Page 10 - VI DERM BOOK COM (002)_FINAL

CHEMICAL PEELING
fundamentals

Chemical peeling, or chemexfoliation, has been a part of clinical dermatology for centuries. From its early inception,
aesthetic benefits to patients were known with an ability to improve texture and reduce freckling, melasma, and acne.
During World War I, Douglass Montgomery made reference to his use of phenol under bandages for healing and
‘beautifying’ the skin. The discoveries made hundreds of years ago have been refined to improve patient outcomes while
minimizing unwanted side effects.

Chemical Peels remove the outer layers of skin to enhance the appearance as well as improve its functionality. They
create controlled damage to the skin, exfoliate dead skin cells, stimulate cell renewal, and regenerate dermal structures.
Chemical Peels are classified based on their depth of penetration, from very superficial (stratum corneum) to deep
(reticular dermis). The depth of penetration is based on the type(s) of peeling agents as well as their percentages. In
addition, the acid pH, application technique, quantity applied, skin preparation, and skin type also affect how deep the
chemical peel will penetrate.

Chemical peels are most commonly classified according to Dr. Harold J. Body’s classification, which is
based to the depth of penetration and injury caused.

• Very Superficial peels penetrate only to the
stratum corneum

• Superficial peels penetrate to any depth within
the epidermis
DERMIS
• Medium-Depth peels penetrate through the
Dermal-Epidermal Junction to the papillary
dermis

• Deep peels penetrate down to the level of the
reticular dermis.

The peeling solution used does not necessarily determine the depth of peel. Depth can be determined by a number of
factors, including the concentration of the solution, the pH, the availability of free acid, the length of time applied to the
skin, the condition of the skin, and the method of application. For example, a glycolic acid 70% solution may act as a
superficial peel when applied for five minutes; however, it can cause a medium peel effect if left for 15 minutes.

VERY SUPERFICIAL PEEL SUPERFICIAL PEEL MEDIUM-DEPTH PEEL DEEP PEEL

Low potency AHAs AHAs 30-40% TCA Straight Phenol –high %

6-10% TCA 10-20% TCA TCA + Jessner Baker- Gordon

Retinoic Acid Peels Jessner Solution All VI Peels 40+% TCA

Salicylic acid

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