Today, there are newer, gentler peels that can be used alone, together, or with other skin-rejuvenating treatments such as lasers or microdermabrasion, researchers said today at the annual summer meeting of the American Academy of Dermatology.
"It's like a rebirth or a second youth," says Neil S. Sadick, MD, a clinical professor of dermatology at the Weill Medical College of Cornell University in New York. "The major uses of chemical peels are basically the treatment of pre-skin cancer, photoaged skin, wrinkle reduction, excess pigmentation, and acne, plus they can be very helpful in the treatment of acne scars," Sadick says.
"One of the major things that is new in 2004 is using peels as combined modality with lasers or microdermabrasion," a treatment in which the dermatologist sandblasts tiny crystals across the face to remove dead skin, he says.
In addition, "at-home regimens are popular, and today most patients should be on an at-home peeling regimen on a nightly basis because it is no longer enough to just do a peel in the office," he says.
How Deep Is Your Peel?
"Superficial peels are more en vogue at this time because they require virtually no downtime and produce good results for the early signs of aging," Sadick says.
Medium-depth peels go slightly deeper than their superficial counterparts, while deep peels penetrate virtually all of the skin's many layers.
"In 2004, we use multiple types of chemical peels on each person," he says. For example, "we can apply a medium-strength peel to the midface a superficial peel on the neck or chest and a deeper peel around the eyes or mouth."
When choosing which peeling agent to use, doctors often consider such factors as how dark the skin is, how much sun damage there has been, and how oily the skin is, he says.
"The new kids on the block are beta-hydroxy acid peels, which are helpful on dark skin and significant acne," he explains. Such peels reduce the amount of sebum, or oil, trapped in the tiny hair follicles of the skin that produce acne.
"Chemical peels still play an important role in practice," he says. "They are underutilized but getting a second rebirth."
Diane S. Berson, MD, assistant professor of dermatology at the Weill Medical College in New York, agrees that chemical peels can play a role in the treatment of female acne -- especially light peeling with salicylic acid, a beta-hydoxy acid peel.
"These agents get into the sebaceous follicles so after the peel, the pores look smaller because they have been unclogged, and since salicylic acid is the main ingredient in aspirin, they can also calm inflammation," she says.
"Hormonal treatments [birth control pills] for acne are very helpful for all women with acne," Berson says. Most contain combinations of the hormones estrogen and progestin, which clear up acne by decreasing the production and availability of the hormone testosterone, which is known to stimulate the sebaceous glands to produce acne-causing oil.