From the Guidelines
Chemical peels can have a positive long-term effect on the skin's overall health and barrier function when used appropriately, as they stimulate cell turnover and collagen production, although they may cause temporary disruption to the skin barrier during the healing process. The use of chemical peels, such as those with trichloroacetic acid (TCA), has been compared to other treatments like photodynamic therapy (PDT) for the management of actinic keratosis 1. While chemical peels can cause temporary skin irritation and discomfort, the incidence of scarring in the treatment area was higher in the TCA arm compared to the PDT arm 1.
Key Considerations
- The depth of the peel determines both results and recovery time, with superficial peels causing minimal disruption and quick recovery, while medium and deep peels create more significant temporary barrier impairment but potentially greater long-term improvements.
- For optimal skin health, peels should be spaced appropriately, combined with proper sun protection (SPF 30+ daily), and gentle skincare during recovery periods 1.
- Those with sensitive skin conditions like rosacea or eczema should approach chemical peels cautiously, starting with the mildest options under professional guidance.
Evidence-Based Recommendations
- The use of chemical peels, such as 35% TCA, can be recommended for the treatment of actinic keratosis, although PDT may be a more effective option with fewer side effects 1.
- The incidence of local skin reactions during chemical peels can be dose-dependent, and the use of longer application times may enhance complete clearance of actinic keratosis 1.
- Proper sun protection and gentle skincare during recovery periods are crucial to minimize the risk of complications and optimize the long-term benefits of chemical peels.
From the Research
Long-term Effects of Chemical Peels on Skin Health
The long-term effects of chemical peels on the skin's overall health and barrier function can be understood by examining the various studies on the topic.
- Chemical peels can be classified into different types, including very superficial, superficial, medium, and deep peels, each with its own level of injury and potential complications 2.
- The choice of peeling agent, its concentration, and the pressure and frequency of applications are crucial in determining the success of the peel and minimizing complications 2, 3.
- Trichloroacetic acid (TCA) is a popular peeling agent used in different concentrations, and it has a broad spectrum of indications due to its versatility in combination with other peeling agents 2.
- Chemical peels can be used to treat various skin conditions, including skin resurfacing, wrinkles, actinically damaged skin, actinic keratoses, and benign pigmented lesions 2, 3, 4.
- The use of chemical peels can lead to significant improvement in skin appearance over a short period, resulting in patient satisfaction and maintenance of clinical results 4.
- However, the long-term effects of chemical peels on skin health and barrier function are not fully understood and may require further controlled studies to set up specific guidelines 5.
Skin Barrier Function and Chemical Peels
- Chemical peels can cause controlled destruction of the epidermis and/or dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues 4.
- The regeneration of new epidermal and dermal tissues can lead to improved skin barrier function, but the long-term effects of chemical peels on skin barrier function are not well established 4, 5.
- Combination peels and the use of different peeling agents can minimize side effects and improve skin outcomes, but the optimal approach for maintaining skin barrier function is not clear 3, 4.