Chemical peels have been around in some form or another for centuries. Professional strength, in-office peels in particular were hugely popular in the 90s. While lasers and other interventions took the spotlight for a while, professional chemical peels are still extremely popular in-office treatments. They are proven effective and results are indisputable. Dullness, signs of ageing, acne and brighter skin are all promised outcomes of the treatment. This blog post introduces the Salicylic Acid Chemical Peel for Acne treatment.
Acne Intervention
June 2019
I must admit that the past few months have not been kind on my skin. While we can try to uphold certain stress-relieving practices in life, stress is sometimes inevitable and unavoidable. Stress will undoubtedly elicit an unfavourable response in anyone’s body. Be it stress-eating, unwanted weight gain or weight loss, diminished hair quality, hair loss, acne, autoimmunity – the list goes on. I have experienced every single one of these adverse reactions to stress. And one way my body unfailingly reacts to stress is flare ups in my skin condition. Not least because stress is inflammatory and sends your entire system into a manic hormonal cascade. It shifts everything out of balance – including your skin.
This has inexorably led to more acne lesions than is typical for me and more reactive skin. Once my eating patterns begin to normalise again (that is to say, I quit my 2am junk food habit I have kept up for a couple months now), and I get a better handle on my stress levels, I am hopeful that my skin will improve. However, an increase in acne lesions also means I have been bestowed with new post-acne hyperpigmentation marks too. Nowadays I do believe in a gentler approach to my skin than the formally abrasive, harsh approach I took as a teenager. However, sometimes a more vigorous intervention is necessary.
Trying A Professional Chemical Peel for Acne
My inner scientist has been curious to try a professional strength chemical peel for acne for a while. Thus, I thought that now might be an opportune time to investigate while my skin is not behaving. Once I see the full extent of the treatment’s efficacy, I can report its effectiveness, and whether I recommend it.
I have decided upon a 30% salicylic acid chemical peel, which has particularly compelling research for acne patients. This blog posts details all about this type of peel in case you were curious to try it yourself. I will also be documenting my experience and journey with the peel in follow up blog posts.
Tailor your treatment to your own needs
I would like to preface by emphasising that a suitable acne treatment varies from individual to individual. Milder cases may only require the use of spot treatments or may even do well with natural interventions or remedies. Moderate cases may be eliminated with a course of antibiotics or even hormonal birth control. More extreme cases of acne may require more urgent interventions. Accutane or other oral medications, for instance, will quickly eliminate the condition and prevent permanent scarring of the skin. At my worst I was given daily antibiotics, abrasive scrubs, along with topical antibiotics.
I am now appalled by the length of time I was kept on these medications. They had deleterious effects on my health and mercilessly tore up my microbiome. However, if you are an acne sufferer, you understand how emotional and distressing it is. When you must look at your acne each and every day, you want nothing more than to eradicate your dreaded skin condition. Admittedly, nothing will do that quite like certain pharmaceuticals. If your acne is taking an emotional toll, such medications can drastically improve your quality of life and self-esteem.
Treatments should complement each other
Unfortunately, a proper skincare regimen was never emphasised by my doctor. I personally found from my own vigorous research that introducing ingredients such benzoyl peroxide and adapalene helped immensely. Here is an entire blog post on the top skincare ingredients for acne. I would encourage addressing the root cause of your acne, as well as introducing a proper skincare routine. These are important even if you are taking medications such as birth control or antibiotics to clear your skin. I made both these mistakes taking hormonal birth control and antibiotics. And I can assure you that your acne will return once you stop the medication.
Each time my acne returned because I was not yet equipped to address my root cause. I did not have a proper skincare regime either at the time. I now maintain my skin solely with OTC skincare products, deciding I do not want to spend my life on medications. There is no magic bullet when it comes to skin. A number of therapies should be used in conjunction with one another for optimal results. The only medication with a track record to truly eliminate acne for good is Accutane. However, I have never personally taken this. If your acne is severe, I strongly advise consulting a dermatologist for a mode of action to suit your needs.
On to the topic of today’s post: chemical peel for acne treatment.
What is a chemical peel for acne?
Chemical peels involve the use of chemical exfoliants, to remove the outer layers of skin and encourage shedding. Acids include Alpha Hydroxy Acids, Beta Hydroxy Acids, Jessner’s Solution or Trichloroacetic Acid. This induced exfoliation can encourage rejuvenation and resurfacing of the skin. This reveals smoother, fresh skin with improved texture and tone.
Which chemical peel for acne should you choose?
Commonly used superficial and medium depth chemical peeling agents include: salicylic acid, glycolic acid, lactic acid, mandelic acid, Jessner’s solution and Trichloroacetic acid. For an explanation of the difference between BHA and AHA exfoliants, read this blog post.
Certain acids are more typically used for the treatment of superficial wrinkles, and other concerns related to anti-ageing. Others are better suited for the treatment of acne and scarring. Today I will be addressing chemical peels for acne-related issues specifically.
Glycolic acid demonstrates clinical efficacy in improving skin condition of acne patients. However, salicylic acid has proven to be even more so effective. Glycolic acid also causes a greater risk of sun sensitivity. This is why I am opting for a salicylic acid chemical peel.
What strength of chemical peel for acne?
Strengths vary from superficial peels, to medium depth peels, to deep peels. Professional chemical peels are much stronger than the daily exfoliants suitable for at-home use. Hence, they provide much quicker, and drastically more noticeable results.
Higher strength, deeper peels cause a greater amount of shedding and possible side effects. Because results are more drastic, however, there can be a longer length of time between treatments. Each treatment is also more expensive but results can last up to a year.
Superficial peels, like the salicylic acid 30% I am choosing, involve less down time post-treatment. Peels must also be done more frequently in order to maintain results. I am having a total of 4 treatments done 2 weeks apart, after which I will evaluate the full extent of the peel.
What do salicylic acid peels do?
Essentially, salicylic acid is a chemical exfoliant that breaks the bonds holding skin together, in order to slough away the top layer of skin. The comedolytic and lipophilic properties of salicylic acid make it favourable for use in the treatment of mild to moderate inflammatory acne. It encourages shedding of epidermal skin cells, is lipid soluble, decreases sebum, penetrates pores to prevent clogging, and has anti-inflammatory and antibacterial properties.
Not only will salicylic acid improve the prevalence of active acne lesions, but its anti-inflammatory properties may also help to decrease facial erythema and lighten post-inflammatory hyperpigmentation. As a naturally medium-toned girl, I develop post-acne dark marks after every blemish. If you too have the same issue, a peel can be of great benefit. Salicylic acid peels can be helpful for use in conditions such as acne vulgaris, melasma, post-inflammatory hyperpigmentation, freckles, mild to moderate photodamage, texturally rough skin and minor wrinkles.
I encourage you to read my in-depth blog post about salicylic acid, to get the most optimal idea of its properties.
Before the peel
Your pre-peel care regimen will vary depending on the condition of your skin and your intended outcome. Some practitioners may encourage use of at-home chemical exfoliants and retinoids prior to your treatment. Others may urge you to discontinue use altogether. Ingredients such as retinoids will thin the skin and enhance penetration of the peeling agent. Personally I am choosing not to use too many active ingredients before my treatment. I want to avoid overloading my skin and increasing any risk of adverse effects. I encourage you to consult your practitioner to decide upon the best regime for your own needs.
The Chemical Peel for Acne Procedure
My practitioner advises avoiding any harsh products on skin the night before the treatment. Instead of applying my regular skincare routine, I only cleansed and applied a basic moisturiser; the Ordinary Natural Moisturising Factors.
Before undergoing the procedure, the practitioner will present you with a consent form you have to sign. The treatment itself is fairly quick. Whoever is doing your treatment will cleanse your skin, then wipe your face with alcohol before applying the peel. The smell of both alcohol and acid are pretty strong and do not dissipate until after the treatment.
The peel is applied to the areas of concern, such as the forehead, cheeks and nose. It is left on for a couple of minutes, during which the face begins to burn, tingle and feel hot. Before the burning sensation is almost too much to bear, the practitioner will neutralise the acid.
Following the treatment, you may apply moisturiser and SPF to the skin in order to protect it. Skin feels taut and tight the remainder of the day following the peel. It feels as though you can’t quite move it fully or be over expressive for fear your face might break. The feeling is similar to how it feels after washing with a foaming wash and then not applying moisturiser.
Side effects of a chemical peel
Side effects of chemical peels include stinging, dryness, peeling, flaking, and worsening of hyperpigmentation. Incidences of hyperpigmentation seem to be more prevalent in darker skin tones (Fitzpatrick skin type IV-VI). Certain medications such as antibiotics and oral contraceptives can also predispose you to developing hyperpigmentation. Due to risk of infection, immunocompromised patients or those susceptible to herpes virus may not want to undergo the treatment. Pregnant women and those allergic to aspirin will also not be able to have a salicylic acid peel.
After the chemical peel
It is advised to reschedule treatments at regular 10-14 day intervals in order to see optimal results. Because a chemical peel essentially wounds your skin, it is sensible to use only soothing, bland moisturisers and skincare products for up to 48 hours after treatment. Avoid any vitamin A or glycolic acid products for 48 hours post peel, or until peeling resolves.
Once your skin has a chance to calm down, you are free to resume your regular skincare routine and reintroduce active ingredients. Remember that you are revealing a fresh, sensitive layer of skin by undergoing a chemical peel. It is therefore essential to protect skin with SPF after the treatment, to ensure you are not increasing your risk of sun damage.
It is also advisable that you avoid any activities that will raise skin temperature; instead opt to keep skin cool. That means no hot showers, saunas, steam rooms, or even exercise for 72 hours post peel. Waxing and other forms of hair removal, as well as peeling or picking at the skin for up to a week post procedure may increase risk of dark spots and scarring.
My results: First Treatment
A mere 24 hours has elapsed since receiving my first treatment. So far, I notice a small reduction in blackheads on my nose. I have never personally had a huge issue with blackheads or large pores but I feel noticeable poreless. My skin seems to have a tighter than usual quality to it, likely due to the oil reducing properties of the acid. It almost feels slightly like sunburn.
Due to the rapid exfoliation, the peel also brings any blemishes to a head. I am experiencing mild peeling and flaking over some older blemishes and a slight darkening of the skin around them. I am choosing not to wear makeup yet, however none of these issues are too severe that it would severely impact my makeup application.
The peeling was truly at its most 48 hours post–peel.
Update: October 2019
I had my third chemical peel for acne at the end of September. I was initially hesitant to book my next treatment and had hence left so long between my second and third treatments. This is partly due to the fact that my skin has cleared significantly and for the most part the slough of active acne lesions I was experiencing have disappeared, aside from the odd hormonal blemish. I feared that since I usually experience intense breakouts after peels due to skin purging, it might disrupt my skin’s good recent behaviour. If you struggle with acne and your skin is finally behaving, it can be daunting to try any intense treatments.
Of course in the name of research, I am not one to back down and eventually braved it and returned for my third treatment. The third time round I noticed the stinging, burning sensation during the actual peel application process was significantly diminished. During the post-peel healing process, I did not erupt with quite as many blemishes, and experienced little to no peeling. My skin also felt a lot less tight than with the initial peels.
I am hoping that by my fourth treatment I will have few, if any, new breakouts from the peel. My skin has not been breaking out in clusters of acne lesions for around 8-12 weeks now, so I am praying things are once again on the up-and-up. The next action step will be to treat and heal all my post-blemish hyperpigmentation. Stay tuned for my next post all about how to clear dark spots and hyperpigmentation. For more on how I keep breakouts under control, see this blog post.
At-home treatments
Before embarking upon a professional chemical peel for acne, you will want to try milder at-home exfoliants first. If your skin is not accustomed to the action of chemical exfoliants, I highly suggest starting with at-home, low strength exfoliants before transitioning to more aggressive professional treatments. For daily use, I recommend salicylic acid products such as Paula’s Choice 2% BHA.
I would also suggest The Ordinary 2% Salicylic Acid Masque, which also contains charcoal and clay to remove impurities, as another treatment when your skin is feeling particularly congested.
For a slightly stronger peel, The Ordinary 30% AHA and 2% BHA Peeling Solution is effective and affordable. It is a red solution that you leave on for 10 minutes and then wash off. This is the highest strength I feel comfortable with using at home. Any stronger and urge you to seek professional assistance from a skin specialist.
If you have never before used salicylic acid and you are a little more sensitive, a rinse-off face wash is also a good way to introduce it to your routine. I recommend the Inkey List Salicylic Acid cleanser.
If you are not considering a chemical peel yet, but would like more advice for clearing blemishes, make sure to read these blog posts:
How to get rid of blackheads for good
Top Acne Supplements for Naturally Clear Skin
The Complete Guide to Salicylic Acid
The Complete Guide to Glycolic Acid
Wishing you boundless love, endless light, and life without limit,
Shannon xo