Last week, Dr. Herzog shared helpful information on the potential hazards of at home chemical peels. She continues sharing her dermatological perspective on the topic of at home peeling for those of us who want to further explore the options.
Dr. Jo Herzog
Last week, I introduced you to facial peels and told you that some peels, if used correctly, could be done at home relatively safely but not without risk. Some peels should be done only in a doctor’s office and administered only by a physician. The choice of which peel to use and how it should be administered involves a fair amount of experience–as does the post peel care (which may or may not involve complications).
I do not recommend that my patients do at home peels unless they discuss their plans with me first, as I think that poor choices can have disastrous effects. Any peel, even the least invasive, can cause inflammation which can result in hyper-pigmentation (darkening of the skin). The darker your natural skin tone, the more likely are you to have this problem. Sun exposure will increase this risk significantly, so the use of a hat and sunscreen is essential. The deeper the peel, the greater the risk for scarring and infection. Skin tests are often recommended to avoid allergic reaction, but I have not ever seen this occur with an in office peel. Follow all directions carefully, and always start with a low percentage before you move to a higher one. Do a skin test when indicated, but remember that just because your arm doesn’t swell there is no guarantee that your face won’t. The Alpha (Lactic, Glycolic, and Mandelic acids) and Beta Hydroxy (Salicylic acid) peels are the ones that are most often used at home. These can be neutralized with water. Here is a breakdown of the acids according to type.
Alpha Hydroxy Acids
- Lactic Acid– This acid is derived from milk and is probably the least invasive of the commonly used peels. This peel is often used for hyper-pigmentation. This is a good choice for dark spots. Lactic acid products help with dry skin and are good choices as mild peels for dry skin.
- Glycolic Acid– Glycolic acids are fruit acids. They are also superficial peeling agents but are a bit more aggressive and irritating than is lactic acid. This is a good choice for very fine lines (but nothing compared to a good TCA in the office). I would start with 10% for just a few minutes and work up weekly–slowly increasing time and then later increasing concentration. I would not use more than a 30% concentration on myself at home.
- Mandelic Acid– This is derived from almonds, and some people say that it is a good choice for dark skin to treat large pores. This is the only peel that I have never used myself, so I cannot say much about it.
Beta Hydroxy Acids
- Salicylic Acid– This acid is oil soluble, whereas the above are all water soluble. Because of this property, the acid penetrates more deeply into the pores and is a good for acne patients. The acid exfoliates dead skin quite well. This acid is available in various strengths. Again, I would start slowly and proceed carefully. I personally think that the salicylic treatment stings quite a bit, so the sting might limit what you would use at home. This crystalizes on the skin and does not need to be neutralized, but a thick moisturizer applied to the stinging skin makes it feel much better, as does a cool washcloth.
Combination peels: Combinations of the above acids in low concentrations can be used to get desired results with less irritation, so these can be considered. None of these peels is without risk. The best option is having your dermatologist go over what would be best for your skin.
All of the at home remedies should be used with caution. You must realize that just because you can buy something online does not mean that it is safe and that you will not be allergic, become hyper-pigmented, break out in acne or a rash, or become scarred. Remember that prior use of a retinoid will give you more dramatic results but also more potential for inflammation.
Remember that the sun is not your friend. Sunscreen and a hat are your best friends. Hope this makes you more informed and more cautious about what you do at home.
Have a good week. We will talk about more aggressive peels next time.