What Is a Phenol Peel?
You may have grown up seeing your mother, grandmother, or aunt with a white (or green) mask on her face. You may not have known how it worked, but it seemed like it was worth it in the end – smooth and baby-soft skin. A lot has changed in skin care over the years.
The products and processes to achieve clear skin have come a long way.
Among the numerous products to improve skin are chemical peels. These products (whether at home or used in a doctor’s office) use various levels of safe acid to remove (or peel) the layers of damaged skin, leaving healthier, clearer skin behind. Think of it as a ‘controlled injury’ or demo for your skin.
Chemical peels come in three levels: light, medium, and deep. A light peel uses fewer chemicals and lower acidic levels. A deep one includes more chemicals with a high acid level. A medium peel is right in the middle.
A phenol peel is one of the more intense treatments. It uses phenol and carbonic acid (and sometimes other substances) to remove damaged skin tissue, allowing skin to heal itself. These types of peels have been banned in some areas and not widely used in others. But they are making a comeback because some feel the risks are worth the possible result.
- Light: Also known as the “lunchtime” peel because of how quick and easy it can be. This type of peel helps remove thin lesions on your skin’s surface. It can help reduce darker skin areas (hyperpigmentation) and dryness. A nurse or esthetician trained in skin care will use glycolic acid, salicylic acid, or something called a Jessner (combination of salicylic, citric, and other chemicals) solution. These are well tolerated by most people and normally require repeat treatments to see full results. These types of peels are normally safe for people with darker skin.
- Medium: This type of chemical peel is done by a dermatologist or plastic surgeon and is used to improve skin texture and reduce blotches, freckles, and dry spots. The treatment can be painful, leaving some swelling, redness, and scarring for about a week.
- Deep: A phenol peel uses the strongest concentration of chemicals for deep skin penetration. It may help you if you have wrinkles, deep lines, tough acne, scarring, or any skin condition on the face or neck that hasn’t responded to other peels. The chemical used is toxic and can cause a fatal heart rhythm or nerve damage. Because of this risk, working with a board-certified doctor is key. After this peel, your skin may look pale and smooth but also somewhat waxy like a mask.
Medical Uses for Phenol Peel
Many people think of peels for beauty benefits, but they are often used to treat serious skin conditions.
Actinic keratosis
Actinic keratosis is a type of skin condition with rough, scaly patches on the skin. It’s also called solar keratosis since it’s caused by sun damage from ultraviolet rays. If the lesions aren’t diagnosed early, they can turn into skin cancer.
Who Is at risk for actinic keratosis?
- People with pale skin, red hair, and blue, green or gray eyes
- People with darker skin, hair, or eyes exposed to sun without protection
- Older adults
- People with weakened immune systems from conditions like AIDS, organ transplant, or other diseases
- People with rare skin conditions who are sensitive to UV rays like albinism
How can deeper chemical peels like phenol peels help those with actinic keratosis? Researchers are still learning.
Recent studies (one with 80% of patients seeing improvement) suggest phenol peels can help improve your skin.
Severe sun damage
Getting enough vitamin D (especially from the sun) is a healthy thing to do. But too much of a good thing – especially without proper protection – can be bad for your skin. Normal signs of aging like wrinkles and some spots may show up as you get older. But too much time in the sun without sunscreen or other protection can speed up the aging process of your skin. Severe sun damage (or photoaging) might look like:
- Uneven skin tone
- Moles
- Thinning skin
- Spider veins (broken capillaries) around your nose, eyes, and cheeks
- Uneven skin color on darker skin tone
- More wrinkles around your eyes that won’t go away
- Worry lines on your forehead that won’t go away
Sun damage may show up as early as your 20s. See a dermatologist to confirm if your skin changes are due to UV rays or something else. Your doctor might suggest a chemical peel to help. Other options include laser therapy, topical creams or ointments, fillers, or techniques like dermabrasion to "sand" the damaged skin away.
Deep acne scars
If you’ve ever had a deep pimple or acne breakout, it can leave a scar. Sometimes the scar looks like a darker mark on your skin. Other times, it may look like a pit (or crater) in your skin. These are called depressions and can give your skin a rough, uneven texture. While some scarring may fade over time, most need some type of treatment.
Light to moderate chemical peels with lower acid can help exfoliate the skin and treat acne. For acne scars, a deeper peel is the option and may require several visits before you see a difference.
Pigmentation disorders
Darker skin coloring in some areas might be a sign of a pigmentation disorder. Common types include melasma (a dark mask-like color on your face or neck normally during pregnancy), solar lentigines (liver spots), freckles, or moles. You may be able to see your primary doctor for a diagnosis and treatment. While these are often not dangerous, they can be annoying or embarrassing for some.
Like with other skin conditions, a chemical peel may help. If you have drastic pigment changes to your skin, your doctor might suggest a deeper (or phenol) peel to help erase some of the dark areas.
Phenol Peel Process
Chemical peel prep
Your doctor will give you instructions on how to prepare for your chemical peel. If you have questions, do not hesitate to ask.
Before your peel, you may have to do a few things:
Dos
- Take any antiviral medication prescribed by your doctor to help prevent infection after your procedure.
- Use a retinoid cream such as tretinoin for a few weeks before treatment to help the peel solution spread more evenly
- Use a bleaching agent. Your doctor might suggest a bleaching agent (hydroquinone), a retinoid cream, or both, before or after the peel to reduce the risk of side effects.
- Arrange for a ride home. You might be put under (sedated) for your procedure, so ask for a ride home.
Don’ts
- Get too much sun. Being in the sun too long can cause permanent pigment changes to your skin before (or after) the procedure. Ask your doctor about sun protection and how much sun is right for you.
- Use certain cosmetic treatments or hair removal creams. Stop using hair removal products or techniques at least a week before your peel. This includes things like electrolysis or depilatories. You’ll also want to avoid hair treatments like hair dyeing, permanent waves, or straightening products. Hold off on face masks and scrubs, too, a week before. Don’t shave any areas that will be treated at least 24 hours prior.
Phenol peel pocedure
The steps for your peel will depend on whether you get a light, medium, or deep peel. Before your peel, your doctor will clean your face and use something to protect your hair and also your eyes with an ointment, cotton gauze, or goggles.
Process for a light peel:
After prepping your face, your doctor will:
Step 1: Use a brush, sponge, or gauze to apply a chemical solution of glycolic or salicylic acid. (These parts of your skin will whiten or get lighter.)
Step 2: Your doctor will leave the solution on your skin for about a few minutes. (You might feel a normal tingling sensation).
Step 3: Your doctor will then apply a solution to neutralize the chemical on your skin.
Step 4: After your peel, your skin may be red, dry, or a little irritated. These decrease with each repeat treatment. Your doctor may apply a protective ointment (like petroleum jelly) to soothe your skin.
You can wear makeup the next day. Your skin will take 1 to 7 days to heal. As your new skin appears, it may be lighter or darker than normal.
Process for a medium peel:
Step 1: For this type of peel, your doctor will apply a chemical solution with trichloroacetic acid (TCA – a form of vinegar) sometimes with glycolic acid. (These parts of your skin will whiten or get lighter.)
Step 2: After a few minutes, your doctor will apply cool compresses to your skin or give you a handheld fan to cool your skin. They won’t use a neutralizing solution.
Step 3: Your doctor will monitor you for another few minutes. You might feel a normal stinging or burning sensation for about 30 minutes.
Step 4: After the peel, your skin may be red or swollen. Your doctor may apply a protective ointment (like petroleum jelly) to soothe your skin and help dryness. After 5 to 7 days you can wear makeup.
Process for a deep (or phenol) peel:
Step 1: Your doctor will give you intravenous (IV) fluids through your veins and monitor your heart rate.
Step 2: Your doctor will use a cotton-tip applicator to apply carbolic acid (phenol) to your skin. The treated areas will begin to whiten or turn gray.
Step 3: To limit your exposure to such a strong chemical, your doctor will apply the solution in 15-minute intervals. It may take up to 90 minutes to treat your entire face. In some cases, your doctor will remove a layer of your skin that looks like a mask being removed. This procedure can be dangerous and should be performed by a certified professional.
Step 4: Your doctor will apply a surgical dressing to your skin. They may prescribe painkillers to help with redness and swelling. Some patients have swelling that makes their eyelids swollen shut.
Phenol Peel Recovery
After your deep peel, you will have at-home care instructions after a deep peel. This includes soaking your treated skin and applying ointment several times a day for 2 weeks. You must use sunscreen every day to avoid damage to sensitive new skin.
Like with other types of peels, you may notice redness for months and treated skin may be lighter or darker than normal.
Some people prefer to recover at home for several weeks since the process can leave visible marks during healing. Your doctor may want to see you several times post-procedure to make sure you are healing properly. You can use makeup after about 2 weeks.
Light and medium chemical peels require less recovery time – sometimes as soon as a few days. Your skin may have some redness, irritation, dryness, or swelling. Some discoloration during healing is normal. Your doctor may suggest over-the-counter pain medications for any discomfort.
Phenol Peel Day by Day
While everyone has a different recovery time and result, there are some common things to expect.
Days 1-5: Expect some swelling or redness, which can be greater if your doctor needs to use a higher chemical solution to treat your skin. You’ll likely be prescribed painkillers to address any discomfort.
Days 6-10: Your new skin will begin to form. It will be important to avoid too much sun exposure and to protect your skin whenever you’re outside.
Days 11-14+: As your skin heals, you’ll be able to wear makeup and resume many of your normal activities. Depending on how damaged your skin was before the peel, your doctor will suggest you schedule another peel for best results.
Phenol Peel Complications
A chemical peel can greatly improve the overall look, feel, and health of your skin. But, it’s not without risks. Talk to your doctor about these possible complications and whether there are better peel options for you.
- Redness, scabs and swelling
- Scarring
- Changes in skin color (which can be permanent in people with darker skin)
- Infection
- Heart, kidney, or liver damage
Doctors will take steps to help you avoid risks such as prescribing an antibiotic pre-peel to avoid infection or doing a phenol peel in 15-minute increments to lessen organ impacts. However, phenol peels may not be right for everyone. Doctors use a Fitzpatrick skin type scale to classify how resilient the skin is to sun exposure and to determine if your skin can withstand a deep peel.
Deep Peels on Dark Skin
Chemical peels are generally safer and more effective on people with lighter skin. While lighter peels (with a lower percentage of acid) are often safe, deeper peels like phenol peels have some risks. People with darker skin may experience permanent skin darkening (hyperpigmentation), skin lightening (hypopigmentation), or raised scars (keloids). Most skin experts suggest that people with darker skin consider a solution of 10% for glycolic and other acids. Talk to your doctor about other options for healing damaged skin like laser therapy, which may have fewer risks for those with brown and Black skin tones. Find a dermatologist with experience working with dark skin to explore your options.
Phenol Peel Benefits
Chemical peels can help the look, feel, and health of your skin. Peels – including deep ones like phenol peels – can help reduce or improve:
- Fine lines near your eyes, around your mouth
- Wrinkles caused by sun damage, aging, or genetics
- Some types of acne
- Mild scarring
- Sun spots, liver spots, age spots, and freckles
- Uneven skin coloring
- Precancerous spots (actinic keratosis)
- Rough skin
- Scaly patches
- Dull complexion
While chemical peels are often used to treat the skin on your face, they can also help treat the skin on your neck or hands.
Phenol Peel Costs
According to the American Society of Plastic Surgeons, chemical peels cost an average of $1,800. The costs may include anesthesia, medications, and facility costs. For procedures like this, doctors suggest balancing training and bedside manner with costs. It’s best to find a board-certified plastic surgeon or dermatologist.
Takeaways
Chemical (phenol) peels can treat a variety of skin issues like scarring, acne, spots, and discoloration.
Phenol peels use a high acid count that should be performed by a board-certified doctor. It could take up to 2 weeks for you to recover. You may also have some symptoms (like redness) lasting for up to 3 months.
If your skin is severely damaged, you may need more than one treatment.
Phenol Peel FAQs
What does a phenol peel do?
A phenol peel uses an acid safe for the skin to remove damaged skin cells to allow healthy skin to surface.
How much do phenol peels cost?
Phenol peels cost about $1,800 per session. This often includes costs for medications and facility costs. Keep in mind, you may need more than one treatment.
How long does it take for a phenol peel to heal?
Depending on how deep your treatment is, a phenol peel can take about 2 weeks to heal. At that point, you should be able to wear makeup and return to your normal routine. Some redness or swelling can last for a few months.
Who are phenol peels good for?
Those with lighter skin tend to be better candidates for phenol peels. People with darker skin tones may not respond well to the acid in phenol peels, possibly leaving permanent damage or scarring.
What are the disadvantages of a phenol peel?
Phenol peels use a high concentration of acid to remove damaged skin. The high toxicity can lead to side effects including permanent scarring, infection, or even organ damage. Speak with a board-certified dermatologist or plastic surgeon about your options and steps to reduce risks.
