Skin resurfacing for beauty has been in use for thousands of years. In prehistoric times, women would use rocks and shells to abrade the surface of their skin. In Babylonia and India, women used pumice stones to exfoliate the top layers of the skin. In the Middle Ages, the first chemical peels were performed; women would soak cloths in lime, mustard, or sulfur to rejuvenate the appearance of the skin. Gypsies were reportedly the first group to use phenol for deep chemical peels, and they are known to have passed secret chemical peel recipes between villages and generations. The Turks would intentionally singe their skin with fire to achieve exfoliation of the skin. The Egyptians are also well known for their fascination with beauty regimens. Early papyruses document the use of acids and balms for chemical peeling. The Greeks and Romans used soured milk, fermented grape juice, and lemon extract to clarify their skin.
Today, chemical peels are an indispensable part of most aesthetic practices, and the chemicals used are frequently derived from the natural ingredients mentioned above. For example, milk contains lactic acid, sour grapes contain tartaric acid, and lemon juice contains citric acid. These are all alpha hydroxy acids, which are used in light chemical peels. Salicylic acid, found in wintergreen, contains beta hydroxy acids, which are useful in peels for acneic skin. Trichloroacetic acid (TCA) is used for medium-depth peels in patients with moderate sun damage. The deepest peels, which use phenol, require general anesthesia for cardiac monitoring, and will create significant skin peeling. The peels I have selected for use in my office are from PCA Skin, which uses a large number of natural ingredients to achieve superior results. All peels and products used in my office are hydroquinone-free.
While deeper peels were popular in the past, most patients today simply do not have the down-time available to sit at home while their skin sheds for 4-5 days. Lighter peels exfoliate the skin, and will encourage the skin the shed dead cells and impurities from the surface. When performed in series, the skin becomes brighter, more even-toned, and smoother. In addition, peels can allow your current skin care products to absorb better, producing optimal results. I perform all peels personally in my office, and most treatments require only 30 minutes. Many patients do not peel after the treatment, but may notice mild flaking for several days which can be easily concealed. They are able to return to all normal activities immediately, with the exception of heavy exercise which should be avoided for two days.