Once a Hollywood favorite, chemical peels are making a major comeback, promising smoother, brighter skin in one treatment. Evolving from Cleopatra’s milk baths to high-tech formulas, they target skin’s biggest concerns. But with so many modern alternatives, are they still worth it?
Going Deeper
Chemical peels have been used for centuries, but today’s versions are more refined, offering a range of benefits depending on their depth and formulation. As Omaha, NE dermatologist Joel Schlessinger, MD explains, mild-to-moderate peels use alphahydroxy acids (AHAs) like glycolic or lactic acid to gently exfoliate the skin, improving texture and radiance. Medium-depth peels, including trichloroacetic acid (TCA) and Jessner’s solution, work deeper to target fine lines, acne scarring and hyperpigmentation. Deep peels go even further, addressing severe sun damage, deep wrinkles, and even precancerous lesions with stronger acids like phenol or croton oil.
10%: the increase in demand for chemical peels from the previous year
Source: American Society for Dermatologic Surgery
Renewal Rage
Medium-to-deep peels use 30 to 50 percent TCA to reach the upper-to-mid dermis. PRX-T33 Derm Perfexion, or the “non-peel peel,” is on the lighter end of the spectrum. “Unlike traditional peels, it penetrates the dermis while leaving the epidermis intact, preserving the skin barrier,” explains Delray Beach, FL dermatologist Dr. Janet Allenby. Though it contains 33 percent TCA, the hydrogen peroxide in the formula modulates its effects, preventing frosting and excessive irritation. Instead of causing visible peeling, it’s massaged into the skin to stimulate collagen production. “We apply about four pounds of pressure, similar to fascia blasting,” she adds. Deeper peels use phenol or very high-concentration TCA require expertise and post-care. Austin, TX dermatologist David Bushore, MD explains that while phenol peels of the past carried risks like hypopigmentation and cardiac concerns, modern formulations with more croton oil and less phenol improve on safety. “We’ve maintained effectiveness while lowering risks,” he says.
While both dermatologists and plastic surgeons perform light and medium-depth peels to address superficial photodamage, lentigines and fine lines, deeper peels are often done in the operating room. Newport Beach, CA plastic surgeon Sanjay Grover, MD explains, “Deep chemical peels are much more effective in rejuvenating the skin and treating deep wrinkles and laxity.”
Safety First
Despite their effectiveness, deep peels also come with significant downtime and potential risks, including prolonged redness, peeling and pigment changes. “We’ve largely replaced deep peels with modern resurfacing lasers,” Dr. Joel Schlessinger says. “These lasers provide similar benefits with more control and less downtime.”
Omaha, NE dermatologist Daniel Schlessinger, MD, warns that not everyone is an ideal candidate for deep peels. “If you’re on Accutane, you’re pregnant or breastfeeding, or you have a history of scarring, you should avoid deeper chemical peels. Those with darker skin tones also have a higher risk of post-inflammatory hyperpigmentation, or PIH.” New York facial plastic surgeon Lee Ann Klausner, MD, adds that darker skin types often require pretreatment with hydroquinone, retinoids or vitamin C for several weeks to minimize this risk and ensure optimal results.
Beyond pigment changes like hypopigmentation, deep peels can cause scarring, and in rare cases, systemic effects. “They can also impact the heart, kidneys or liver in some cases,” Dr. Daniel Schlessinger adds.
Results can be impressive and dramatic, making for great clickbait.
Dr. Daniel Schlessinger
Misleading Buzz
Deep-peel videos have also received tons of views on social media, where striking before-and-after photos make them seem like a miracle fix. The dramatic results might make for viral content, but experts say people don’t always realize the intensity of the healing process. “The results can be impressive and dramatic, making for great clickbait,” says Dr. Daniel Schlessinger. “For some people, the prospect of results like that can be quite persuasive and exciting, which creates a buzz and makes for highly shareable content on TikTok or Instagram.”
Certain name-brand deep peels, like the BioRePeel, (it’s sometimes referred to as an “organic peel”) are also gaining popularity online for a gentler approach. However, Bloomfield Hills, MI dermatologist Linda C. Honet, MD cautions that despite branding, the BioRePeel is still a 35-percent TCA peel that carries risks. “If not applied correctly, it can lead to redness, burning or scarring,” she says.
Future Peeling
While these treatments may be trending, many experts are steering patients toward more controlled treatments. “We have so many great lasers that offer similar results with fewer risks,” says Southlake, TX dermatologist Janine Hopkins, MD, who says she prefers the precision of laser resurfacing over chemical peels. Yet, peels remain a cornerstone of the rejuvenation toolkit. As Dr. Grover explains, “The enduring popularity of peels lies in their ability to provide both immediate and long-lasting results.” As we’ve seen time and time again in cosmetic surgery, tried-and-true classics never go out of style.
