Cleopatra is said to have slathered her skin with spoiled milk (full of lactic acid) to get glowing. While not a new concept, using acids to shed superficial layers and reveal a more radiant surface can be tricky: Some formulas gently dissolve dead cells; others tackle dark spots and fine lines but require considerable downtime.
When it comes to professional peels, they’re not a one-strength-fits-all type of service. There are roughly three levels of treatment. Each handles different issues and involves a different degree of recovery. Pinpoint your problem areas and find a solution to discuss with your doctor. To take out some of the guesswork, we’ve broken down which common skin issues each level of peel tackles best.
A LIGHT PEEL
For more superficial skin conditions such as acne, fullness, and enlarged pores, a low dose of glycolic, lactic, mandelic, or salicylic acid can exfoliate the surface without major irritation. A cocktail of two or three of these can address multiple issues at once: For example, glycolic and salicylic acids may be combined to boost radiance and clear out pores so they appear smaller. These peels typically cost about $50 or more and require virtually no downtime (though vigilant sun protection afterward is necessary).
THE FINE PRINT: Superficial peels are usually not a one-and-done proposition: "In an ideal world my patients would come in for a light peel every month to maintain a healthy glow," says Neal Schultz, a New York dermatologist and founder of the Beauty Rx Peel Bars. For acne, a series of four to six peels, spaced two weeks apart, may be recommended. "To tackle dullness, I suggest coming in whenever your skin starts to look drab," says N.Y.C. plastic surgeon Michelle Yagoda.
A MEDIUM PEEL
In a concentration of 10 to 35 percent, trichloroacetic acid (commonly referred to as TCA) can be used to treat deeper, more severe sun damage, fine lines, and enlarged pores. It may also be used in conjunction with brightening glycolic acid. This kind of service can go for $200 or more, but prices vary widely, with some medium peels approaching $1,000. You may also experience redness, swelling, and peeling in the 10 days to follow.
THE FINE PRINT: While one session may be enough to see a more even, smoother-looking complexion, keep in mind that you're now affecting skin down to the more delicate papillary dermis. "Medium and heavy peels should be performed only by a doctor, not an aesthetician," says Dr. Schultz. This depth of peel may not be advisable for anyone with a medium-dark or dark complexion, due to the risk of inflammation and hyperpigmentation, says Dr. Yagoda. Some patients need a topical anesthetic or pain pill for this treatment.
A DEEP PEEL
Phenol or TCA at around 50 percent can also be used to improve the appearance of deep lines, skin laxity, and severe sun damage. The price hovers at around $500 or more, and if you opt for anesthesia, the cost will jump into the thousands. Count on up to two weeks of shedding skin and redness post-treatment; it may take six weeks for the skin to reach its brighter, tighter-looking pinnacle.
THE FINE PRINT: Deeper peels are less common than they were in their 1990s heyday, says N.Y.C. dermatologist Elizabeth Hale, who in her practice uses fractionated lasers to target the same issues (some of which require less downtime). That said, many doctors who have been doing peels for decades and have perfected their techniques find deep versions like this "very effective and less expensive than lasers," says Joel Cohen, director of AboutSkin Dermatology in Greenwood Village, Colo., and PCA Skin Peel expert.