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Chemical peels are a lot like your favorite pair of shoes: They come in a variety of styles and prices. Some are durable and long-lasting, while others provide a quick pick-me-up for a special occasion. Regardless of what it does, it isn’t a one-size-fits-all solution. Different strengths are used for different things.

There’s no doubt people love the quick results and smooth, blemish-free skin. The American Society of Plastic Surgeons report it was one of the top three non-invasive cosmetic procedures performed last year. From erasing sunspots to reducing wrinkles, these mini-miracles pack quite a punch at a very reasonable cost.

Peels are available in a wide range of formulas that can be customized to target specific problems. Before we dive into how strong of a peel you need, it’s important to talk about who is a good candidate for different levels of peeling. This largely comes down to your Fitzpatrick skin type.

Fitzpatrick Skin Types

A doctor at Harvard University invented the Fitzpatrick Scale in 1975. It’s still widely used today to gather important information about how the skin might react to certain procedures. It takes into account genetics and how the skin responds sun exposure. The factors are:

eye color;

hair color;

skin color;

reaction to the sun;

skin cancer risk;

hyperpigmentation risk;

and the tendency to scar.

At the lowest end of the spectrum are Type I people with blue eyes, blonde or red hair, pale skin and possibly freckles. They burn easily and don’t ever get a tan in the sun. The risk of skin cancer is very high for this group, but they usually have a lower risk of hyperpigmentation and scarring.

The scale advances as skin tone and hair color get darker. The ability to tan also goes up with each level. The risk for procedural side effects also increases beginning at type III, but isn’t considered elevated until type IV. The highest end of the scale is type VI, with black skin that doesn’t burn, dark eyes and black hair. This group has the highest risk of all for hyperpigmentation and scarring.

Higher Fitzpatrick skin types may be more limited in the strength of peel they can get. Hyperpigmentation causes spots of discoloration that can be difficult to reverse. Scars in this skin type can also be problematic.

Mild Chemical Peels

Alpha hydroxy and beta hydroxy acids make up the bulk of most mild chemical peels options. These formulas are gentler than other types. The beta hydroxy is usually salicylic acid. Alpha hydroxy includes glycolic, lactic, malic, citric and/or tartaric acid.

They work by removing the most superficial layer of skin, revealing the fresh skin underneath. It doesn’t take long to get one and there’s no downtime afterward. For this reason, you’ll often hear it referred to as a lunchtime peel. It’s usually safe for all Fitzpatrick skin types.

As a single application, it works best on milder problems or as part of a regular skin care routine. For better results, a series of peels can be done relatively close together. Doing five to eight in a row can stimulate collagen production and increase elasticity. Mild peels are good for:

very fine lines;

acne;

mild discolorations, such as sun spots;

large pores;

and uneven skin tone.

Medium Strength Chemical Peels

Even though this class of peel is considered medium strength, it can be very intensive. It’s perfect for Fitzpatrick skin types I, II, and III but may be fine for other types as well. Trichloroacetic Acid, or TCA, is a stronger type of acid used in this type of peel. It may be combined with Jessner’s solution, which is lactic acid, resorcinol, and salicylic acid.

It damages several layers of skin at once. The layers of skin will dry up and come off, revealing fresh, new skin underneath. It’s more durable than lunchtime peels because it triggers the body’s healing mechanisms to send more collagen to the area. It’s beneficial for

age or sun spots;

leathery, photodamaged skin;

moderate wrinkles;

and acne scars.

Medium depth chemical peels can be uncomfortable. You can ask for a topical numbing agent to be applied beforehand. This peel requires more dedication to following aftercare instructions. From start to finish, you can expect it to take an average of ten days for all of the old skin to come off. It will usually look the worst around day three to six.

Deep Chemical Peels

These peels are the strongest you can get and the results are impressive. The possible formula combinations include high concentrations of TCA or a Gordon-Baker phenol solution. It is offered for severely photodamaged skin and requires sedation.

Higher Fitzpatrick skin types are most likely not good candidates, as the risk of hyperpigmentation and scarring is significant. The process of applying the solutions can take well over an hour. Sometimes tape or bandaging is added. Deep peels can cause discomfort six to eight hours after it’s finished. Healing takes weeks, although collagen will continue being deposited in the skin for up to four months.

While deep chemical peels do take longer to heal and are more uncomfortable, they produce outstanding results for most people. It’s the longest lasting and most effective choice for deeper wrinkling, especially around the mouth and forehead.

How Strong Can You Go?
Overall, the determination of the strength of your chemical peel depends on several factors, including what you’re using the peel for and how much downtime you can live with. Dr. Frankel will take that information and factor in your skin type and level of photodamage to make a recommendation. Please visit Dr. Frankel’s website for more information.