Chemical Peels
- The claim
- Resurfaces skin, evens pigment and softens fine lines for far less than a laser.
- The verdict
- Depth is everything. Superficial peels do a little; medium-depth peels do a lot and carry matching downtime.
- Worth it?
- Yes, particularly for pigmentation. A well-chosen medium peel remains one of the better-value treatments in aesthetics.
What the evidence supports
Peels are graded by the depth of injury, and the outcome tracks the depth almost exactly. Superficial peels improve dullness and mild pigment with no downtime and no dermal change. Medium-depth peels reach the papillary dermis and produce a real, durable improvement in photodamage, with about a week of visible peeling. In experienced hands the results of a medium peel compare well with fractional laser for pigmentation, which is not the impression most device marketing gives.
Why this entry is short
This is a graded stub. The verdict, the grade and the citations are settled and reviewed; the long-form write-up is queued behind a recorded consult-room explanation, in the order these questions actually come up in the office. The row is here now because an evidence index with twenty honest lines is more use than one with four essays and nothing else.
What this is based on
- Kubiak et al., 15% TCA with 70% glycolic acid versus 35% TCA for photodamaged facial skinJournal of Cosmetic Dermatology · 2020
- El-Domyati et al., microneedling with TCA or PRP for facial rejuvenation — split-face trial with histologyInternational Journal of Dermatology · 2018
- Castillo & Keri, chemical peels — patient selection, and the higher post-peel pigmentation risk in Fitzpatrick IV-VIClinical, Cosmetic and Investigational Dermatology · 2018
Grades describe the quality of the human evidence, not my opinion of the treatment. Where the literature changes, the grade changes and the review date moves with it.
The full guide
All guides →Fractional CO2 Recovery, Day by Day: What the Two Weeks Actually Look Like →
The most powerful resurfacing tool we have, and the one most often used on the wrong patient. Here is what the treatment does to skin, who it suits, and an honest day-by-day account of the recovery nobody describes in advance.
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What changed in facial rejuvenation this week, one guide we updated, and why it matters. Written by Jay Keni, MD.