Chemical Peel and the Pathology Behind It

Definition – Chemical peeling is a medical procedure which includes application of a chemical agent to the skin, causing controlled destruction of the epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues.

In simple words chemical peeling or chemical rejuvenation is procedure where a chemical agent or combination of agents of defined strength are applied the skin causing a controlled destruction of layers of the skin. This is followed by regeneration and remodeling leading to improvement of texture and surface abnormalities. It is a safe, effective and affordable option for improving skin ageing and imperfections.

Skin Histology

Skin is considered the largest organ of the body and has many different functions. The skin is divided in two main regions, the epidermis and the dermis. The dermis is attached to an underlying hypodermis also called subcutaneous connective tissue.

Epidermis – It is the most superficial layer of the skin. The first barrier of protection from the invasion of foreign substances. The epidermis is divided into four layers – stratum corneum, stratum granulosum, stratum spinosum and stratum basalis (basal layer).

Dermis – It is composed of fibroblasts which are responsible for secreting collagen, elastin and ground substance that gives support and elasticity to skin. It supplies the epidermis with nutrients and has its role in thermoregulation. The dermis is subdivided Derma Prime Plus  into two zones, upper papillary and lower reticular layer.

Classification of peels according to histological depth

Very superficial peel – Exfoliation of the stratum cormeum, without any epidermal necrosis.

Superficial peel – Destruction of the full epidermis, up to the basal layer

Medium peel – Destruction of the epidermis, papillary dermis and up to the upper one third of the reticular dermis.

Deep peel – Necrosis of the entire epidermis and papillary dermis with inflammation extending to the mid reticular dermis.

Classification of chemical peeling agents

Very superficial Peel:

Glycolic Acid 30-50% applied for 1-2 minutes

TCA* 10% applied as one coat

Jessner’s solution 1-3 coats

Superficial Peel:

Glycolic acid 50-70% applied for 2-10 mins (depending on the type and thickness of the skin)

TCA 10-30%

Jessner’s solution 4-10 coats

Very superficial and superficial Peels are the mildest form and often called, “the lunchtime peel.” These peels break down corneocyte adhesion, causing dead skin cells to shed off to reveal the fresh, healthy underlying skin. These peels address minor skin irregularities like discoloration, acne, surface scarring, fine lines, and sun spots.