Facial peelings have risen in popularity in recent years – and rightly so, because a properly chosen and performed peeling not only improves the appearance of the skin, but also promotes cell renewal and can thus improve the elasticity of the skin. The goal of the treatment lays in the removal of skin impurities and refinement of skin tone by reducing the size and visibility of skin pores. This results in skin that is toned, cleaner, and visibly refreshed.
What many may not be aware of is that the term peeling refers to both cosmetic and dermatological treatments, which can be in the form of mechanical, chemical, or laser peels. Laser peeling is a skin resurfacing treatment, and like all peeling forms, it has the potential to damage the skin if performed incorrectly, or as in the case of a chemical peel, with the incorrect substances.
Generally speaking, mechanical peels are well tolerated and suitable for most skin types. They work via tiny particles incorporated into topical creams that when applied and massaged into the skin rub off the impurities found in the superficial layer. In particular, dead skin cells, dirt, and fine particles can be removed using gentle pressure during the massage.
The particle shape, size, and hardness determine the intensity of the peel. The softer, smaller, and rounder the particles are, the gentler the exfoliation. Harder particles that are large and have rough edges exert a stronger mechanical force and result in a more intense treatment.
Besides the physical properties of the particles, their composition is also important. Plastic microbeads are particularly damaging and unfortunately still frequently used. Although since 2013, they are no longer allowed to be incorporated into dental care products, there exists no such ban on shower gels, shampoos, or exfoliating scrubs.
Substances such as polypropylene and polyethylene terephthalate have been increasingly found to be harmful in the body and are still frequently used (1). Fine particles derived from plants or other organic products, such as seashells, almonds, or eggshells are much softer and gentler on the skin, not to mention eco-friendly.
Another popular exfoliation technique is the chemical peel. In fact, it’s the third most common non-invasive cosmetic procedure performed in the United States (2). Depending on the depth of skin penetration, varying results can be achieved.
For example, a superficial exfoliation is recommended for skin diseases such as comedogenic or cosmetic-induced acne, superficial pigmentation (melasma), as well as photodamage. Mid-depth peels penetrate into the papillary dermis (the middle part of the skin) and are suitable for the reduction of superficial scars and small wrinkles.
Deep peels can be used in the case of severe skin aging, as well as to treat deep wrinkles and pronounced scars, as they penetrate to the reticular dermis (the deep middle layer). Although mid-depth and deep chemical peels are low-risk procedures, both may only be administered under medical supervision (3).
It is extremely important to use an exfoliant that provides the desired effect on the skin without damaging it. Too much or unnecessarily deep exfoliation will damage the underlying layers, resulting in scarring, infection, irritation, and subsequent pigmentation (4). Caution should be used when taking oral contraceptives: in these patients, there is an increased risk of post-peeling hyperpigmentation.
For this reason, the chemical peel should not be carried out immediately prior to strong UV exposure. Adequate care should be taken to prevent post-peeling sun exposure in the summer months, or the treatment should be avoided entirely prior to a planned vacation in very sunny regions, for example.
After an exfoliating treatment, whether through a mechanical peeling or otherwise, the skin is more permeable and is better able to absorb the active ingredients found within skincare products, such as vitamin C or hyaluronic acid. Although these substances extend their beneficial properties through deeper penetration into the skin, be advised that this can still cause mild burning and irritation when used directly post-peel, as these substances are mild acids. It is important to adequately inform patients about this minimal yet relevant complication.
At home, a mild mechanical peeling can be performed regularly at a rate of once or twice a week. When choosing a scrubbing cream for personal use, it is important to look for a cosmetic formulation that uses organic exfoliation particles and contains moisturizing ingredients in order to prevent unnecessary skin irritation.