Acne is an extremely common condition that affects up to 50 million Americans. Characterized by blemishes on the surface of the skin caused by excess oil production and clogged pores, acne can plague many people well beyond their teenage years. What is more, when not cared for promptly, acne can lead to the appearance of acne scars, which may remain visible on the surface of the skin until they are treated. For those patients who are particularly acne-prone, the risk of developing scarring following a breakout may be higher. Acne scars form as a result of inflamed acne breakouts in which bacteria multiply in pores where oil, sebum, or dead skin cells have built up. There are several different kinds of acne scars, including atrophic scars, which are characterized by indents on the surface of the skin, and hypertrophic scars, which are characterized by raised bumps. Inflamed acne breakouts can also lead to hyperpigmentation, which is when dark spots appear on the skin where the breakout occurred. For those patients who suffer from atrophic acne scars or hyperpigmentation following a breakout, a chemical peel treatment may be the best option for eliminating the appearance of unsightly scarring.
Chemical peels are an excellent way to exfoliate and rejuvenate the skin. A chemical solution is placed on the treatment area, which then reacts with the surface of the skin to remove dead skin cells, unclog pores, eliminate hyperpigmentation, and stimulate the production of new collagen to reduce the appearance of acne scars. For the treatment of acne scars, light or medium strength chemical peels may be best to eliminate acne scars and acne scarring. Dr. Green uses different types of chemical peels for different skin tones, from TCA, lactic acid, and glycolic peels. As new collagen is formed as a result of the chemical peel, your skin is rejuvenated, as new skin cells are formed. As an expert in chemical peels and treating patients with all skin types, Dr. Green will choose the best type of acid peel as well as the strength of the chemical peel for the proper exfoliation.
Dr. Michele Green is a board-certified cosmetic dermatologist who has been treating patients at her discreet, private, New York City Upper East Side office for over 25 years. She has been consistently as one of the best dermatologists in NYC by Castle Connolly, the New York Times, New York Magazine, and Super Doctors. Dr. Green is an expert in creating individualized cosmetic treatment plans to meet the goals of each of her patients. As an expert in treating acne and acne scars, she often combines different treatment modalities and types of chemical peels with dermal fillers or lasers to remove acne scars and rejuvenate your skin. In addition, Microneedling and the use of other injectable treatments may be used for the best combination approach. If you are suffering from acne breakouts and acne scars, Dr. Green is here to help.
What are acne scars?
Acne scars can develop following a breakout of acne if the acne itself is not treated. A breakout of acne become infected when bacteria multiply in the pores clogged with excel oil, sebum, or dead skin cells. This can lead to inflammation and damage to skin. The type of scarring that can occur depends upon the success of the healing process. Atrophic scars, which are characterized by indents in the skin, occur if the body is unable to produce enough collagen to repair the damage. Atrophic scars can be further broken down into Ice Pick Scars, which are deep and narrow scars that occur after a deep infection, Boxcar Scars, which are wide and round indents, and Rolling Scars, which are shallow indents that makes the surface of the skin appear wavy. A second type of scarring is Hypertrophic scars, which occur when there is an excess of collagen production in the healing process resulting in raised bumps on the skin. When looking to eliminate acne scars, Dr. Green will examine the scars and make a determination about the best treatment process for that type of scar. Chemical peels are best used to treat atrophic scars and hyperpigmentation that can occur after an acne breakout.
What is it like to get a chemical peel for acne scars?
In the process of a chemical peel, the skin is cleaned of all makeup, sunscreen, and oils. Patients are advised not to use exfoliating products, including Retinols and Retin-A for 24 hours before the chemical peel. A chemical agent is applied to the clean skin, to remove the outermost layer of the skin, the stratum corneum. Depending on the strength of the acid used to peel the skin, the solution may be left on the skin for 1 to 5 minutes. During the chemical peel, the topical solution which is applied to the skin and causes the surface skin cells to exfoliate and peel off. This allows new skin cells to regenerate. As the dull skin peels off, your complexion becomes more radiant, acne and acne scars are reduced, and your skin is rejuvenated. The result is new skin which is luminous, brighter, with an improved texture, and even skin tone.
In addition to treating acne and acne scars, chemical peels are commonly used to treat fine lines and wrinkles, and hyperpigmentation which results from sun damage. Chemical peels also improve skin tone, including discoloration such as sunspots, age spots, and melasma which can result from pregnancy or from taking birth control pills. Pre-cancerous skin lesions, actinic keratoses, caused by too much sun exposure, can also be treated with chemical peels. Special care will be taken by Dr. Green to match the type of chemical peel needed with your skin tone.
How do I select the best chemical peel for my skin type?
Dr. Green offers a wide range of chemical peels in order to provide patients with the best choice of treatment options. Dr. Green will work closely with you to guide your selection of the type of chemical peel which is best suited to your skin type and problem area, also taking into account the amount of downtime your schedule allows. She will review the risks and benefits in deciding between a glycolic peel versus a deeper peel.
A peel should be selected based upon your specific skin tone and the various skin conditions which need to be addressed. A superficial peel is effective for changes to the superficial layers of the skin, including hyperpigmentation and skin texture. Dr. Green may advise a deeper chemical peel when addressing deeper lines and wrinkles, especially for problem areas around the eyes (periocular) and mouth (perioral wrinkles).
What Chemical Peel is best for acne scars and acne?
In general, the best superficial chemical peels for acne consist of glycolic acid or light trichloroacetic acid (TCA). Alpha hydroxy acids, such as glycolic acid at 30-50%, are ideal for superficial chemical peels for acne and acne scars. These acids help to unclog the pores, and through the process of exfoliation, remove the dead skin cells. Through this peeling process, the pimples and acne breakouts are unclogged and the acne is under much better control. In terms of acne scars and hyperpigmentation, when the new skin forms after the peel, the blemishes are lighter and the discoloration improved. Dr. Green often combines chemical peels with the home use of her MGSkinLabs lines of skin-care products, containing hydroquinones, Retin-a, tretinoin and Vitamin C serum, to further improve your acne and acne scars. In addition, salicylic acid has been used for decades and remains a good peeling agent for patients with acne.
You will see improvement in your skin’s complexion even after one chemical peel. The best results for acne and acne scars is a series to 3 to 6 chemical peels, depending on the degree of acne, acne scars, and hyperpigmentation. Proper SPF protection should be used throughout this chemical peel process, to avoid a sunburn or further sun damage. As a result of the chemical peel, your new skin will be even-toned and radiant.
Best Medium depth chemical peels
Medium depth peels are usually done using done with an acid solution containing a 20% trichloroacetic acid (TCA) solution, or higher. The higher the strength of acid used, the more care needs to be used in proper patient selection. Darker skin patients run the risk of hypopigmentation or hyperpigmentation from higher strength TCA peels, when strong acid solutions are used. Dr Green will help you decide which percentage and type of acid would be best for your skin type.
A common medium strength chemical peel is a Jessner peel. A Jessner peel has been traditionally been a combination of Lactic acid, salicylic acid, and resorcinol in a 95 percent ethanol solution. There are some health concerns about the resorcinol, since it is a phenol derivative, and most Jessner’s peel now being replacing resorcinol with TCA. This type of chemical peel is called a modified Jessner’s peel. This medium strength chemical peel involves removing skin cells not just from the top layer of the skin, but also the top layer of the dermis. Jessner’s peels have been around for over one-hundred years. While they are safe and effective, the specific radio of alpha and beta-hydroxyacids needs to be maintained with a pH of the overall solution typically around 1.9. It is essential to control the pH of the acid solution, since this controls any unwanted side effects from the chemical peel. Retinols and other AHAs, such as phytic, azelaic, glycolic, and mandelic acids, can be used to modify the Jessner’s formulation for added benefits.
The benefits of a medium strength chemical peel is that while removing the skin cells, it causes new skin to heal and remove more hyperpigmentation for skin lightening, acne scarring, and wrinkles. The result is smoother, softer, tighter, and more even skin tone and texture. Again, Dr. Green will help decide which type of chemical peel would be best for you based on your skin type and the amount of downtime needed.
Deep chemical peels
These deep peels are rarely performed because of the long healing time required and the higher risk of hypopigmentation and hyperpigmentation to the skin. Deep peels remove skin cells from the epidermis and from the mid to lower dermal layer. Deep peels are recommended if you have deep lines and wrinkles, deep scars, and extensive sun damage. Most patients prefer a series of light or medium strength peels, which have a cumulative effect over time, over such a strong chemical peel.
A deep peel can only performed once. Deep chemical peels cannot be done on patients with darker skin tones, since this can damage the skin. There can often be a significant contrast in coloration, or demarcation, after a deep peel in the area peeled compared to the untreated skin. Deep chemical peels are not needed to treat moderate acne. Since deep chemical peels are painful, they require anesthesia or pain management both before and after the procedure. You will leave the office with your face bandaged after the procedure.
The Best Chemical peel for all skin types
Cosmelan peels are an amazing depigmentation peel which treats dark marks from acne, acne scars, melasma, and overall skin hyperpigmentation. Many patents are unhappy after the acne marks and dark discolorations which remain after their acne breakouts heal. Cosmelan peels can be used in patents of all skin types, no matter what the skin tone. In this two part chemical peel, which is performed in the office of Dr. Michele Green, the cosmelan peel is applied on the patient’s skin with strict instructions for at home removal and corresponding at-home skincare products. Strict sun avoidance with a high SPF is needed after this procedure.
TCA, or trichloroacetic acid, Cross is a chemical treatment that is best used on atrophic ice pick scars and works by stimulating the production of new collagen and elastin. The TCA Cross treatment works by depositing a small amount of concentrated TCA directly into the indentations on the skin, as opposed to a TCA peel, which is used to treat the full face. When placed directly into the deep scars, the TCA Cross triggers the body’s natural healing process, which leads to the production of collagen and elastin. These proteins help the body to produce new skin cells that fill in the indentations in the skin and make the skin appear lighter and brighter. The treatment is not suitable for patients with type 3 skin or darker, as there is a risk of hyperpigmentation. Dr. Green typically recommends between 3 and 5 treatments for optimal results spaced 6-8 weeks a part. The production of new collagen can begin as little as four weeks following the treatment with ongoing improvements to the surface of the skin for as long as 4 months following each procedure.
Recovery time and expected results
A superficial peel, such as one to improve moderate acne, or acne scars requires very little recovery time with some dryness or flaking for just a few days. Recovery from a medium depth peel generally takes about one week. After a deep chemical peel, several weeks or more must be allowed for a complete recovery.
A light to medium depth chemical peel, including those used to treat acne and acne scars, has no discomfort. During the peel patients may feel a slight stinging sensation which lasts a few minutes. A deep chemical peel, on the other hand, may require significant pain medication both during and after the treatment.
How do I take care of my skin after a chemical peel?
Dr. Green will review the best skin care products to use at home after your chemical peel. It is very important to continue moisturizing your skin after your chemical peel with rich moisturizers that do you contain any irritating ingredients. Daily moisturizers counteract the irritation or peeling that can occur from the chemical peel. A gentle skin cleanser is also important to use. Dr. Green recommends avoiding retinoids, Retin-A, exfoliating products and any alpha hydroxy acids for one week after the peel, or until your skin is back to normal. Careful use of a broad spectrum sunscreen with an SPF 50 is essential to prevent further discoloration and the recurrence of pigmentation. Your new skin is more susceptible to the sun after your chemical peel, so the daily use of sunscreen is very important.
What is the Best Skin Care to use with chemical peels?
If you are undergoing treatment for your acne at the same time as your chemical peels, Dr. Green will most likely prescribe a topical antibiotic for daily use. In addition, using a retinoid, Retin-A, or Differin gel at night time, helps to exfoliate the dead skin, controls acne breakouts, and helps make your chemical peels more effective.
If the main objective of your chemical peel is for the discoloration caused by old acne breakouts and acne scarring, Dr. Green will recommend a combination of products from her MGSkinLabs line of products including HQRA (which combines Retin-A and hydroquinone), topical Vitamin C serum (powerful antioxidant), and high potency hydroquinones to use with your chemical peels. Dr. Michele Green specially compounds these products for her private patients and customizes her products based on the individual and their skin tone.
Side effects of chemical peels
There are several potential side effects of chemical peels. This is one of the reasons that an expert in dermatology should only be treating you with chemical peels. The most common risks of a chemical peel include:
- Redness (although redness is expected and normal from any chemical peel)
- Hypopigmentation or loss of pigment
- Increased Photosensitivity
- Herpes flare (If you have a history of herpes infections, an antiviral medication may need to be taken for one week)
How much is a chemical peel for acne scars?
The price for cosmetic peels varies in the type of peel and the experience of the provider. According to the American Society of Plastic Surgeons, the average price for a cosmetic peel is approximately $650. A deep peel is more expensive since it requires anesthesia in a doctor’s office as well.
Who performs the best chemical peel?
While estheticians and spas do perform chemical peels, chemical peels of medium strength or higher, or those containing trichloroacetic acid (TCA), can only be performed by a dermatologist. It is always best to consult a board certified dermatologist who is experienced in the different skin types, cosmetic procedures, and potential side effects. Dermatologists are experts in treating acne and acne scars, and are in the best position to perform these in office chemical peels.
DIY at home chemical peels
Dr. Michele Green cautions against at home chemical peels. The first consideration is understanding if you have sensitive skin and only using a product from a reputable cosmetic company. If your skin is sensitive, you may only want to use glycolic or salicylic acid peel pads. Glycolic acid peel pads are very good for oily skin types and exfoliate the top layer of your skin. Lactic acid is good for all skin types and fading acne scars. Mandelic acid and Phytic acid are good for fading dark spots on darker skin tones, especially for patients with sensitive skin or who are suffering from post-inflammatory hyperpigmentation from acne. It is very important when looking at treatment options for at home chemical peels for your acne or blackheads, to avoid any strong acids since these chemical peeling agents can cause blisters and scarring if applied incorrectly.
Chemical Peels versus Laser Resurfacing
In simple terms, chemical peels and laser treatments are both designed to “remove” the top layer of skin and rejuvenate the skin by reducing pigmentation, sun damage, wrinkles or acne scars. The choice of lasers or peels depends on many factors. Key to the decision is your skin type. Skin types I and II (light skin) can be safely treated by both lasers or peels. However, skin types III and darker (darker skin) are generally more sensitive to lasers and careful choice of lasers is paramount to avoid pigmentation and worsening of the current condition. Dr. Green is an expert in treating hyperpigmentation caused by lasers and cautions patients with darker skin tones about the importance of doing their research.
Chemical peel – 6 months before and after
Do chemical peels help with acne scars?
Many patient ask, do chemical peels get rid of acne scars, and the answer is yes! Chemical peels work very well to eliminate acne scars that can form after an inflamed breakout. In particular, chemical peels work well to eliminate the appearance of atrophic, or indented, acne scars as well as hyperpigmentation that can occur following an outbreak. Chemical peels work by resurfacing the skin and triggering the body’s natural healing process for firm, bright skin.
Can a chemical peel remove acne scars?
When patients ask, do chemical peels work for acne scars, they can be assured that the answer is yes! Chemical peels work to exfoliate the outer layer of skin and, depending on the depth, can penetrate layers of the dermis for a deeper cleanse. Chemical peels work to declog pores, eliminate the appearance of acne scars, reverse discoloration, and improve the appearance of fine lines and wrinkles. When the chemical solution is applied, the acid reacts with the surface of the skin to break down dead skin cells and trigger the body’s production of collagen and elastin. The dead skin cells will peel away and the cell turnover will promote bright, acne scar-free skin.
How many chemical peels for acne scars?
The number of chemical peel treatments necessary depends on the size and scope of the treatment area, the type of peel that needs to be used, and the strength of the peel. When you have your initial consultation with Dr. Green, she will be able to assess the treatment area to determine your treatment schedule including the number of treatments necessary. Dr. Green is also very careful to take her patients’ skin type into account when creating each treatment plan, as some forms of chemical peels are not safe for all skin types. Depending on your treatment plan, you may have 3 to 5 chemical peel treatments.
Are chemical peels good for acne scars?
Chemical peels are very effective at eliminating the appearance of atrophic acne scars. When performed by an expert dermatologist, such as Dr. Michele Green in New York, they are a safe and effective way to eliminate acne scars on the face. Particularly when paired with products from MGSKINLABs, chemical peels eliminate the appearance of acne scars, improve the texture of the skin, and can reduce the appearance of fine lines and wrinkles.
Should I get a chemical peel for acne?
While chemical peels are a very effective treatment for acne and acne scars, it is best to consult with a board-certified dermatologist, such as Dr. Green, who can help you determine if a chemical peel is the best treatment for you. Factors such as the type of acne scar or your skin type can inform the treatment that is safest and most effective for you. When you have your first meeting with Dr. Green, she will help to determine the treatment plan that is best for your individual needs.
How do I get started with chemical peels for the treatment of acne today?
Dr. Michele Green is an expert in treating patients with acne and acne scars. Whether the best treatment for your skin type are chemical peels, laser resurfacing, dermal fillers, TCA cross, or other procedures, Dr. Green will help improve your skin and rejuvenate your acne scars. Dr. Green is consistently voted as one of the best dermatologists in New York City by Castle Connolly, New York Magazine, and Super Doctors. With over 25 years of experience in cosmetic dermatology and an expert in treating acne scars, Dr. Green will help you achieve beautiful, glowing skin. To schedule a consultation please contact the office of Dr. Green online or call our New York City office at 212-535-3088 to learn if chemical peels are right for you and what the best acne scar treatment option is overall.