Chemical Peels

Abstract Chemical peels are a popular aesthetic treatment, combining efficacy with minimal downtime and low cost. Indications include skin rejuvenation, photoageing, pigmentary dyschromias, acne vulgaris and scarring. Currently, the most commonly used chemical peeling agents are glycolic acid 20–70%, trichloroacetic acid 10–35% and Jessner's solution. Chemical peeling causes controlled skin destruction which is classified according to the depth of the wound created and the corresponding histological level of necrosis. These include: (i) very superficial (exfoliation): destruction of the stratum corneum but no wound below the stratum granulosum; (ii) superficial (epidermal): necrosis of part or all of the epidermis; (iii) medium (papillary dermal): necrosis of the epidermis and part or all of the papillary dermis; and (iv) deep (reticular dermal): necrosis of the epidermis and papillary dermis with extension into the reticular dermis. Generally speaking, treatment benefits correlate with the level of tissue destruction, as do the potential risks.