Your Guide to Chemical Peels for Acne Scars, According to a Dermatologist

Everything you need to know about chemical peels for acne scars, including if they're safe for all skin types.

Are Chemical Peels for Acne Scars Safe for all Skin Types?
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As if dealing with acne wasn't frustrating enough, the battle isn't over once the breakouts disappear. Acne scarring, a source of insecurity for many acne sufferers, can remain for months or even years for more severe cases like cystic acne after the initial breakout is long gone. Even when you've tried your hardest to avoid picking pimples an acne scar may still appear as your body is trying to heal itself at the site of the breakout. Acne scars form as a result of the inflammation, and resulting trauma to the skin, that occurs during breakouts. One of the most effective ways to diminish or completely remove the appearance of acne scars on the skin is a chemical peel. Here, experts explain everything you need to know about chemical peels for acne scars and all things to consider before and after booking an appointment.

How Chemical Peels for Acne Scars Work

Though the term "acne scar" is often thought of to be a kind of hyperpigmentation (dark spots on the skin), acne scars are actually a completely different concern. There are generally two types of acne scars — atrophic and hypertrophic scars. Atrophic scars form a depression compared to the level of the surrounding skin because of damage to the collagen, fat, or other tissues below the skin's outermost layer, according to the National Library Of Medicine. On the other hand, hypertrophic scars are raised above the skin due to an overproduction of collagen.

During a chemical peel, a licensed professional — typically an esthetician or dermatologist — applies an acid that triggers a "controlled injury" to the skin, causing the top layer of skin to peel off during the healing process revealing healthier skin underneath, explains Dr. Angela Casey, M.D, a board-certified dermatologist. "Chemical peels work by accelerating skin turnover, stimulating collagen, and unclogging pores," adds Dr. Dina D. Strachan, M.D., a board-certified dermatologist. Though all chemical peels work in the same way to renew the skin, different types of acids can be used, and the strength of the treatments may range from superficial (light) to deep peels that penetrate more layers of skin.

While chemical peels may be effective for atrophic scars, they are not recommended as first-line treatment for hypertrophic scarring because there's a possibility that the peel will worsen current scars or trigger new scars to form, explains Dr. Casey. Other treatments, such as lasers, may be a more effective option for hypertrophic scarring, she says. Additionally, lighter-strength peels may have little effect on atrophic acne scarring. In this case, a medium-strength peel may be the best option, according to Dr. Strachan.

Below are some popular types of chemical peels for acne scars and their relative strengths:

  • Mandelic and Lactic Acid (light)
  • Salicylic and Glycolic Acid (light-medium)
  • Jessner and VI (medium)
  • TCA (medium-deep)
  • Phenol (deep)

These are the generally accepted strengths of these specific peels; however, it is important to note that the number of passes or applications to the skin during one session can render a smaller or weaker peeling experience, explains Dr. Casey.

Are Chemical Peels for Acne Scars Safe for All Skin Types?

Chemical peels can be a skin-care game changer for many people as there are several types to address various skin-care concerns. For example, chemical peels can improve a wide range of skin conditions, such as melasma, hyperpigmentation, fine lines, razor bumps, and sun damage. This means chemical peels for acne scars are just the tip of the iceberg as far as the possible benefits of the treatment.

Though chemical peels are generally safe for all skin types (namely dry, oily, combination, and "normal" skin), there are still some risks to consider in certain cases. For example, those with sensitive skin due to conditions such as eczema, psoriasis, and seborrheic dermatitis should be careful when getting chemical peels. Individuals with a history of eczema have sensitive skin that is more reactive; therefore the skin may not heal as expected following a chemical peel, says Dr. Casey.

Similarly, skin conditions such as psoriasis, vitiligo, and other conditions can exhibit koebnerization (the tendency of skin to develop new lesions in response to injury or trauma), so it is important to be aware of a history of any of these conditions before undergoing a chemical peel, explains Dr. Casey. In short, a chemical peel can cause adverse effects for those with some preexisting skin conditions.

Experts highly suggest disclosing any skin conditions when consulting with a professional for a chemical peel. To be safe, if you really want to explore getting a chemical peel for acne scars and have a pre-existing condition, the best, safest way in would be to consult a trusted dermatologist as they can come up with a treatment plan (that may or may not include chemical peels) for both conditions, adds Dr. Strachan.

Chemical Peels for Acne Before and After Care

The first step to ensuring your chemical peel for acne scars is a success is to follow any pre-treatment instructions given to you by your esthetician or dermatologist, as it may vary depending on the peel, provider, and current condition of your skin, says Dr. Strachan. These pre-peel instructions may include avoiding retinoids and acids (such as salicylic or glycolic acid) that may overly irritate the skin when the chemical peel is administered.

Once your chemical peel is done, you should avoid sun exposure, wash your face twice daily with a gentle cleanser, and moisturize at least twice a day as your skin is healing, advises Dr. Strachan. Also, no matter how tempting it may be, do not pick at your flaking skin as it may cause more scarring, hyperpigmentation, and infection, says Dr. Casey. "Your skin needs to undergo a full 28-45 day cycle of recovery whereby the epidermis is able to regenerate; picking off the protective outer layer too soon can reveal raw skin underneath that is not fully ready to act as a protective barrier." Your shedding skin may be unsightly and uncomfortable, but it's an integral part of the chemical peel process to see the best results.

Are Chemical Peels for Acne Scars Safe for Darker Skin Tones?

Though it is a common misconception that people with deeper skin complexions must avoid chemical peels at all costs, that isn't necessarily the case, explains Dr. Strachan. "People of color benefit tremendously from chemical peels, but they are more prone to scarring and discoloration from peels," she says. While chemical peels can treat concerns such as hyperpigmentation and acne scars, the healing process from a chemical peel causes inflammation in the skin, which can activate melanocytes causing post-inflammatory hyperpigmentation, adds Dr. Casey. Melanocytes are a type of cell found in the skin and hair that provide pigmentation (color) to those areas, and are larger and more abundant in those with darker skin tones. It's important to consult with a professional that has experience administering chemical peels on darker skin tones to minimize the chances of adverse effects from a chemical peel.

Though acne scars may feel like another bump on the road when working toward your skin goals, all is not lost. If you haven't considered trying chemical peels for acne scars, take this as your sign to book an appointment (or at least a consultation) with a licensed professional today.

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