The Complete Guide to Chemical Peels — Superficial to Deep

Last updated: 5 March 2026

What Are Chemical Peels?

Chemical peels are one of the oldest and most well-established treatments in aesthetic medicine, with roots dating back to ancient Egypt. They involve the controlled application of chemical solutions to the skin to remove damaged outer layers, stimulate cell turnover, and promote the growth of new, healthier skin. Modern chemical peels range from gentle lunchtime treatments to deep resurfacing procedures, offering solutions for virtually every skin concern.

At Axiom Aesthetics, we offer a comprehensive range of chemical peels tailored to individual skin types, concerns, and goals. Our practitioners are trained to assess skin thoroughly and select the most appropriate peel type and strength for each patient.

How Chemical Peels Work

Chemical peels work by disrupting the bonds between skin cells at a specific depth, causing controlled exfoliation and triggering the skins natural wound healing response. This process:

• Removes dead and damaged skin cells from the surface
• Stimulates increased collagen and elastin production
• Accelerates cell turnover and renewal
• Improves skin texture, tone, and clarity
• Reduces the appearance of fine lines, pigmentation, and scarring

Classification of Chemical Peels

Superficial Peels (Epidermis Only)

Superficial peels penetrate only the outermost layer of the skin (epidermis) and are the gentlest option with minimal downtime:

• Glycolic acid (20-50%) — an alpha-hydroxy acid (AHA) derived from sugar cane. Excellent for general skin brightening, fine lines, and mild pigmentation. The smallest AHA molecule, so it penetrates well
• Lactic acid (20-50%) — a gentle AHA derived from milk. Has humectant properties, making it particularly suitable for dry or sensitive skin types
• Mandelic acid (30-50%) — a larger AHA molecule that penetrates more slowly and evenly. Excellent for darker skin tones as it carries a lower risk of post-inflammatory hyperpigmentation
• Salicylic acid (20-30%) — a beta-hydroxy acid (BHA) that is oil-soluble, allowing it to penetrate into pores. The gold standard for acne-prone and oily skin
• Pyruvic acid — an alpha-keto acid with both exfoliating and sebum-regulating properties

Downtime: Minimal. Slight redness and mild flaking for 1-3 days. Most patients can return to normal activities immediately.

Medium-Depth Peels (Papillary Dermis)

Medium peels penetrate through the epidermis into the upper dermis, producing more significant results with more pronounced recovery:

• TCA (trichloroacetic acid) 15-35% — the most commonly used medium-depth peel. Concentration and application technique determine the depth of penetration
• Jessners solution + TCA — combining Jessners solution (salicylic acid, lactic acid, resorcinol) with TCA enhances penetration and produces more uniform results
• Glycolic acid 70% + TCA — another combination approach that achieves medium depth

Downtime: Moderate. Significant redness, swelling, and peeling for 5-10 days. Social downtime of approximately one week.

Deep Peels (Reticular Dermis)

Deep peels penetrate into the mid-dermis and produce the most dramatic results but carry the highest risks:

• Phenol (Baker-Gordon formula) — the classic deep peel, used for severe photodamage, deep wrinkles, and significant scarring. Requires cardiac monitoring during the procedure due to potential for phenol absorption
• High-concentration TCA (50%+) — can achieve deep penetration but with less predictability than phenol, and higher risk of scarring

Downtime: Significant. 2-4 weeks of recovery with oozing, crusting, swelling, and redness. Redness may persist for several months. Usually performed only once.

Conditions Treated by Chemical Peels

Chemical peels are effective for a wide range of skin concerns:

• Acne and acne scarring — salicylic acid peels for active acne; TCA and combination peels for scarring
• Hyperpigmentation and melasma — mandelic acid and glycolic acid for mild cases; TCA for more resistant pigmentation
• Fine lines and wrinkles — medium and deep peels stimulate collagen remodelling
• Sun damage — all depths of peels can address photoageing at varying intensities
• Dull, uneven skin tone — superficial peels restore radiance and improve texture
• Enlarged pores — regular superficial peels reduce pore size through improved cell turnover
• Rough skin texture — exfoliation smooths the skin surface

The Treatment Process

1. Consultation and skin analysis — assessment of skin type, concerns, and medical history. Contraindications are reviewed
2. Pre-treatment preparation — for medium and deep peels, a pre-treatment regimen of retinoids and/or hydroquinone may be prescribed for 2-4 weeks to prime the skin
3. Skin cleansing — thorough degreasing of the skin to ensure even penetration
4. Peel application — the solution is applied in a controlled manner, with the practitioner monitoring the skins response (frosting, erythema) to gauge depth
5. Neutralisation/timing — some peels self-neutralise (TCA, salicylic), while others require active neutralisation (glycolic acid)
6. Post-peel care — soothing agents are applied and detailed aftercare instructions provided

Safety and Contraindications

Chemical peels are generally safe when performed by trained practitioners, but certain conditions preclude treatment:

• Active skin infections (bacterial, viral including cold sores, or fungal)
• Use of isotretinoin within the past 6-12 months (depending on peel depth)
• Pregnancy or breastfeeding
• Active eczema or psoriasis in the treatment area
• Recent radiation therapy to the face
• History of poor wound healing or keloid scarring (for medium/deep peels)
• Unrealistic expectations regarding outcomes

Skin Type Considerations

Fitzpatrick skin types IV-VI carry an increased risk of post-inflammatory hyperpigmentation from chemical peels. Safer options for darker skin include mandelic acid, low-concentration glycolic acid, and salicylic acid peels. Pre-treatment with topical agents and careful post-peel sun protection are essential.

“Chemical peels remain one of the most versatile and cost-effective treatments in aesthetic dermatology. With proper patient selection and technique, they deliver consistent, evidence-based results across a wide range of skin concerns.” — British Journal of Dermatology

Frequently Asked Questions

Summary

Chemical peels offer a proven, versatile approach to skin rejuvenation suitable for a wide range of concerns and skin types. From gentle superficial peels that brighten and refine to deeper treatments that remodel and resurface, there is a peel option for virtually every patient. At Axiom Aesthetics, our thorough assessment process ensures you receive the right peel at the right strength for your individual needs, delivering safe and effective results.