Overview
Chemical peels: types and how to choose
A chemical peel applies an acid to the skin to remove damaged outer layers. Peels are grouped by how deep they reach: superficial (light) peels stay in the epidermis, medium-depth peels reach the papillary dermis, and deep peels reach the mid-reticular dermis (Soleymani et al., J Clin Aesthet Dermatol 2018). Depth sets the healing time, the risks and, in Texas, who may legally perform the peel (TDLR). This site does not publish a Houston price range for chemical peels. Ask the spa for the price of the specific peel and whether it covers one session or a series.
| Attribute | Light peel | Medium peel | Deep peel |
|---|---|---|---|
| Healing time | About 1 to 7 days | 7 to 14 days | 14 to 21 days |
| Makeup | Right away or next day | Camouflage makeup after 5 to 7 days | After at least 14 days |
| Setting | — | — | General anesthesia in a surgical setting |
| Repeat | Often 3 to 5 peels, every 2 to 5 weeks | Can be repeated | Only one per person |
All figures in this table are from the American Academy of Dermatology.
Mechanism
How chemical peels work
The acid damages the skin to a planned depth, and the skin heals by growing new layers. Strength depends on the acid, its concentration, how it is applied and whether the skin was pretreated. Glycolic acid and TCA are stopped by neutralizing them with an alkaline solution such as sodium bicarbonate; salicylic acid stops on its own (Soleymani et al. 2018).
Depth
Three depths of chemical peels
Superficial peels reach only the epidermis. Common agents are glycolic acid (30–50%), lactic acid (10–30%), mandelic acid (40%) and salicylic acid (30%) (Soleymani et al. 2018). For light peels, the AAD says you may need 3 to 5 peels, repeated every 2 to 5 weeks (AAD).
Medium-depth peels reach the papillary dermis. Agents include 35% TCA or 50–70% glycolic acid, often after a first coat of Jessner’s solution (salicylic acid, resorcinol and lactic acid) (Soleymani et al. 2018). Healing takes 7 to 14 days (AAD).
Deep peels reach the mid-reticular dermis. The main agent is the Baker-Gordon phenol formula, diluted to 50–55% phenol. Phenol absorbed into the body can cause heart rhythm problems, reported in 34–50% of patients, as well as liver and kidney toxicity, and cardiac monitoring is recommended. The same review says lasers have largely replaced deep chemical peels (Soleymani et al. 2018). In a 1979 study of 43 patients, arrhythmias were frequent when half or more of the face was treated with phenol in under 30 minutes and did not occur when the same was done over 60 minutes or more (Truppman & Ellenby 1979). The AAD says deep peels require general anesthesia in a surgical setting, the skin is treated one small section at a time, and a person can have only one deep peel (AAD).
Indications
What chemical peels treat
- Superficial peels: sun spots (solar lentigines), superficial hyperpigmentation, mild to moderate photoaging and fine lines. A 30% salicylic acid peel is used for mild to moderate inflammatory acne.
- Medium-depth peels: fine lines, sun-damaged skin, melasma, superficial acne scars and actinic keratoses.
- Deep peels: moderate to severe photoaging with deep wrinkles and marked hyperpigmentation.
Deep wrinkles, sagging jowls and drooping skin are unlikely to respond to chemical peels (Soleymani et al. 2018).
Skin Safety
Chemical peels for darker skin tones
A 5-year single-center retrospective study at Boston University reviewed 473 superficial peel treatments in patients with Fitzpatrick skin types III to VI. Complications followed 18 treatments (3.8%), most often crusting (2.3%), post-inflammatory hyperpigmentation (1.9%) and redness (1.9%). All resolved within 8 months. Skin type VI had higher odds of side effects (odds ratio 5.14) (Vemula et al., JAAD 2018).
A review of peels for melasma in dark-skinned patients found glycolic acid peels the best choice for safety and effectiveness, advised caution with TCA, and said deep peels cannot be used in dark skin and medium-depth peels need extreme caution (Sarkar et al., J Cutan Aesthet Surg 2012). The AAD advises people with skin of color to choose a dermatologist experienced with darker skin, because permanent pigment problems can otherwise develop (AAD).
Pre-peel skin preparation. For melasma, an Indian expert consensus review recommends 2–4% hydroquinone for at least 4 weeks before a peel, and tretinoin started 2 to 4 weeks before and stopped the day before (Sarkar et al., Indian J Dermatol 2017). Ask your provider whether they recommend a pre-peel plan for your skin.
Branded Peels
VI Peel and branded peels
The VI Peel is a branded peel sold only through authorized clinicians. The manufacturer says providers choose from six formulas (VI Derm), including formulas for pigment and melasma, acne, early aging, mature skin and a body peel for areas below the collarbone (VI Derm, Our Peel Formulas). The manufacturer describes flaking by day 2, peeling on days 3 to 5, and most patients finished peeling by day 7 (VI Derm). The manufacturer’s consumer pages do not list each formula’s ingredients and strengths. Ask the provider which formula they plan to use and how deep it reaches, because depth determines who may perform it in Texas.
What to Expect
What to expect during and after treatment
Recovery depends on peel depth. All figures below are from the American Academy of Dermatology unless noted.
-
Before the peel
Some patients follow a pre-peel skin care plan for 2 to 4 weeks. People with a history of oral herpes start antiviral medicine 1 to 2 days before peeling (Soleymani et al. 2018).
-
Light peel
Redness, then scaling for 3 to 7 days. Healing takes about 1 to 7 days. Makeup is usually allowed right away or the next day.
-
Medium peel
Swelling peaks around 48 hours and blisters may form. Daily soaks and ointment, antiviral medicine for 10 to 14 days, and total sun avoidance until healed. Camouflaging makeup after 5 to 7 days. Healing takes 7 to 14 days, and a follow-up visit is required.
-
Deep peel
The area is bandaged. The dermatologist sees you the next day, with several follow-ups in the first week. Antiviral medicine for 10 to 14 days. Healing takes 14 to 21 days, with 2 to 3 weeks of recovery at home. Makeup after at least 14 days. Total sun avoidance for 3 to 6 months.
-
After healing
Daily sunscreen. No tanning beds. Do not scratch or pick treated skin. After medium and deep peels, redness may last months and the skin may become temporarily darker or lighter. Results are not permanent because skin keeps aging.
Houston Climate
Sun exposure and timing
Post-peel sun protection is part of every aftercare plan: daily sunscreen after any peel, total sun avoidance until healed after a medium peel, and for 3 to 6 months after a deep peel (AAD). In the Boston study of superficial peels in skin types III to VI, side effects were less common in winter (Vemula et al., JAAD 2018). If you have a beach trip or outdoor event coming up, plan the peel so you can stay out of the sun while you heal.
Houston Pricing
Houston pricing
This site does not publish a Houston price range for chemical peels. Prices depend on the type and strength of the peel. Ask the spa for the price of the specific peel and whether it is for one session or a series.
Combinations
How chemical peels pair with other treatments
We could not find a published professional guideline that sets a standard waiting period between a chemical peel and microneedling, Botox or dermal fillers. The VI Peel manufacturer promotes adding a VI Peel to a neurotoxin appointment (VI Derm) and to a microneedling treatment series. Spacing depends on the peel depth, the other treatment and how your skin heals. Ask your provider to plan the order and timing before booking more than one treatment.
Peels and laser treatments: A 2018 review says lasers have largely replaced deep chemical peels (Soleymani et al. 2018).
Isotretinoin: A 2017 expert consensus review found insufficient evidence to support delaying superficial chemical peels for people taking or recently finished with isotretinoin (Spring et al., JAMA Dermatol 2017). Its summary does not mention medium or deep peels. Tell your provider if you have taken isotretinoin.
Texas Law
How to choose a provider in Houston
Who may perform each peel depth. The Texas Department of Licensing and Regulation says estheticians may perform light or superficial peels that remove dead cells from the epidermis and do not pierce the dermis. Medium and deep peels penetrate the dermis and are medical procedures regulated by the Texas Medical Board (TDLR).
| Peel depth | Esthetician (TDLR license) | Medical procedure under Texas Medical Board rules |
|---|---|---|
| Superficial | Yes | — |
| Medium | No | Yes |
| Deep | No | Yes |
Texas Medical Board rules for delegated procedures. Rules in 22 TAC Chapter 169, Subchapter E took effect January 9, 2025 (Texas Medical Board). Under them:
- Before a delegated procedure, a physician, or a PA or APRN acting under a physician’s delegation, must establish a practitioner-patient relationship with you (22 TAC §169.26).
- The delegation requires a written order (22 TAC §169.27). The person performing the procedure must also sign and date a written protocol (22 TAC §169.26).
- The delegating physician’s name and Texas license number must be posted in each public area and treatment room (22 TAC §169.28).
Before a medium or deep peel, ask:
- Who will perform the peel, and what license do they hold?
- Who is the delegating physician? Look up the physician’s license on the Texas Medical Board’s Look Up a License page.
- How deep does this peel reach, and what is the plan if a complication occurs?
- If you have darker skin, how much experience does the provider have peeling darker skin tones?
Treatment Areas