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Topical Acids and Chemical Peels

There is nothing like a solid chemical peel! Every once in a while, I like to channel my inner chameleon and shed some dead skin for a quick pick me up. Chemical peels are commonly used for acne, fine lines, discoloration (sun damage and melasma), and just general smoothing, tightening, and brightening. There are also plenty of acids that are found in over-the-counter preparations that are safe for regular, at home use too. These are very mild and light, “bare minimum peels” compared to anything you can’t in a dermatologists office.

In-office chemical peels can be categorized into LIGHT alpha hydroxy and beta hydroxy acid peels, MEDIUM trichloroacetic acid peels, and DEEP phenol peels.

· Alpha hydroxy acids include lactic, glycolic, and mandelic acid, which allows for a quick recovery time, increased cell turnover rate, and gentle exfoliation. Mandelic acid is quite special and has both alpha and beta hydroxy acid properties and is ideal for deeper skin tones that tend to pigment. Studies show that mandelic acid does not trigger melanocytes to become as active as its counterparts, which allows less of a chance for post inflammatory hyperpigmentation to occur.

· Salicylic acid is a beta hydroxy acid that has keratolytic and comedolytic properties, which are excellent for acne. This acid is able to dissolve dead skin cells and dirt on the skin, dissolve oils, unclog pores and also act as an anti-inflammatory agent for the skin.

· Trichloroacetic acid (TCA) peel is like the middle child of chemical peels, but also the most popular. A higher strength TCA peel can get deep into the dermis and significantly renew the skin, while a lighter strength can give some mild flaking. Though the healing can be a few extra days of tightness, flaking and peeling, the results are absolutely worth it and that’s why patients and providers like this very much.

· Phenol peels are the deepest and strongest peel of them all. This peel is quite uncomfortable while being applied and thus, usually requires some sort of anesthetic. It also comes with a lengthy recovery process. However phenol peels can smooth out coarse wrinkles in a single treatment and offer the most dramatic results. Sometimes taking 5-10 years off a face.

All acids are not created equal, and there are TONS of acids that are found in over-the-counter topical preparations that offer incredible benefits for the skin when done regularly. Of course, along with regular sun protection and follow up skincare.

· Tranexamic acid, at the moment, tranexamic acid is such a hot topic! Topical preparations of tranexamic acid is trending and on the rise to treat discoloration. Oral tranexamic acid (Lysteda) is is gaining popularity in dermatology offices. To be prescribed off label for melasma.

· Kojic acid is a classic and popular pigmentation fighter that brightens the skin by inhibiting your melanin making machine.

· Azelaic acid is a powerhouse that can fight acne and also decrease inflammation and redness. Despite all the benefits, azelaic acid is the acid that doesn’t get much publicity but is commonly used to treat Rosacea.

The world of acids can be quite overwhelming and confusing, and there are plenty more acids that this article has not discussed. All these acids offer a unique role in a skin care regimen, but don’t forget, all acids are not meant for all skin types! It is important to visit your Dermatology office to have a professional fully evaluate your skin for an individualized skincare regimen and a consultation for a chemical peel.

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