Peeling: Complete guide to types and care

Peeling: complete guide to types, acids and care

Peeling is a dermoesthetic treatment that removes layers of damaged skin through controlled exfoliation to stimulate cell regeneration. Unlike what many believe, it is not limited to the face: it can be applied to the neck, décolleté, hands, back and other body areas where texture, pigmentation or aging problems exist. Depending on the mechanism used, three main categories are distinguished: chemical peeling (acids), mechanical (physical abrasion) and enzymatic (proteolytic enzymes). And depending on the depth reached, peeling can be superficial, medium or deep.

This guide covers everything you need to know to understand which type of peeling is appropriate for each concern, what to expect from the treatment, and how to prepare and recover correctly.

If you are looking for specific information about facial peeling, consult our guide to facial peeling. To understand exfoliation in general, check out our article on exfoliation.

Summary

• Peeling can be chemical (acids), mechanical (physical abrasion) or enzymatic (fruit enzymes), and is applied to the face, neck, décolleté, hands and body.
• The depth is classified as superficial (epidermis), medium (papillary dermis) and deep (reticular dermis), and determines both results and recovery.
• Each acid has a distinct action profile: glycolic for texture and photoaging, salicylic for acne, mandelic for dark skin, TCA for scars and discoloration.
• Body peeling uses higher concentrations than facial peeling because body skin is thicker.
• Strict sun protection and prior preparation are as important as the procedure itself.

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What is peeling

Peeling is a procedure that in a controlled manner removes the outer layers of skin—damaged by the sun, aging, acne or other factors—so that the body replaces them with new skin. The basic mechanism is to cause a controlled injury that activates the natural repair response: keratinocyte renewal, collagen production and melanin redistribution.

The term "peeling" (from the English to peel) is used for both facial and body procedures, and encompasses different mechanisms of action and depth levels.

Types of peeling by mechanism

Chemical peeling

Uses acidic solutions that dissolve the intercellular bonds (desmosomes) of the stratum corneum, causing the shedding of damaged layers. It is the most versatile type because it allows precise depth adjustment depending on the acid, its concentration, the pH of the formula, the number of layers and the contact time. The most commonly used acids include alpha-hydroxy acids (AHA), beta-hydroxy acids (BHA) and trichloroacetic acid (TCA).

It is the reference standard in dermoesthetic practice and has the most published clinical evidence. Regulatory indications such as those from the FDA, COFEPRIS, EMA and ANVISA establish safety standards for concentrations used in professional settings.

Mechanical peeling

Removes the superficial skin layers through physical abrasion. The most common methods are:

• Microdermabrasion: Projection of aluminum oxide microcrystals or diamond tip onto the skin. Works at the superficial level (epidermis) and requires no significant recovery time.
• Surgical dermabrasion: Uses a rotating instrument (burr) to remove deeper layers. It is a medical procedure that can reach the dermis and is used for deep scars or marked irregularities.

Mechanical peeling offers less control over depth than chemical peeling and does not allow the same uniformity of application, but it is a useful alternative when acids are contraindicated.

Enzymatic peeling

Uses proteolytic enzymes of plant origin—mainly papain (papaya), bromelain (pineapple) and pumpkin enzymes—that digest the proteins of dead cells without affecting living underlying cells. It acts exclusively at the superficial level (epidermis).

Its advantages are gentleness and tolerability: it does not generate the irritation that acids can cause, making it suitable for sensitive, reactive skin or mild rosacea. However, its scope is limited: it cannot treat wrinkles, scars or deep hyperpigmentation. It is a maintenance option, not a correction option.

Note on polyhydroxy acids (PHA)

PHAs—such as gluconolactone and lactobionic acid—are a third category of hydroxy acids, with larger molecules than AHAs. They penetrate more slowly, generate less irritation and have additional humectant properties. They are especially useful for patients with rosacea, atopic dermatitis or extremely sensitive skin that does not tolerate even gentle AHAs. Its use as a professional peeling agent is less common than AHA/BHA, but it is found in cosmetic maintenance formulations and pre-peeling preparation protocols.

Chemical peeling depth spectrum

Superficial peeling

Works in the epidermis. Uses AHA (glycolic, lactic, mandelic) or BHA (salicylic) at low to moderate concentrations, or Jessner's solution in a single layer. Recovery is minimal: mild redness and subtle flaking in 1-3 days. Can be performed every 2-4 weeks in series of 4-6 sessions.

Indications: irregular texture, dull tone, dilated pores, mild acne, superficial hyperpigmentation, maintenance of healthy skin.

Medium peeling

Penetrates into the papillary dermis. The most common agents are TCA 15-35%, or synergistic combinations (Jessner's solution + TCA 35%, glycolic acid 70% + TCA 35%). Recovery lasts 5-7 days with visible flaking and redness that can persist 1-2 weeks.

Indications: fine to moderate wrinkles, superficial to moderate acne scars, solar lentigines, epidermal melasma, actinic keratosis.

Deep peeling

Reaches the reticular dermis. Performed with phenol (Baker-Gordon formula) under medical supervision with cardiac monitoring. Recovery is 2-4 weeks with scab formation, significant swelling and residual redness that can last months. Generally performed only once per area.

Indications: deep wrinkles, severe photoaging, marked scars. Contraindicated in skin types IV-VI.

Comparative table of acids for peeling

Jessner's solution deserves special attention: by combining three agents with complementary mechanisms (salicylic penetrates the follicle, lactic hydrates and exfoliates, resorcinol is keratolytic), it produces uniform exfoliation that can be modulated depending on the number of layers. It is frequently used as a "primer" before TCA application, improving the uniformity of medium peeling penetration.

Peeling for specific concerns

Acne scars

Atrophic acne scars (ice pick, boxcar and rolling types) respond to peeling depending on their depth. Superficial scars improve with series of glycolic acid 50-70% or TCA 15-25%. For moderate scars, TCA 35% or the TCA CROSS technique (spot application of TCA 70-100% directly to the scar) produces localized collagen remodeling. Deep ice pick scars generally require combined approaches (peeling + microneedling + subcision).

Melasma

Melasma is one of the most complex indications because peeling can both improve and worsen the condition if not managed correctly. Superficial peelings with glycolic acid 30-50%, mandelic or Jessner's solution are the safest options, always as part of a comprehensive protocol that includes topical depigmentants (hydroquinone, kojic acid, tranexamic acid) and strict sun protection. TCA at medium concentrations can be used with caution, but deep peelings are contraindicated in melasma due to the risk of rebound hyperpigmentation.

Photoaging

Accumulated sun damage (wrinkles, lentigines, rough texture, elastosis) is one of the classic peeling indications. Serial superficial peelings improve tone and luminosity progressively. TCA 25-35% effectively treats solar lentigines and fine wrinkles. Phenol produces the most dramatic results in severe photoaging, but with the greatest restrictions and risks.

Texture and pores

Irregular texture and dilated pores respond well to frequent superficial peelings. Salicylic acid is especially effective for pore congestion because it is lipophilic and penetrates within the follicle. Glycolic acid improves overall texture by promoting uniform cell turnover. Series of 4-6 sessions every 2-4 weeks produce visible cumulative improvement.

Keratosis pilaris and actinic keratosis

Keratosis pilaris (keratinized follicles, commonly on arms and thighs) improves with superficial peelings of glycolic or lactic acid on body areas. Actinic keratosis (precancerous lesions from chronic sun exposure) is treated with medium peelings under dermatological supervision as part of a field protocol.

Body peeling

Peeling is not limited to the face. The most commonly treated body areas are:

Hands

The hands are one of the first areas to show signs of photoaging: solar lentigines, irregular texture and volume loss. Peelings with TCA 15-25% or glycolic acid 50-70% significantly improve spots and texture. Hand skin is thinner than body skin but thicker than periocular skin, which allows intermediate concentrations. Sun protection post-procedure is especially difficult on hands (due to frequent washing), requiring constant SPF reapplication.

Décolleté

The décolleté accumulates sun damage similarly to the face but the skin is thinner and has fewer sebaceous glands, making it more susceptible to irritation. Acids are used at slightly lower concentrations than for the face (for example, TCA 10-20% instead of 25-35%). Recovery may be longer and the risk of postinflammatory hyperpigmentation is greater, especially in dark skin types.

Back

The back is a frequent site of acne and post-acne scars. The skin is significantly thicker than facial skin, which allows higher concentrations of acid. Peelings with salicylic acid 20-30% are especially effective for back acne. For scars, TCA protocols similar to facial ones are used but with concentration adjustment depending on skin thickness.

General considerations for body peeling: Body skin is often thicker and more resistant than facial skin, which allows higher concentrations. However, the regeneration capacity is slower and the risk of irregular scarring is greater in certain areas (shoulders, sternum). Areas with thin skin (inner arms, neck) require the same care as facial skin.

Pre-peeling preparation

Proper preparation improves results and reduces complications:

• Sun protection: Start daily use of SPF 30+ at least 2-4 weeks before the procedure. Tanned or sunburned skin has a higher risk of post-peeling hyperpigmentation.
• Retinoids: Stop retinol, tretinoin and adapalene 3-7 days before (superficial peelings) or 2-3 weeks before (medium/deep peelings and dark skin).
• Depigmentants: In skin with hyperpigmentation tendency or skin types IV-VI, the professional may indicate hydroquinone 2-4% for 2-4 weeks prior to prepare melanocytes.
• Hair removal: Do not perform waxing, threading or plucking in the treatment area at least 7-14 days before.
• Home exfoliants: Stop AHA, BHA and scrubs at least 5-7 days before.
• Medical history: Inform the professional about medications (isotretinoin, oral contraceptives, photosensitizers), history of cold sores (may require antiviral prophylaxis), allergies and tendency to abnormal scarring.

Post-peeling care

Post-procedure care is as important as the procedure itself:

First 24-48 hours

• Wash the face with lukewarm water and sulfate-free gentle cleanser.
• Apply barrier repair moisturizer.
• Do not apply makeup (on medium peelings; on superficial ones mineral makeup may be allowed the next day).
• Avoid intense exercise, saunas, swimming pools and hot baths.

Days 3-7 (flaking phase)

• The skin begins to flake: do not scratch, rub or manually remove the skin flakes.
• Maintain constant hydration.
• SPF 30+ broad spectrum sun protection is mandatory, with reapplication every 2 hours of exposure.
• Avoid AHA, BHA, retinoids, active vitamin C and any exfoliants.

Weeks 2-4 (regeneration)

• Continue strict sun protection for at least 4 weeks.
• Reintroduce active products gradually only when the professional indicates: typically 1-2 weeks for superficial peelings, 3-4 weeks for medium ones.
• Deep peelings require continued medical follow-up for weeks or months.

Healing timeline by depth

Risks and contraindications

Possible risks

• Postinflammatory hyperpigmentation (PIH): The most frequent risk, especially in skin types IV-VI and in medium/deep peelings. Preparation with depigmentants and rigorous sun protection significantly minimizes it.
• Hypopigmentation: More common with deep phenol peelings, can be permanent.
• Prolonged erythema: Redness persisting beyond expected time may indicate an exaggerated reaction or infection.
• Infection: Bacterial, viral (herpes simplex reactivation) or fungal. Antiviral prophylaxis is recommended in patients with a history of herpes before medium or deep peelings.
• Abnormal scarring: Rare with superficial peelings, possible with medium and deep, especially in patients with keloid predisposition.
• Systemic toxicity: Exclusive to phenol in deep peelings; can cause cardiac arrhythmias, requiring monitoring during the procedure.

Absolute contraindications

• Pregnancy and breastfeeding
• Current or recent use of isotretinoin (wait 6-12 months)
• Active infection in the treatment area (herpes, bacterial, fungal)
• Open wounds or compromised skin barrier
• Documented allergy to solution components

Relative contraindications

• Skin types IV-VI: Controlled superficial and medium peelings are safe with proper preparation. Deep peelings with phenol are contraindicated due to the risk of permanent hypopigmentation. Mandelic and salicylic acid are the safest options for dark skin.
• Recent sunburn: Wait at least 2-4 weeks until complete recovery.
• Use of photosensitizing medications: Doxycycline, minocycline, certain chemotherapy drugs.
• History of abnormal scarring: Keloids or hypertrophic scars.
• Autoimmune diseases or immunosuppression: Greater risk of infection and poor scarring.
• Recent procedures: Wait 7-14 days after waxing, laser or microneedling; 4-6 weeks after surgery.

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Frequently Asked Questions

What is peeling and what is it used for?

Peeling is a treatment that removes layers of damaged skin through controlled exfoliation—chemical, mechanical or enzymatic—to stimulate cell regeneration and collagen production. It is used to improve texture, treat hyperpigmentation, reduce fine wrinkles, attenuate acne scars, control active acne and reverse signs of photoaging. It can be applied to the face, neck, décolleté, hands, back and other body areas. The type of peeling (depth and acid) is selected based on the problem to be treated, skin type and individual patient tolerance.

What is the difference between chemical, mechanical and enzymatic peeling?

Chemical peeling uses acids (glycolic, salicylic, TCA, phenol) that dissolve bonds between dead cells; can be superficial, medium or deep. Mechanical peeling removes cells through physical abrasion (microdermabrasion with crystals or diamond tip, surgical dermabrasion). Enzymatic peeling uses fruit enzymes (papain, bromelain) that digest proteins of dead cells without irritating living ones. Chemical offers greater versatility and depth control, mechanical is useful when acids are contraindicated, and enzymatic is the gentlest option for very sensitive skin.

Can you do peeling on the body?

Yes, body peeling is an established procedure performed on hands, décolleté, back, arms and legs. Body skin is generally thicker than facial skin, which allows higher concentrations of acid. The most frequent indications are sun spots on hands and décolleté, back acne, post-acne body scars, keratosis pilaris on arms and thighs, and irregular texture. Special considerations include that regeneration is slower, sun protection can be more difficult to maintain, and certain areas (shoulders, sternum) have a higher risk of irregular scarring.

What acid is best for spots?

Glycolic acid 30-50% is the most widely used for general hyperpigmentation and photoaging due to its ability to penetrate uniformly and accelerate the turnover of pigmented keratinocytes. For dark skin with spots, mandelic is preferable for lower risk of postinflammatory hyperpigmentation. For stubborn solar lentigines, TCA 15-35% produces more striking results in a single session. For melasma, serial superficial peelings combined with topical depigmentants and sun protection are the safest and most effective approach. The key is that no peeling works without rigorous post-treatment sun protection.

Can peeling worsen my skin?

Yes, if selected incorrectly or if pre and post-treatment care instructions are not followed. The main risks are postinflammatory hyperpigmentation (especially in dark skin without proper preparation), excessive irritation and, in rare cases with deep peelings, scars. Melasma can worsen with overly aggressive peelings. That is why it is essential that peeling is performed by a professional who evaluates skin type, skin condition and contraindications, and that the patient strictly follows the sun protection protocol and post-care.

How many peeling sessions do I need?

The number of sessions depends on the type of peeling and the problem being treated. Superficial peelings usually require series of 4-6 sessions every 2-4 weeks for optimal results, with maintenance sessions every 1-3 months. Medium peelings are performed every 3-6 months, and 1-3 sessions may be enough to treat moderate lentigines or scars. Deep peelings with phenol are generally performed once per area. Individual response varies depending on skin type, condition being treated, depth of the lesion and adherence to post-treatment care.

Can I do peeling if I have dark skin?

Yes, with proper precautions. Superficial peelings with mandelic, salicylic or glycolic acid at low concentrations are safe in skin types IV-VI when skin is prepared with depigmentants and sun protection. The key is to avoid excessive inflammation, which is the main cause of postinflammatory hyperpigmentation. Deep peelings with phenol are contraindicated in dark skin types. The professional should adjust the concentration, contact time and number of layers, and establish a preparation regimen of at least 2-4 weeks before the procedure.

Is it safe to do peeling during pregnancy?

It is not recommended. Although not all acids have clear evidence of teratogenicity, the precautionary principle prevails. Salicylic acid in high concentrations, topical retinoids and TCA lack sufficient safety data during pregnancy. Furthermore, hormonal changes during pregnancy make skin more reactive and increase the risk of hyperpigmentation. The recommendation of international dermatological organizations is to postpone any chemical peeling until after delivery and breastfeeding. Safe alternatives such as gentle facial cleansing can be maintained with prior consultation with the physician.

How long should I wait after taking isotretinoin to do a peeling?

The classic recommendation is to wait 6-12 months after stopping isotretinoin before performing a medium or deep peeling. Isotretinoin thins the skin, alters sebaceous function and can compromise scarring, increasing the risk of atypical scars, prolonged erythema and excessive flaking. Some recent reviews suggest that gentle superficial peelings could be safe before that timeframe, but the evidence is not conclusive. The professional should evaluate skin condition, time elapsed and depth of planned peeling before proceeding.

What should I not do after peeling?

The main restrictions are: do not scratch or peel off flaking skin layers (causes scars and hyperpigmentation); do not expose yourself to the sun without SPF 30+ protection; do not use retinoids, AHA, BHA or exfoliants until the professional authorizes it; do not do intense exercise, sauna or swimming for 48-72 hours (medium peelings); do not apply conventional makeup for 5-7 days (medium peelings); and do not use hot water on the treated area. Adherence to these care guidelines is what makes the difference between excellent results and complications.

In what season is it best to get peeling?

Superficial peelings can be performed year-round with strict sun protection. Medium and deep peelings are more advisable in autumn and winter, when environmental UV exposure is lower and the patient can more easily comply with the post-treatment sun protection protocol. In summer, well-managed superficial peelings—with daily SPF 50+ and no direct sun exposure—are still viable in experienced hands. The key is not the season itself, but the patient's ability to adhere to rigorous sun protection during the regeneration phase.

Are peeling and exfoliation the same thing?

Not exactly. Exfoliation is a broad concept that includes any method to remove dead skin cells from the skin's surface, from home scrubs and brushes to serums with acids at low concentration. Peeling is a professional procedure that uses agents at controlled concentrations to produce deeper, more uniform and intense exfoliation, capable of reaching not only the epidermis but also the dermis. The fundamental difference is the depth of action, the intensity of the regenerative response and the need for professional supervision.

When will I see results after peeling?

With superficial peelings, skin looks brighter and more even once subtle flaking is complete (2-5 days), but cumulative results are appreciated after 3-4 sessions. With medium peelings, improvement is visible once redness disappears (1-2 weeks), with collagen production continuing over 2-3 months. With deep peelings, final results are appreciated at 3-6 months, when collagen remodeling reaches its peak. In hyperpigmentation, improvement is progressive and depends on adherence to sun protection and topical depigmentants.