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Although it would be nice to look in the mirror and have it tell me that I'm the fairest one of all, certain insecurities of mine—ahem, acne scars—beg to differ. That being said, I know there's nothing wrong with acne scars, in fact, women have been embracing these so-called "flaws" rather than feeling ashamed by them.
Still, for those of you who are interested, or maybe just a little bit curious, I've done the research and checked in with top skincare professionals on all there is to know about how to treat acne scars. While there are preventative measures we can take to keep acne scars from forming—like washing our faces daily, controlling oil buildup in our pores, and not picking at blemishes once they appear—the most effective tool for diminishing and even vanishing acne scars from skin's surface appears to be a chemical peel. It's gentle on the skin but tough on scars. Keep reading to learn everything you need to know about using chemical peels to treat acne scars.
What Is a Chemical Peel?
A chemical peel is a cosmetic treatment in which acids with exfoliating properties are applied to the skin—typically the face. The chemical solution removes dead skin, oil, and debris to reveal newer, smoother, and clearer skin.
According to NYC plastic surgeon Melissa Doft, MD, chemical peels are a strong form of chemical exfoliation in which "an acid solution" does away with dead skin and pore-clogging impurities on contact. Doft says that they "cause a controlled injury to surface skin cells." It sounds a lot scarier than it is, but remember these injuries are on a cellular level (kind of like microneedling). "The strength of the peeling solution will determine the level of injury to your skin," Doft says. "After the skin is injured, it will peel off and new cells will replace the old ones. Stronger peels will cause a deeper injury and thus require more downtime to heal." Since brand new cells replace the old, expect the skin to look more even, glowy, and fresh.
Benefits of a Chemical Peel
If trying to decide whether a chemical peel is right for you, consider the benefits, which, according to Jennifer MacGregor, a board-certified dermatologist at Union Square Laser Dermatology in New York City, are many:
- Brightens pigment
- Smooths skin
- Evens skin tone
- Unclogs pores
- Reduces acne
- Improves the penetration and efficacy of your other skincare products
Not too shabby if you ask us. She adds, "If you use a peeling agent regularly for four to six weeks or more (or opt for a stronger peel), you can also smooth texture by building new and healthier collagen and elastin and even boost skin's own internal hyaluronic acid, which gives it that plump, luminous quality."
As for the pros of peels if you have acne-prone skin, "The improvement in comedonal acne—the type where pores are blocked and skin is oily—is significant and there can be a mild improvement in texture for shallow-depth boxcar scars over time," says MacGregor. She continues, "More aggressive peeling can improve acne scars significantly, but these have fallen out of favor due to the recovery profile as it compares to laser and energy devices (the latter having a better ratio of improvement to downtime). Occasionally, we place a stronger peeling agent just into the center deeper scars, which is a spot treatment often called the cross method."
How to Prepare for a Chemical Peel
"If you have routine skincare, stick to your regimen before the peel. If you use any new and active cosmeceuticals that irritate you before your peel, it could cause even more irritation, unnecessary recovery, and uneven peeling," says MacGregor.
When it comes to retinoids, she explains, "If you use [them] regularly just inform your physician and don’t change anything leading up to the peel. Some people disagree on this point since retinoids are also peeling agents that thin out the outer dead cell layer, so a peel will be stronger; however, retinoids also thicken the epidermis. The outer healthy cell layer of skin is thicker in retinoid users, not thinner). Just don't start new retinoids a few weeks before and don’t go to have a professional peel without informing them of your retinoid use and strength."
Lastly, "Definitely don’t get waxed before a peel. If you are doing peel pads or solution at home, start very gently, and gradually build to more frequent use. If it’s a new product, always test a small area first," advises MacGregor.
What to Expect During a Chemical Peel
Since there is not just one type of chemical peel, MacGregor says, "[Expectations] vary so widely based on the treatment and formulation." However, according to the American Academy of Dermatology, when you arrive for your peel, you will receive a thorough cleansing of your skin. Deep peels will require general anesthesia to put you to sleep and therefore, must be performed in a surgical setting. Once you're prepped and ready to go, your dermatologist will quickly and evenly apply the peel and then carefully remove it once ready.
As for how soon you can expect to see results, it depends on a couple of different factors, namely, the type of peel, how often you use it, and your specific skin type. Celebrity esthetician Shani Darden who works with the likes of Jessica Alba and Emmy Rossum says, "Generally, I recommended having a peel every four to six weeks for best results."
At-Home vs. In-Clinic
Darden uses chemical peels in her studio, using safe-for-skin acids like glycolic, salicylic, and lactic. Doft lauds the powers of a chemical peel for reducing acne scars and acne in the first place. "Both at-home and in-clinic chemical peels can be helpful in treating acne," she says.
"The peels that are used in a doctor's office are stronger than those available at home. When applied, they remove the top layer of skin, unclogging pores and improving skin texture by increasing skin turnover. They are also helpful in removing hyperpigmentation and darkening caused by acne flares." In her office, she uses the VI Peel for acne-prone and aging skin. "It is a medium-strength peel that is excellent for hyperpigmentation and superficial acne scars."
The Best At-Home Chemical Peels
At home, Darden recommends using Dr. Dennis Gross Peel Pads, which use a combination of acidic ingredients to target uneven tone and texture, fine lines and wrinkles, and enlarged pores through cell turnover.
Although MacGregor says, "No at-home peel products will work for acne scars" she recommends using "Skinbetter Alpharet peel pads one to two times weekly for blackheads, pigment, smooth texture, and glow."
MacGregor is also a fan of these peel pads, which happen to come in a variety of strengths. They address skin concerns like large pores, acne, blackheads, and whiteheads by gently exfoliating and moisturizing.
(Editor's note: If you're in between chemical peels and you aren't gearing up for one or healing from one, retinol is a good idea for reducing acne scarring. Darden says, 'For reducing the appearance of acne scars and the chance of new scars from forming, I recommend using Resurface Retinol Reform. It stimulates cell regeneration, which reduces the signs of aging, scarring, and acne.' This retinol is a Byrdie editor favorite for its effective yet gentle formula which brightens and evens your complexion).
Don't panic if you experience slight irritation or even some actual peeling. According to Doft, "All peels are different as they contain varying acid combinations, which penetrate the skin at a unique level. Superficial peels may leave you slightly dry that evening. Medium-strength peels will cause your skin to peel and blister two to three days after the peel is applied. During this time, your skin may feel dry and tight. It is necessary to keep your face moist using products like Aquaphor Healing Ointment ($5)." It's after you pass these stages that the real results appear. "If you are prone to cold sores then medication can prevent an outbreak," adds MacGregor. Just make sure to consult your doctor.
Post peel, the new skin cells will be more susceptible to sunburn. MacGregor advises, "Generally speaking, [aftercare] depends on the peel type, strength, and formulation but the common theme for most is: Sun protect the area with a hat or other physical cover and good zinc, titanium-based sunscreen—the sunscreen in your makeup is not sufficient—also, do not apply retinol or retinoids of any kind of benzoyl peroxide (The number of days you skip depends on the peel strength and how sensitive your skin is)."
If you decide to wash the first 24 to 48 hours after your peel, she recommends, "using a gentle cream or milky cleanser, not a foam-based product. Also, do not wax and avoid abrasives or physical scrubbing modalities (Think: loofah mitts or rough paste cleansers) and other irritating ingredients. Instead, stick to a gentle cleanser, physical sunscreen, and hydrate well with a bland, plumping, soothing moisturizer like Skinmedica TNS Ceramide Treatment Cream ($69) or Cerave Moisturizing Cream ($14). Some mild active topicals may be allowed the day after, but these should be tested on compromised or lasered skin before considering. Examples would include Skinbetter Alto Defense Serum ($150) and Skinceuticals C E Ferulic ($166)."
MacGregor notes, "Intense peeling may call for ointments until the outer layer of cells recovers (epithelialization) and has a whole other list of post-care requirements." Again, it's best to reach out to your doctor.
The Final Takeaway
While in-clinic chemical peels can work to fade the appearance of acne scarring over time, at-home treatments offer other benefits for skin, whether it's acne-prone or not. Chemical peels vary in strength and it's best to consult your doctor when deciding which treatment would work best for you—that can even mean deciding to flaunt your scars and forgo peels altogether.