A facial peel is a procedure for deep skin cleansing, aimed at removing dead skin cells, evening out the skin surface, removing impurities, and stimulating the renewal of the epidermis.

Types of Peels Based on Depth of Action:

• Superficial Peel: Works on the level of the stratum corneum of the skin, without penetrating deeply. It does not cause inflammation or peeling and provides mild skin renewal.
• Medium Peel: Penetrates the papillary layer of the dermis and partially damages the basal membrane. It can be subdivided into superficial-medium peel (works only on the epidermis) and medium peel with basal membrane damage.
• Deep Peel: Penetrates the reticular dermis and completely destroys the basal membrane, leading to significant skin renewal.

Chemical Peel:

A chemical peel is based on the use of acids (lactic acid, glycolic acid, azelaic acid, phytic acid, lactobionic acid, phenol, etc.), enzymes, and biologically active substances (vitamins, minerals, amino acids).

• AHA (alpha-hydroxy acids): Fruit acids such as lactic acid, glycolic acid, and mandelic acid, which are water-soluble and have a mild action. They provide a fast but short-term effect.
• BHA (beta-hydroxy acids): Oil-soluble acids like salicylic acid, which have an aggressive effect on the skin. They are slowly excreted, but provide a fast and long-lasting effect.
• Enzymatic Peels: Suitable for all skin types, with a mild effect similar to AHA acids.
• Biologically Active Substances (BAS): Include retinoids (vitamin A) and peptide peels, which contribute to deep skin renewal.

Peel by Age Group:

• Adolescence (14 to 20 years): A peel can be performed from the age of 14 after consultation with a dermatologist, if there are indications. At this age, mainly superficial peels with alpha-hydroxy acids (AHA) and enzymes are performed. Ultrasonic peeling can also be used for facial cleansing.
• Age 25 to 30: Peels are performed to combat acne, post-acne, hyperpigmentation, and photoaging. These are superficial peels and ultrasonic peels. If necessary, laser peeling and superficial microdermabrasion can be performed.
• Age 35 to 45: Peels are used to remove cosmetic defects (wrinkles, pigmented spots, scars), combat photoaging and chronaging, hydrate the epidermis, and improve the skin’s turgor and elasticity. The main task of peeling at this age is hydration and a lifting effect. These are superficial and medium peels, as well as peels with retinoids (vitamin A). Chemical peeling, ultrasonic peeling, laser peeling, and microdermabrasion can be applied.
• Age 45 to 60: Superficial peels are less effective, medium and, in extreme cases, deep peels (phenol or crotonic acid) are recommended. Menopause affects the skin, estrogen production decreases, the thickness of all skin layers reduces, and deep wrinkles form. The main task of peels is to combat signs of aging. All procedures are indicated.
• Age 60 and above: Facial peels are used as preparation for plastic surgery, if there are no contraindications.

Peel by Skin Type:

• Peel for Dry Skin: Use peels with alpha-hydroxy acids (especially moisturizing lactic acid, tartaric acid, and pyruvic acid). Peels with gluconolactone and arginine are also recommended.
• Peel for Oily Skin with Excess Sebum Production: Peels with glycolic acid and salicylic acid, ultrasonic peels, laser peels, and microdermabrasion are suitable for oily skin.
• Peel for Problematic Skin: To treat acne and its consequences, the following peels are used: mandelic acid, glycolic acid, salicylic acid, retinoic acid, pyruvic acid, azelaic acid, Jessner’s peel, and ABR peel. Ultrasonic, vacuum, and laser peels, as well as microdermabrasion, can also be performed.
• Peel for Sensitive Skin with Rosacea: Recommended peels are mandelic acid, lactic acid, azelaic acid, phytic acid, lactobionic acid, retinoic acid, TCA peel, and enzymatic peel. Mechanical peels are not recommended.
• Peel for Normal Skin: All types of peels can be performed depending on indications and contraindications.

Features of Facial Peels:

• Avoid exposure to direct sunlight after a peel, use sunscreen with an SPF of at least 25, and wear a wide-brimmed hat during sunny periods.
• Many peels should be performed in the autumn-winter period, when sun radiation is the lowest.
• Avoid tanning beds and direct sun exposure one week before the peel and during the recovery period. In extreme cases, cover the face with a thick towel.
• Avoid baths and saunas during the recovery period.
• Many peels should not be combined with the use of certain medications (retinoids, hormones, photosensitizing agents, anticoagulants, etc.).
• Preparation for the peel and post-procedure care are necessary.
• Consider the indications and contraindications.
• Be aware of possible complications after a peel.

Indications and Contraindications:

• Problematic skin and acne (acne, post-acne, comedones, milia, scars)
• Hyperpigmentation
• Chrono- and photoaging
• Decreased turgor and elasticity of the skin
• Hyperkeratosis
• Dull, uneven complexion
• Enlarged pores
• Gravitational ptosis and sagging skin
• Preparation for more serious and deeper cosmetic procedures

Contraindications:

• Pregnancy and breastfeeding period
• Cold and fever
• Chronic diseases in the acute phase
• Herpes in the acute phase
• Infectious skin diseases
• Tendency to form keloid scars
• Skin damage
• Blood diseases and cardiovascular conditions
• Oncological diseases
• Skin diseases in the acute phase (eczema, allergic dermatoses, atopic dermatitis, psoriasis, etc.)
• Diabetes mellitus

Results of Facial Peel:

• The skin is smooth, even, and soft.
• Increased turgor and elasticity.
• Lifting effect.
• Even and healthy complexion.
• Reduction of wrinkles and scars.
• Reduction or disappearance of pigmented spots.
• Reduced acne symptoms.
• Renewed skin (rejuvenation).
• Activation of the skin’s protective and regenerative functions.
• Normalization of skin pH and sebaceous gland function.

Combination of Facial Peel with Other Procedures

Facial peels give good results when combined with other cosmetic procedures such as masks, mesotherapy, biorevitalization, manual facial cleansing, thread lifting without surgery, and Botox injections.

Each facial peel, even a deep one, cannot replace surgical rejuvenation because it only targets improving the appearance and condition of the skin, without affecting underlying tissues such as muscles and fascia. For the best rejuvenation effect, it is necessary to combine peels with surgical lifting.

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