What is a chemical peel?
The chemical peel is an aesthetic medicine treatment that exploits the controlled action of acid solutions to remove the damaged or aged superficial layers of the skin, promoting the growth of new skin that is smoother, more even and more luminous. The principle behind the treatment is keratocoagulation: the applied acid denatures the proteins of the skin layers, inducing a repair response that stimulates new collagen production and keratinocyte proliferation.
According to the depth of action, three main categories are distinguished:
- Superficial peel — acts on the epidermis and the superficial papillary dermis. Alpha-hydroxy acids (AHA) are used, such as glycolic acid (10–35%), mandelic acid, lactic acid, or Jessner's solution. Indicated for mild pigmentation, enlarged pores, very fine lines and general skin radiance. Practically no downtime.
- Medium peel — reaches the superficial reticular dermis. The key agent is trichloroacetic acid (TCA) at 20–40% concentrations, sometimes combined with Jessner's solution (Monheit protocol) to enhance its effect. It is the reference treatment for sun spots, keratoses, moderate acne scars and medium-depth wrinkles.
- Deep peel — penetrates to the mid-deep reticular dermis. Phenol (carbolic acid), alone or in the Baker-Gordon formulation, produces radical skin renewal: indicated for deep perioral and periocular wrinkles, severe sun damage and marked pigmentation. It requires medical monitoring during the session because of systemic phenol absorption.
Dr. Marco Galati selects the most appropriate type of peel according to the patient's phototype, expectations, skin condition and tolerance for downtime, guaranteeing a personalised, safe approach.
How the treatment is performed
Preliminary visit and preparation
Before any peel, Dr. Galati carries out an in-depth skin assessment: phototype analysis (Fitzpatrick scale), mapping of pigmentation, drug history and evaluation of contraindications. In the 7–14 days before treatment, retinoids (tretinoin, retinol), exfoliating acids and waxing must be suspended. Intense sun exposure in the two preceding weeks is an absolute contraindication. For darker phototypes or a history of herpes, prophylactic antiviral therapy and a pre-treatment depigmenting cream may be prescribed.
The session
The treatment takes place on an outpatient basis in 30–60 minutes, depending on depth and the areas treated. The main phases are:
- Cleansing and degreasing — the skin is thoroughly cleaned with a specific cleanser and treated with acetone or alcohol to remove sebum and ensure uniform penetration of the acid.
- Topical anaesthetic (medium and deep peels only) — an anaesthetic cream is applied for 20–30 minutes before proceeding.
- Application of the chemical agent — the solution is spread uniformly with a brush, gauze or applicator. The physician monitors the skin's response by observing the frosting (whitening of the skin), an indicator of penetration depth.
- Neutralisation or removal — AHAs are neutralised with a bicarbonate solution; TCA and phenol are self-neutralising. A soothing barrier cream is then applied.
- Sun protection — broad-spectrum SPF 50+ protection is applied before leaving the clinic.
Treatable areas
The chemical peel can be applied to the face, neck, décolleté and hands. Facial treatment is the most common, with the option of focused peels on specific zones (perioral area, eye contour, forehead) or the entire face.
Recovery and results
The post-treatment course
Recovery depends on the depth of the peel. After a superficial peel the skin appears reddened for 12–24 hours and may flake moderately over the following 2–3 days: in most cases normal activities can be resumed the next day. After a medium peel the redness is more intense and visible flaking lasts 5–7 days, during which the skin appears swollen and darkened before shedding. Full recovery from a deep peel takes 10–14 days, with significant swelling in the first 48–72 hours and marked desquamation.
In all cases, the fundamental post-peel recommendations are:
- Do not scratch, rub or mechanically remove the flaking skin.
- Moisturise generously with the creams prescribed by the specialist.
- Apply SPF 50+ sun protection every morning for at least 4–6 weeks.
- Avoid direct sun exposure for at least one month.
- Do not use active products (retinoids, AHA, BHA) until the skin barrier has fully recovered.
Expected results
The results of a chemical peel cycle are fully appreciated 3–4 weeks after the session, once healing and collagen remodelling are complete. The main benefits include: a more even skin tone, visible reduction of sun spots and melasma, smoothing of superficial wrinkles and improvement of acne scars. The skin appears brighter, firmer and finer in texture. Results of a medium peel last 1–3 years; those of a deep peel can be very long-lasting as far as wrinkles are concerned, though consistent photoprotection remains essential to maintain the even tone achieved.
Frequently asked questions
During application of the acid solution a burning or stinging sensation is normal, more or less intense depending on the depth of the peel. Superficial peels cause only mild, well-tolerated discomfort. For medium or deep peels a topical anaesthetic cream is applied beforehand and, if necessary, light sedation can be used. Post-treatment redness and tightness are easily managed with the prescribed soothing products.
It depends on the type of peel and the goal. Superficial AHA peels are generally performed in cycles of 4–6 sessions at two-week or monthly intervals. Medium TCA peels may require 1–3 sessions. A deep phenol peel produces long-lasting results from a single session. Dr. Galati defines the personalised protocol at the preliminary visit.
Yes: after a medium or deep peel, visible flaking in the following days is physiological — a sign that cell renewal is under way. After a superficial peel, flaking is finer and more discreet. Recovery times vary: next day for superficial peels, generally 5–7 days for medium peels, 10–14 days for deep peels. Never pick at the flaking skin and always use SPF 50+ protection.
It can be tailored to most skin types, but some conditions require special care. Darker skin (phototype IV–VI) carries a higher risk of post-inflammatory hyperpigmentation, so gentler superficial peels with selective molecules such as mandelic acid or the Jessner combination are preferred. Recurrent herpes, active inflammatory acne, isotretinoin treatment or recent sun exposure may postpone or modify the treatment. The preliminary visit assesses suitability, phototype and goals.
The full result is appreciated 3–4 weeks after the session, once healing and collagen remodelling are complete. Results of a medium peel last 1–3 years; a deep peel's effect on wrinkles can be very long-lasting. Consistent sun protection is essential to maintain the even tone achieved.