nytimes.com
When Laura Messina, 43, wanted to lighten the dark spots under her eyes this summer, she tried a chemical peel she bought online from a department store.
Hours later, her face was covered in rough, red, burning splotches. The irritation lingered for days, so she rushed to a dermatologist who prescribed a cream that she applied twice a day for two weeks.
“It was silly of me to even try it,” she said. “This was a lesson for me.”
Chemical peels, procedures where liquid is applied to skin to remove outer layers, are typically administered by dermatologists and other licensed professionals. There’s evidence that peels help manage pimples, discoloration, scarring and signs of aging.
While at-home versions are widely available, they can come with some risks, experts say. In July, the Food and Drug Administration warned consumers against buying chemical peels with high concentrations of certain acids and urged consumers to use peels only under professional supervision.
For those who want to try peels themselves, dermatologists said it’s crucial to be safe.
Over-the-counter chemical peels are similar to those used in dermatologists’ offices — they both may contain a variety of acids. At-home versions usually include alpha-hydroxy acids like glycolic or lactic acid, or beta-hydroxy acids such as salicylic acid. Both types improve skin texture and appearance by penetrating and removing the outer layer of skin.
The solutions in at-home versions, however, are generally weaker than those used in doctor’s offices, so their results are often more subtle.
You can think of a chemical peel as “a very intense exfoliation,” said Dr. Shari Lipner, an associate professor of clinical dermatology at the Weill Cornell Medical Center in New York City.
By removing the outer layer of skin, chemical peels reveal the skin underneath and encourage cell growth. But some penetrate deeper layers, depending on the ingredients. Experts sort peels into three categories based on depth: superficial, medium and deep.
Superficial or light peels are the weakest kind, and they can be found in stores. They contain low concentrations of acids and penetrate the epidermis, the outermost layer of skin. They can help manage mild acne and fine lines.
Medium-depth peels, often used for uneven skin tone, acne scarring and wrinkles, should only be administered by a licensed professional because they contain harsh acids such as trichloroacetic acid, or TCA. They penetrate the top of the middle layer of skin — the dermis.
Deep chemical peels, administered at a doctor’s office for blemishes including pronounced wrinkles, scars and sun damage, reach the bottom of the dermis, often with a corrosive acid called phenol.
Deep chemical peels create more dramatic results than superficial ones, said Dr. Gary Goldenberg, an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. By penetrating deeper layers, the peels stimulate more skin cell growth and collagen, the protein that keeps skin elastic and plump.
Chemical peels found in stores are usually gentle on the skin, Dr. Lipner said, so when used correctly, they’re generally considered safe for people who don’t have sensitive skin or other conditions.
But disregarding directions and keeping a peel on for too long can have consequences, Dr. Goldenberg said. It can result in redness, irritation or hyperpigmentation. In more serious cases, misuse can cause chemical burns, blistering and permanent scarring, Dr. Lipner said.
Deep chemical peels typically aren’t sold over the counter, but dodgy solutions containing TCA or phenol are sold online. Before buying a peel, check the product label for those ingredients. “You do not want to go even close to that,” Dr. Lipner said, because it’s easy to injure yourself.
Using chemical peels at home has inherent risks. But there are ways to minimize them, experts said.
Consider the brand. Countless companies sell chemical peels on sites like Amazon and eBay, said Dr. Hope Mitchell, a fellow of the American Academy of Dermatology. Consider avoiding peels from brands or websites you’ve never heard of. It’s possible their products may be counterfeit or contain higher acid concentrations than what their label might indicate.
Try a test patch. Some chemical peel manufacturers don’t list acid concentrations on product labels, making it hard to assess a solution’s strength or how your skin will react. Apply the solution to a spot underneath your jawline, Dr. Lipner suggested. Then, over a few days, look out for a reaction.
Apply sunscreen. You should wear sunscreen with an SPF of 30 or more every day, but it’s even more crucial after using a peel so that you can avoid developing sunburns or dark spots. In general, try to limit direct sunlight for a few weeks before and after using a peel, Dr. Lipner said. If the sun is inescapable, consider wearing a sun hat and staying in the shade.
Keep skin sensitivity in mind. If you have sensitive skin or conditions like eczema, rosacea, psoriasis or cold sores, don’t use a peel without consulting your doctor: The acids may irritate your skin and worsen the condition. People using retinoids, or vitamin A derivatives, to manage blemishes should also talk to a provider, Dr. Goldenberg said.
Ultimately, it’s potentially hazardous to try at-home peels on a whim or without talking to a dermatologist, Dr. Lipner said. “You really have to think this through.”