According to the International Society of Aesthetic Plastic Surgery, there were nearly 1.4 million chemical peels performed in 2016, making it third most common minimally invasive cosmetic procedure performed that year.
In short, if your esthetician’s toolkit doesn’t come with an expertise in peels and a unique repertoire of peel services, you are likely missing out on a growing base of satisfied clients.
Depending on the formulation and strength, a chemical peel offers clients a multitude of benefits:
- Unclogs pores to prevent and heal acne
- Improves the look of dark spots and uneven pigmentation
- Reduces fine lines and wrinkles
- Improves the appearance of rosacea and pilaris
- Improves the skin’s overall tone and texture
- Creates a dewy, fresh complexion
What are Chemical Peels?
Chemical peels are acid solutions applied to the skin. Most chemical peels aren’t actually peels, but instead gels, lotions, grams, and cleansers that dissolve the outermost layer of skin, allowing it to peel off over the following days. By removing old skin cells, chemical peels reveal the fresher layer below. Chemical peels are also referred to as epidermal exfoliation, chemexfoliation, and derma-peeling.
Chemical peels can be light, moderate, or deep. As a licensed esthetician, your state license will likely limit you to light and moderate peels. Deep peels can only be performed by licensed physicians, such as dermatologists.
Light Peels
Light chemical peels, also known as superficial peels, lunchtime peels, and deep exfoliants, are generally administered in a salon, skincare clinic, or spa.
There are a host of chemical peel formulations. However, most contain a solution of alpha hydroxy acid (AHA) or beta hydroxy acid (BHA). A thin layer of the peel is applied to the skin and allowed to remain on the skin for a set period of time. Some peels require more than one layer.
AHAs are derived from natural sources, such as sugar cane, milk, and tomato juice. Some of the most well-known AHAs are citric acid, glycolic acid, lactic acid, and malic acid. AHAs are used to treat fine lines and wrinkles, uneven skin tone and texture, and improve acne, among others.
BHAs are used to treat scars and acne-prone skin, as they control the production of oil and loosen dead skin cells. Salicylic acid is the most popular BHA.
Moderate Peels
Medium peels penetrate the outer and middle layers of skin to remove damaged skin cells. Medium peels use a formulation that includes glycolic acid (derived from sugar cane), trichloroacetic acid (TCA), pyruvic acid, or lactic acid (derived from milk), or a combination of two or more acids (called a Jessner Peel).
TCA is one of the highest level peels that delivers more pronounced results. It is used to reduce the appearance of wrinkles, brown spots, and acne scars. TCA is also used to treat the lip and eye area to improve the appearance of dark circles, wrinkles, and fine lines.
The Jessner Peel uses a combination of salicylic acid, lactic acid, and resorcinol (a mild antiseptic). This potent peel is used for advanced acne scarring, hyperpigmentation, sun spots, wrinkles, and freckles.
What Estheticians Should Know About Chemical Peels
Chemical peels have the potential to cause scarring, infection, and changes in skin tone if they aren’t administered under the careful hands of a licensed esthetician trained in chemical peels.
Other less severe contraindications include:
- Cold sore breakouts
- Swelling
- Burning/itching/stinging
- Skin sensitivity
A comprehensive consultation, including a patient history and evaluation, should always be done before a chemical peel. The client consultation should cover factors that could affect the outcome of a chemical peel and the client’s perceived outcomes of the procedure.
Some of the factors to be considered include:
- Present medical conditions (e.g., diabetes, high blood pressure, seizures, etc.)
- Past medical conditions, including shingles, previous surgeries, skin cancer
- Current medications, including prescription and OTC, such as birth control, heart medication, retinol products
- Pregnancy, nursing
- Any allergies
- Previous chemical peels (when, what type?)
- Current skincare regimen, including what type of products used
Pre-service preparations should also be considered as part of the client consultation, including a skin test performed at least 24 hours prior to the procedure.
You must have an in-depth understanding of chemical peel acids, their concentrations, and which ones to use on which clients. For some clients, you may need to use a lower-grade acid concentration to prevent adverse reactions, while on other patients, you may need to use a higher grade concentration to achieve the desired effect. Client consultation is crucial for ensuring you are using the correct chemical peel on your clients.
Part of the client consultation process includes client education, which includes educating them about what to expect before, during and after the peel, at-home care, and expected outcomes and side effects.
Following the procedure, you will rebalance and moisturize the skin, which involves bringing the client’s pH level back to normal using a manufacturer’s recommended solution and replenishing the skin and protecting it from the sun.
Advanced Training and Certification in Chemical Peels
You must follow the rules and regulations of your State Board of Cosmetology and practice within the scope of your state esthetician license when performing chemical peels.
In many states, your esthetician license will allow you to perform only light AHA and BHA chemical peels. For example, California estheticians are prohibited from removing tissue beyond the epidermal layer of skin. In other words, they are limited to performing only light peels.
You may be allowed to perform moderate peels in some states, but only if you hold a master esthetician license, as is the case in Washington State, or a chemical peel certificate in addition to your esthetician license, as is the case in Colorado.
Your state esthetician license may also limit the type and strength of chemical peel solutions you are able to use. In most states, you can only apply solutions of less than 30 percent, as anything higher is considered “medical grade.” For example, Ohio estheticians can mix and use peels with an ingredient concentration of 30 percent or less at final formulation and with a pH value of no less than 3.
Regardless of whether your state requires additional training in chemical peels, it will always benefit you to pursue advanced training in chemical peels through a certificate or diploma program. These programs, which require a current esthetician license and include both hands-on and classroom work, explore different types of chemical peels and their differences and functions, along with contraindications to treatment and the management of adverse side effects.