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Procedure guide · Skin and non-surgical
Chemical peelA chemical peel applies an acid solution to remove damaged outer layers of skin and stimulate new, smoother skin. Superficial peels (glycolic, salicylic) brighten with a few days of flaking and are repeated in courses; medium peels (TCA) treat pigmentation and fine lines with a week of peeling; deep phenol peels reshape heavy sun damage and lines around the mouth with two weeks of downtime and permanent lightening. A peel takes fifteen to sixty minutes, deeper peels under sedation, and sun protection afterwards is essential.
Chemical peels use acids of different strengths to remove skin layers in a controlled way. Superficial peels with glycolic, lactic or salicylic acid exfoliate the epidermis and brighten dull skin; medium peels with trichloroacetic acid reach the upper dermis to treat pigmentation, fine lines and mild scars; deep phenol-croton oil peels reach the mid-dermis and can transform heavy sun damage and lines around the mouth, at the cost of long downtime and permanent lightening. The peel is matched to the problem, skin type and the downtime you can accept. Pre-treatment with retinoids and pigment inhibitors, and strict aftercare, reduce complications.
Skin's reaction to a peel depends heavily on how much melanin it carries, assessed clinically on the Fitzpatrick scale from type I (very fair) to type VI (deeply pigmented). Patients with darker skin tones carry a meaningfully higher risk of post-inflammatory hyperpigmentation, dark patches that appear as the skin heals, sometimes taking far longer to fade than the problem the peel was meant to correct. A practitioner experienced across a range of skin tones will typically choose a shallower depth, build results gradually across a course, and prescribe several weeks of pre-treatment with pigment-inhibiting agents before any acid is applied. Darker skin can be peeled safely and often responds well, but the choice of depth and protocol matters more here than for lighter skin.
Deep phenol peels carry a safety consideration specific to this technique: phenol is absorbed through the skin into the bloodstream, and in sufficient quantity it can affect heart rhythm, including triggering arrhythmias. This is why a full-face deep phenol peel is performed with continuous cardiac monitoring and intravenous fluids, typically in a proper clinical or hospital setting rather than a standalone aesthetic clinic. This is a genuine safety detail worth confirming before booking a deep peel abroad: ask specifically whether cardiac monitoring is used and where it takes place. A deep peel performed without this monitoring is a different, less safe procedure.
Surgeons look for these points at the consultation.
Adults with sun damage, pigmentation, acne scars or fine lines, with skin type matched to peel depth and the ability to avoid sun afterwards.
Reasons a good surgeon will ask you to wait or choose something else.
Active infection or cold sores, isotretinoin in the last six months, keloid tendency, darker skin types for medium and deep peels, and pregnancy for some agents.
Ask your surgeon which technique they recommend for you and why.
Alpha or beta hydroxy acids exfoliate the top layer.
Trichloroacetic acid reaches the upper dermis.
Phenol-croton oil reaches the mid-dermis; requires cardiac monitoring.
Step by step, from arrival to discharge.
Skin is cleansed and degreased; antivirals started for medium and deep peels.
The acid is applied in layers and neutralised or left according to the agent; you feel heat or stinging.
Cool compresses, then ointment or a dressing.
Instructions for cleansing and moisturising; a review as the skin peels.
Frequencies follow published guidance; your personal risk depends on your health and the surgeon.
Risk with a chemical peel rises in direct proportion to depth. A superficial peel carries a low likelihood of lasting complications, while medium and especially deep peels, which deliberately injure living tissue to force genuine renewal, carry correspondingly higher risks of pigment change and scarring. A patch test before a first treatment, and for medium and deep peels a pre-treatment skincare regimen of several weeks, meaningfully reduce these risks. Cold sore reactivation deserves particular attention before any peel around the mouth.
Expected; depth determines duration.
Post-inflammatory darkening in darker skin; lightening after deep peels.
Antiviral prophylaxis for medium and deep peels.
From too deep a peel or infection.
The visible stages of peel recovery, tight, darkened skin followed by visible peeling, can look alarming to anyone experiencing it for the first time, particularly after a medium or deep peel. This is the expected mechanism of the treatment, not a complication. Strict sun avoidance is necessary throughout the healing period, not only on the most dramatic days.
Days 1-3
Treated skin darkens and tightens before peeling.
Days 4-7
Do not pull skin; moisturise; fly home after two to three days for medium peels.
Weeks 2-4
Sunscreen daily; makeup once intact.
Months 1-3
Pigmentation evens out.
Skin darkens and tightens for two to three days, peels over the following week and emerges pink and smooth; pigmentation evens over one to three months. Superficial peels are repeated in courses; medium peels last a year or more; deep peels give long-lasting results.
Peel pricing is driven mainly by depth and by whether treatment is a single session or a course. A superficial peel is inexpensive per visit but is usually repeated six to eight times, while one deep phenol peel costs more upfront yet is typically a single treatment. See the dedicated cost page for typical ranges.
Why quotes for the same procedure differ, so you can compare packages fairly.
Options to weigh before deciding, surgical and non-surgical.
More control of depth and better results for scars.
Texture improvement safe for darker skin.
Ask the same questions at every consultation so you can compare answers.
The most common mistake in choosing a chemical peel is treating depth as something to maximise, on the assumption that a stronger peel must give a better result. The useful question is not "how strong a peel can I tolerate" but "what is the shallowest peel that reliably fixes what is actually wrong with my skin."
If your main complaints are dullness, rough texture or mild unevenness, a superficial peel, delivered as a repeated course, is almost always the right starting point. Each session causes only a few days of light flaking.
If the problem is genuine pigmentation, fine lines, or mild acne scarring, a medium-depth TCA peel is usually the better match, producing a more visible improvement in a single session at the cost of around a week of visible peeling.
A deep phenol peel belongs to a narrower category: static wrinkles visible at rest, heavy accumulated sun damage, and deep lines around the mouth that have not responded to lighter treatments. Choosing a deep peel for a mild concern exposes you to the highest risks and longest recovery for a problem a lighter peel could likely have solved.
A chemical peel does not end when the acid is removed in clinic. Freshly peeled skin has lost its outer protective layer and is considerably more reactive to ultraviolet light than normal skin for weeks to months, depending on depth. Sun exposure during this window is the single biggest preventable cause of post-peel hyperpigmentation.
Strict sun protection is a specific, time-limited clinical requirement, not a general skincare suggestion: daily high-factor sunscreen plus physical coverage for at least several weeks after a superficial peel, and two to three months after a medium or deep peel.
Makeup, retinoids and active skincare ingredients all need to wait until the visible peeling phase is complete and the skin barrier has recovered, which your clinic will confirm at a follow-up check. Skipping aftercare does not simply slow results, it actively risks causing the pigment irregularity or scarring a well-executed peel is designed to avoid.
A good consultation is mostly a conversation about your skin and your history, and only briefly about acids. Before any agent is chosen, a careful practitioner will want to understand what bothers you, how long it has been present, what you have already tried, and how your skin has behaved in the past. Expect questions about sun exposure, tanning habits, previous peels or lasers, and how your skin reacts to injury: whether cuts and spots leave dark marks or raised scars.
Your medical history matters because several conditions and medicines change what is safe. The practitioner will usually ask about:
What to bring. A list of every medicine, supplement and skincare product you use is more helpful than an attempt to remember them. Bring photographs of your skin taken in natural light before any recent treatment, so the practitioner can see your baseline and any history of marks. If you have had a reaction to a cosmetic treatment before, note what was used and what happened. If you are travelling for the treatment, ask whether records from your own doctor or dermatologist would be useful, and bring your planned dates so the clinic can judge whether the schedule leaves enough room for the skin to settle.
What you should see in the room. The skin is usually examined without makeup, often under magnification and in good light, and your skin tone is assessed so that the depth can be matched to it. Many practitioners test a small area before a first treatment. You should be told which agent and strength are proposed, why that depth rather than a lighter or stronger one, what the expected peeling will look like, and what the realistic limits of the result are. A practitioner who cannot explain why a particular depth suits your skin, or who moves straight to a price list, is giving you less information than you need.
What should be put in writing. Written aftercare instructions, a way to contact the clinic out of hours, and a clear statement of who performs the peel are reasonable things to expect. You should also be given time to decide. Consent for a medium or deep peel is better given after a pause than on the spot, particularly when you have travelled a long way and may feel committed.
It is also worth asking how many treatments the practitioner performs each week and how often they see complications. You are not looking for a particular figure, only for an honest, unhurried answer. Practitioners who treat many skin tones, and who describe what they do when a peel does not go as planned, tend to give a more reliable picture than those who describe only the best outcomes.
Finally, the consultation is the moment to say what you are not willing to accept, such as a long period of visible peeling, so that the plan is built around your actual circumstances rather than adjusted afterwards.
Most peels heal as expected, but it is useful to know in advance which problems are manageable and which need prompt attention. The expected course of redness, tightness and peeling is described elsewhere on this page. This section is about the departures from it.
Pigment change. Darkening that appears weeks after a peel, known as post-inflammatory hyperpigmentation, is the most frequent unwanted effect in people with deeper skin tones. It is treated rather than ignored: strict sun protection, a gentle routine, and often prescribed pigment-inhibiting agents, with further peels paused. It usually fades, but it can take months. Lightening, or loss of colour, is a different problem and can be much slower to correct, which is one reason depth is chosen so carefully.
Prolonged redness or irritation. Skin that stays red, hot or swollen well beyond the period your clinic described may mean the barrier has not recovered, that a product is irritating it, or that it has been over-treated. This is worth reporting early. Persistent redness is often a warning sign that the skin needs a gentler regimen, and in rare cases of deeper injury it can precede a thickened scar.
Infection. Broken skin can become infected. Signs include increasing pain rather than easing discomfort, yellow crusting, pus, spreading redness, a bad smell or fever. A herpes flare can look similar, with clustered blisters or sores, and needs different treatment. Both need prompt assessment, not a wait-and-see approach, because early treatment lowers the chance of scarring.
Allergic or contact reaction. Itching, swelling or a rash that spreads beyond the treated area can indicate sensitivity to a product used before, during or after the peel. Stopping the product and seeking advice is the usual first step.
Scarring. Scarring is uncommon with correctly chosen peels, but it is the most serious outcome. Early warning signs include areas that stay unusually red, feel firm or raised, or fail to heal on the same timetable as the rest of the face. Scars caught early can often be treated with topical or injected therapy, so early reporting matters.
What a responsible clinic does. It tells you in advance what is normal and what is not, gives you a number to call, and sees you promptly when you are worried. It does not dismiss concerns as part of the process, and it does not treat a complication by simply applying more peel.
When you are away from home. Complications can appear after you have returned, so ask before treatment how follow-up will work: whether you can send photographs, whether a video review is offered, and who would treat you locally if you needed it. Knowing your own doctor or a dermatologist at home is willing to review the skin is a sensible precaution. Take the product names and concentrations used with you, because they help whoever sees you next.
Photographs are persuasive, which is exactly why they need to be read carefully. A single dramatic pair says little about what a typical patient can expect, and with peels in particular, small differences in how a picture is taken can create a large difference in how skin appears.
Check that the conditions match. Lighting, camera distance, angle, makeup and even the time of day change how texture and pigment look. Warm, soft light hides fine lines and uneven tone; harsh overhead light exaggerates them. If the two pictures differ in any of these ways, the comparison is unreliable. A neutral expression and the same pose in both images are good signs.
Look at the timing. An image taken a few days after a peel may show pink, tight skin that looks polished but has not yet settled. An image taken after a few months shows the real result. Ask when the after photograph was taken, and whether the patient had finished their course. For superficial peels, find out how many sessions were involved.
Look for people like you. Skin tone, age, the problem treated and the depth of peel all affect the outcome. Photographs of fair skin with sun damage tell a person with deeper skin tones very little about their own risk of pigment change. Ask to see results in patients with a similar skin type and a similar concern, and ask whether any had problems.
Be wary of heavy editing. Strong smoothing, filters and unusually uniform colour suggest retouching. Photographs belonging to the practitioner or clinic, rather than borrowed from elsewhere, are a minimum expectation, and a clinic should be willing to say so.
Remember what photographs cannot show. They do not show the discomfort, the weeks of sun avoidance, the patients who had a poor outcome, or the ones who stopped attending. A few well-chosen images are a selection, not a sample.
Assessing the provider. Beyond photographs, consider who is performing the peel and what training they have in managing complications. A deeper peel should be offered by a medically qualified practitioner in an appropriate clinical setting, with emergency equipment and an arrangement for monitoring. Consider whether the clinic asks about your history, discusses risks plainly, and is comfortable with you taking time to decide. A provider who plays down downtime, treats every skin type with the same protocol, or promotes the strongest option as the default is showing the opposite of the caution a peel requires.
Reading photographs honestly will not remove uncertainty, because skin varies. It will, however, help you separate evidence about a practitioner's work from marketing, and it gives you better questions to ask in the consultation.
Both resurface skin. Peels are cheaper and work well for pigmentation and texture; lasers offer more control of depth and better results for scars. Skin type often decides.
One medium or deep peel; a course of four to six superficial peels spaced two to four weeks apart.
Superficial and medium peels are fine two to three days before flying; deep peels need two weeks of care and are best done early in a trip.
Medium-depth peels can improve mild, shallow acne scarring by smoothing texture, though they are less effective on deep, pitted scars, which usually respond better to microneedling or laser resurfacing.
Most clinics avoid medium and deep peels during pregnancy and breastfeeding as a precaution, since some acids and pre-treatment medications are not established as safe in these circumstances.
Superficial peels give a temporary brightening that fades within weeks unless the course is maintained. Medium peels often hold for a year or more. Deep phenol peels are generally a one-time treatment, since the effect is effectively permanent.
Superficial peels are often combined with Botox or filler without difficulty. Medium and deep peels are usually sequenced separately from injectables, before or several weeks after.
Generally no, not until visible flaking has resolved and the skin barrier has recovered enough for your clinic to clear you.
Melasma is notoriously difficult to treat and can be worsened by a peel that is too aggressive for the patient's skin tone. When peels are used for melasma, they are typically superficial and combined carefully with pigment-inhibiting pre-treatment.
A superficial peel typically needs around a week of reduced sun exposure, a medium peel two to three weeks of strict avoidance, and a deep peel several months of careful sun protection.
At-home peels use low concentrations of mild acids designed for self-application and produce modest, gradual results. Clinic-grade peels use higher, carefully calibrated concentrations applied by a trained practitioner who can judge skin response in real time.
Most people feel warmth, tingling or stinging as the acid is applied, which usually builds for a short time and then eases. Superficial peels are generally well tolerated and need no anaesthetic. Cool air or compresses are often used to make the application more comfortable.
Medium peels can feel more intense, and the sensation may be strong enough that a practitioner offers oral medication or other comfort measures. Deep peels are performed with sedation or anaesthesia and monitoring, so the procedure itself is managed by the team. Soreness, tightness and a sunburn-like feeling can follow for a few days. Ask beforehand what will be done to keep you comfortable and what to expect afterwards.
Yes, this can be normal. Superficial peels tend to cause fine, dry flaking, while medium and deeper peels often lift skin in larger pieces as the damaged layer separates from the new skin beneath. The pattern depends on the depth, the agent, your skin type and how well the area is moisturised.
The important rule is to let the skin come away by itself. Pulling or picking can tear healthy tissue underneath, which raises the chance of marks and scarring. If a loose piece is catching, a clinic may advise trimming it with clean scissors. If the skin underneath looks raw, weeps, or becomes increasingly painful, contact the clinic rather than waiting.
Peels are used on these areas, but they are treated more cautiously than the face. Skin on the neck, chest and backs of the hands has fewer oil glands and heals more slowly, so it is more prone to prolonged redness, pigment change and scarring after deeper peels.
For this reason, superficial peels, or lighter medium peels, are usually chosen for areas below the jawline, and deep peels are rarely applied there. The face is sometimes treated at a different depth from the neck so the transition does not look abrupt. Because the same sun protection is needed over a larger area, it is worth asking how the plan would work for your skin before agreeing to treat more than the face.
It depends on how active the condition is. Skin that is currently inflamed, broken or flaring is generally not peeled, because the barrier is already compromised and the reaction can be stronger and less predictable. Rosacea in particular can be aggravated by heat and irritation.
When the condition is well controlled, some practitioners use very gentle superficial peels, chosen for tolerability rather than intensity, sometimes with a small test area first. In other cases a different treatment is more suitable. Tell the practitioner about every skin condition you have, including past episodes, and about the products you use to manage it. This is a decision made by examining your skin, not one that can be made in advance.
A short period of spots can occur after a peel. As the skin sheds and renews, congestion that was sitting beneath the surface may come to the top, and heavy ointments used during healing can also contribute in people who are prone to blocked pores. Some breakouts settle within a couple of weeks.
Do not squeeze or pick them, because healing skin marks easily. Tell your clinic what you are seeing, since they can advise on a lighter moisturiser or a gentle treatment that is suitable for recovering skin. Sudden pus-filled spots, clustered blisters or rapidly worsening pain are different and should be seen promptly, because they may indicate infection or a cold sore flare rather than ordinary congestion.
Most clinics advise avoiding vigorous exercise for a short period after a peel, with the length depending on depth. Sweating, heat and increased blood flow can sting freshly treated skin, increase swelling and introduce bacteria, and the friction of towels or equipment can irritate it.
After a superficial peel, many people return to light activity within a day or two if the skin feels comfortable. Medium and deep peels call for a longer pause, and your clinic will tell you when the skin is ready. Swimming pools and saunas are usually avoided until the skin has healed because chlorine and heat can irritate it. Outdoor exercise also brings sun exposure, so it carries the added need for protection.
Waiting allows the skin barrier to recover fully, and the interval depends on the depth of the peel. After a superficial peel, practitioners often leave a few weeks before another resurfacing treatment. After a medium or deep peel the gap is usually longer, and the skin needs to be fully healed and no longer sensitive.
Treating skin that is still recovering increases the risk of burns, pigment change and scarring. The same applies in the other direction: your clinic may ask you to pause waxing, depilatory creams, scrubs and hair removal on the treated area for some time before and after the peel. Share a full list of recent and planned treatments with the practitioner so they can sequence them sensibly.
The skin around the eyes is thin and delicate, so it is treated with extra care. Superficial peels can be used in this area, often with a lower strength or a shorter contact time than elsewhere on the face. Medium and deep peels near the eyelids are performed only by experienced practitioners, because excessive treatment can cause swelling, irritation or, in rare cases, changes affecting the position of the eyelid.
Eye protection is important, and the practitioner should take care to prevent the product reaching the eye. If you wear contact lenses, you may be asked to switch to glasses for a time. Discuss any history of dry eye, previous eyelid surgery or eye conditions before the treatment.
Yes, all of them. Some prescription and over-the-counter products affect how skin heals or reacts. Isotretinoin, topical retinoids, certain antibiotics that increase sun sensitivity, blood-thinning medicines and some herbal supplements are among those a practitioner will want to know about, as are any skincare products that contain acids or exfoliants.
Do not stop a prescribed medicine on your own because of a peel. Raise it at the consultation, so the clinician can decide whether the peel should be delayed, changed or discussed with the doctor who prescribed the medicine. If your medicines change between the consultation and the treatment date, tell the clinic again.
It often is. During healing, skin can look patchy, with some areas darker, others pinker and some still flaking, because it renews at different rates across the face. Areas that were treated more thoroughly, or that have thicker skin, may peel later or for longer than others, so the early appearance is not a reliable guide to the final result.
Judge the outcome after the peeling has finished and the redness has faded, which can take weeks, not days. Keep protecting the skin from sun and avoid trying to correct the colour with makeup or active products. If the unevenness is getting worse, turning brown or grey, or looks raised or thickened, contact your clinic and show them photographs.
Mild itching is common as the skin renews and the outer layer dries and lifts. It tends to be most noticeable once peeling begins, and it usually eases as the new skin settles.
Do not scratch, since broken healing skin marks and becomes infected more easily. Regular moisturising as advised by your clinic, cool compresses and keeping the room temperature moderate can help. Do not start an antihistamine or a new cream without checking first, particularly if it could make the skin more sensitive to light. Itching that is intense, accompanied by a spreading rash, swelling or blistering, may point to a reaction or infection and should be reviewed promptly.
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