Chemical peels for acne scars make use of a chemical agent to exfoliate the skin and promote collagen production. When a chemical peel is applied to the skin, a controlled burn is created to the upper skin layers. This causes the skin to slough and stimulates collagen and hyaluronic acid production. The overall result is a rejuvenated look and less visibility of atrophic acne scars. Another major benefit of chemical peels for acne scars is a reduction in hyperpigmentation (dark blemishes) that are commonly seen with acne.
Which Chemical Peel For Acne Scars Works Best?
There are many peeling agents available. Which chemical peel for acne scars works best depends on the type of acne scars being targeted, skin tone, and skin sensitivity.
Mild Chemical Peels
Hydroxyacids, glycolic acid, salicylic acid, and low concentration trichloroacetic acid (TCA peel for acne scars) fall into this category. The risk of complications is low due to the minimal depth of penetration. Treatments usually need to be repeated frequently to maintain results.
Deep Chemical Peels
These chemical peels for acne scars use phenol or higher concentration trichloroacetic acid (TCA peel for acne scars). They penetrate deeper so can target scars including ice pick types. Deeper burn depth also means longer recovery and a higher chance for complications. Hyperpigmentation or even scarring can occur, especially in darker-skinned people. A special type of deeper chemical peel is called the CROSS (Chemical Reconstruction Of Skin) Technique.
Over-The-Counter Peels
These peels can be purchased for home use. They are designed to produce only very mild and superficial peels. Home peels are not considered effective chemical peels for acne scars.
Cost Of Chemical Peel For Acne Scars
The cost for these acne scar treatments depends mostly on the type of peel being done and the extent of the area needing treatment. Cost ranges are:
- Mild peels: $1000 – $3000
- Deep peels: $2500 – $6000
Keep in mind that costs will also vary depending on:
- your need to travel
- consultation fees
- popularity and experience of your chosen practitioner
- number of treatment session required
- after care products needed
Who Shouldn’t Get A Chemical Peel?
- history of an allergic reaction to the peeling agent
- infection or wounds in the area of the peel
- recent cold sores
- isotretinoin use in the last 6 months
- pregnant or breastfeeding
- patients with psoriasis, connective tissue diseases, atopic dermatitis, exposure to radiation therapy, or who had recent facial surgery
- known propensity for keloid formation or poor wound healing
- uncontrolled diabetes
- iimmunosuppression
- darker-toned people (prone to abnormal pigmentation)
Preparing For Chemical Peels For Acne Scarring:
It is generally recommended that the skin is “prepped” for treatments. Prepping involves the use of topical applications for 2-4 weeks prior to treatment. The goal is to soften the outer skin layers so that the chemical peel works most effectively. Your chosen practitioner will recommend a prepping agent suitable for your case. Examples include tretinoin (0.025 to 0.05%) cream, and salicylic acid cream. If you are of a darker skin tone, you may be asked to use hydroquinone prepping agents. Hydroquinones can help prevent hyperpigmentation problems after the chemical peel in susceptible individuals.
You will also be instructed to avoid direct sun exposure to your skin. Other treatments to the area, such as waxing should be avoided in the weeks leading up to your peel.
After Your Chemical Peel:
After a chemical peel for acne scars, your skin will become red and possibly swollen. The look resembles a sunburn. The depth of the peel will determine the severity of redness and swelling. Healing time also relates to the depth of the peel. Skin sloughs and peels over several days. Redness can take weeks to resolve, especially with deeper peels.
Makeup and regular skin routines can resume as soon as healing is complete. This can take days or weeks, depending on the depth of the peel.
Protection from sun exposure should be maintained for the first year after a chemical peel. The use of good quality sunscreens (SPF at least 50) is a must. Failure to avoid sun exposure can increase the risk of blotchy pigmentation arising.
Complications From Chemical Peels For Acne Scars:
Immediate Complications
- swelling
- burning and itching
- blistering
- allergic reactions
- inadvertent eye burns
- heart rhythm abnormalities with phenol
Delayed Complications
- infections
- prolonged redness and swelling
- acne flare ups
- post-inflammatory hyperpigmentation
- hypopigmentation
- scarring (especially in keloid-prone individuals)
Conclusions:
Chemical peels for acne scars are a minimally invasive treatment. There are many chemical agents to choose from and different depths of peel possible. A customized treatment plan is necessary to know which type and how many peels will work best for you. People with darker skin types or who are prone to keloids may not be good candidates for chemical peels for acne scars.
Medical References:
Samargandy S, Raggio BS. Skin Resurfacing Chemical Peels. [Updated 2021 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547752/
Gupta A, Kaur M, Patra S, Khunger N, Gupta S. Evidence-based Surgical Management of Post-acne Scarring in Skin of Color. J Cutan Aesthet Surg. 2020 Apr-Jun;13(2):124-141. doi: 10.4103/JCAS.JCAS_154_19. PMID: 32792773; PMCID: PMC7394107.