti-inflammatory properties(5). They also enhance the absorption of the other topical treatments the penetration and absorption of other topical treatments (2)

In this article, you will find the answers to most of your questions related to treatment of acne and acne scars with chemical peels.

How to select the best chemical peel for you?

Before selecting the appropriate peel for you, the dermatologist examines your skin thoroughly and asks questions regarding your past medical history, current medications, history of surgery and any past or current infections. They then decide the type of peel most suitable for you and design your treatment plan. Some common chemical peels for acne are salicylic acid peel and mandelic acid peels.

Which area can be treated with chemical peel?

Chemical peels are most commonly used for the treatment of acne on the face. However, the same peeling agents can be used to treat the acne on your back and arms. The chest area is avoided as chemical peels may result in scarring in this area. 

How do chemical peels help with acne scars?

Acne can leave behind a variety of scars on your face to remind you of the not so happy relationship with it. Some superficial marks and scars heal with time while others require expert treatment. The lighter marks such as the post inflammatory hyperpigmentation or “the black marks” as we like to call them can be treated simply with a combination of topical medicines and superficial peels. The intentional damage inflicted to the skin not only removes the topmost dead layer of skin but also stimulates body’s natural response to produce collagen that might help to fill in the scars

Although peels are an excellent treatment for scars, they might not be the best for the deeper scars such has Ice pick scars, and the Box scar that are usually done with other interventional therapies such as (subcision, skin graft, cryosurgery, dermabrasion, microneedling, and fillers), non ablative and ablative laser, to name a few.(6)

What to do while preparing for the procedure?

Before the procedure, you should discuss your skin conditions and treatment goal with your dermatologist. Reveal any history of scarring, cold sores, or any other infection to the doctor. Start using a broad spectrum sunscreen and avoid any kind of topical acne medications for a week before the procedure.(2) Discuss your expectations, potential risks and outcomes of the procedure in details

How is the procedure done?

The procedure is performed in the doctor’s office and you can go home the same day. Before starting the procedure, the face is thoroughly cleaned and degreased. The peeling agent Is then applied for a specific time period ranging from 2 to 5 minutes and gently removed. Topical creams and sunscreen is applied to the skin and you are allowed to go home with a set of instructions to be followed at home.

What are the Post Peel Precautions to be taken?

Use a broad-spectrum sunscreen and topical agents advised to you by your doctor. Avoid sun exposure for at least 2-3 days post peel. Avoid using makeup for 2 days and any other parlour activities for at least a week. Contact your doctor in case you notice anything unusual on your skin. follow-up regularly.

Are there any complications of chemical peeling?

Even though chemical peeling is a very safe procedure, and even when proper measures are taken, complications can occur. The common complications that can occur a few days or weeks following the procedure, include swelling, redness, pain and burning, itching, blistering or infection.(7) These complications are usually mild and resolve within a few weeks. 

How often can chemical peels be repeated?

Your treatment plan and the number of sessions required is decided by the treating doctor depending on the need of your skin and the severity of the acne you have. 

Superficial mild peels may be repeated after three to four-week while medium-depth peels may be repeated every six to 12 months.

What is the cost of chemical peeling?

Per sitting cost usually varies from 2-5 thousnds INR. However, it can vary due to many reasons. Usually 5 or more sessions are required. 

Reference:

  1. Hosthota A, Bondade S, Basavaraja V. Impact of acne vulgaris on quality of life and self-esteem. Cutis. 2016;98(2):121–124.
  2. Singh-Behl D, Tung R. Chemical peels. In: Alam M, Tung R, Gladstone H, editors. Cosmetic Dermatology Saunders. Elsevier; 2009. 
  3. Al-Talib H, Al-Khateeb A, Hameed A, Murugaiah C. Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris. An Bras Dermatol. 2017;92(2):212–216.
  4. Dréno B, Fischer T, Perosino E, et al. Expert opinion: efficacy of superficial chemical peels in active acne management: what can we learn from the literature today? Evidence-based recommendations. J Eur Acad Dermatol Venereol. 2011;25(6):695–704
  5. Kontochristopoulos G, Platsidaki E. Chemical peels in active acne and acne scars. Clin Dermatol. 2017;35(2):179–182.
  6. Rivera AE. Acne scarring: a review and current treatment modalities. J Am Acad Dermatol. 2008;59(4):659–676
  7. Costa IM, Damasceno PS, Costa MC, Gomes KG. Review in peeling complications. J Cosmet Dermatol. 2017;16(3):319–326.

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