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The Truth About Peels

August 6, 2015 Reviewed by Marta 11 Comments

Although the image is well-worn enough to be cliché, the flaking face of Samantha in Sex In The City still comes to the minds of many of us at the mere mention of a facial peel. I had my first professional peel last week at the offices of New York Dermatologist, Dr Dennis Gross (arguably, the father of the facial peel). Actually, it was my first peel period. It was such a revelation that I immediately wanted to understand the skin’s physiology and how this procedure really works. I also launched my one-woman campaign to demonstrate that “peel” is a misnomer and that, if properly done, this is really about cell rejuvenation. But before getting into that, I went in search of the truth about peels.

Peeling begins with exfoliation

A peel treatment is setting out to exfoliate the skin. The stratum corneum is the skin’s outermost layer and it is made up of dead skin cells (corneocytes). The stratum corneum is responsible for the skin’s moisture retention and the build up of dead cells results in dryness and loss of radiance. Peeling removes dead cells only (unless it is a deep chemical peel treatment, of which more to come below).

Exfoliation and cell turnover

As we age, the turnover rate of our cells slows down. In our teens they turnover at an average rate of 28 days. At my age (55) this has slowed down to 60 days. This is the rate at which cells reproduce in the epidermal junction and where they are held together by lipids, ceramides and long chain fatty acids.* The young cells gradually migrate to the skin surface where they die. Exfoliation speeds the process of skin cell turnover. Hence, my observation that a peel is really all about cellular rejuvenation.

The DDG peel

The first thing to be said about my peel experience with Dr Dennis Gross is that I did not peel. Exfoliation should not be about taking off layers of skin and visible skin peeling should not be seen. The sloughing of dead skin cells is barely visible. On the other hand, bits of flaking skin are the unfortunate result of heavy-handed use of strong exfoliating actives such as retinol.

Dr Gross is probably best known for his signature chemical peels and proprietary mix of alpha hydroxyl acids (AHAs) and beta hydroxyl acids (BHAs). AHAs (acids such as glycolic, lactic, citric, malic, mandelic and tartaric) exfoliate the surface of the skin, accelerate cell turnover and some, such as lactic acid, act as humectants. BHAs (willow bark) go deeper and actually exfoliate dead cells hanging around in the skin’s pores.

As I reported in my video, I experienced notable, but not uncomfortable tingling, that subsided within a few minutes. My cheeks looked red for a couple of hours. There was no peeling or flaking, just refreshed-looking skin.

The deep peel

This is all very different from the deep peel. Most deep chemical peels are based on TCA (trichloroacetic acid). Downtime can last several days or a week. Even more dramatic is the phenol peel. There are tons of variations, but mostly they come down to TCA with, in the case of the Vi Peel, some retinol, an AHA or two and some phenol. Peeling will be significant, but the shiny new skin, some of it actual scar tissue, will be enough for some people to have regular treatments. Personally, I think the results look unnatural and that regulars have noticeably thin-looking skin. According to Dr Gross the downsides of a deep peel include potential increase of free radical damage and permanent epidermal atrophy.

Gentle and regular versus deep and damaging

I have to confess a personal and deep-rooted bias against inflicting damage on my skin. Traumas (deep peeling, ablative laser and so on) force the skin to produce new cells as if it had been wounded – which it has. I don’t want injure myself in the name of anti-aging. In any case, although the short-term results can be seductive, in the long term they can lead to thinner skin and, perhaps, the speeding up of the Hayflick limit. With this in mind, I was intrigued when Dr Gross said that gentle and regular treatments get better results.

Peeling at home

After my office visit, I was given a month’s supply of Dr Dennis Gross Original Alpha Beta Peel ($88 in the shop) daily peels. Six days in, I am in love with this product. It is a two-step system that deploys pre-moistened towelettes. Step one is the application of AHAs and BHAs, some green tea and chamomile. After two minutes a neutralizing and hydrating solution is applied with vitamins C and E, ubiquinone and retinol. I’ll be writing a full review at the end of 30 days, but already I can report a fresher complexion and wrinkle softening. But no tingling, redness and absolutely no peeling.

*Thank you to the office of Dr Dennis Gross for sharing an internal (and very insightful) presentation on skin physiology.

I'd love your input. Have you ever had a facial peel - what was your experience? If not, what are your perceptions of a peel? Chime in by leaving me a comment below.

  • October 9, 2015

    by Sasha

    There's more to take into account with TCA, beyond how good it makes you look: "The California E.P.A. first flagged [TCA] as a potential carcinogen in 1999, but decided the evidence wasn’t strong enough to say more. But scrutiny intensified after a 2011 review by the federal Environmental Protection Agency, which cited study after study in lab mice linking TCA to liver cancer; one research group called it a 'complete carcinogen.'" (NYT, 2013)

    More recently, The Center for Environmental Health sought legal action against Walgreens for selling skin peel products that could expose women to more than the lifetime limit for TCA. Before its use in beauty produces, TCA was mainly used as a pesticide. (http://www.ceh.org/news-events/press-releases/content/cancer-causing-chemical-found-in-skin-peels/)

    Understanding the health risks of a product's ingredients is important. Though I enjoyed your article, I think your readers should be made aware of the research around these beauty products in the future.

  • August 10, 2015

    by Dennis

    I love me some TCA. I have been doing an annual full face peel, double under the eyes for years and the results were always great! however last year I tried a 30% under eye peel and that is no joke! it took months to heal and I had to use a variety of lighteners to fix it. BE careful with those at home peels!

  • August 7, 2015

    by Denise

    I totally agree with Dawn above! She actually took the words right out of my mouth! And thanks for the sunscreen tip. I also wear sunscreen 365 days a year, my husband says I'm a vampire, but I'm mistaken for being in my 40's and I'm 58. I also do my own at-home TCA peels. I'm very smart about using TCA and started out slow and cautious. I also read tons about cutting edge skin actives and make my own skin care potions, along with trying out various new products. I also believe in what goes inside your body shows up on your skin. All in all, I love the TCA peels and feel they keep my skin youthful-looking.

  • August 7, 2015

    by Susan

    I had my first TCA peel (12.5% solution) done by my dermatologist about 6 or 7 years ago. The procedure itself is quick and stings like heck. But the stinging subsides, full peeling is over and done with after 7 days, and I gotta tell ya...my skin has never looked as pretty, supple, smooth, and clear (not shiny or tight) as it does after a TCA peel. I get one done about once a year. I use Retin A once or twice a week. Been using that since my late 20s because of acne. Believe it or not, even at my age, I still get breakouts here and there if I stop using the Retin A. And then I round out my daily facial care with whatever goodies I might try from the TIA store, including my Ultra Renew. I get a lot of compliments on my skin.

  • August 7, 2015

    by Marta

    I am very cautious about phenol and I am not sure that I would use a product that contains it. Phenol is considered to be a systemic toxin and highly corrosive. I will do some more research, but here is a useful article from Cornell University: https://sp.ehs.cornell.edu/lab-research-safety/Documents/Phenol_First_Aid_and_PPE.pdf

  • August 7, 2015

    by Pam

    I used the Dr. Gross Alpha Beta peel pads years ago, but my skin did not react well (extremely dry and irritated). Two years ago, I found a product that has completely transformed my skin - Biologique Recherche P50 1970 original (one of the ingredients is phenol). I've used 2X daily as my toner and then I use Brad products after. I'm 63 - my skin looks incredibly smooth, youthful and glowing. People constantly compliment me & ask what skincare I use. I always refer them to the Biologique and to the TIA website.

  • August 6, 2015

    by Mark

    Of the many and varied things I have tried on my face, peels have not been among them. I'm not sure how they slipped by, most likely due to the downtime involved. A gentle peel such as Dr. Gross has developed sounds interesting, but I would think one would have to temper their expectations accordingly.

  • August 6, 2015

    by Dawn

    "Gentle and regular" are not going to accomplish any kind of immediate improvement that you can see. It's a great idea, and it would be great if it were possible. The procedures that really effect change are the ones that cause CONTROLLED injury to the skin. In the last 10 years or so, I have had regular photofacials and chemical peels, and about once a year I have a 10-15 micron depth microlaser peel, which keeps me in the house for 3 or 4 days. I've also used Retin A regularly for about 15 years now. The upshot of this is that I'm regularly mistaken for my daughter's sister rather than her mother - and by people who ought to know better , too. I'm 51, she's 33. And it's not because I wear mini skirts or buckets of makeup, because I don't. The kind of skin injury that makes this happen is the kind that stimulates the skin to heal and rejuvenate itself. I don't have thin, shiny skin or scar tissue. Those are NOT signs of procedures that were done well or yielded good results. The thing I DO wear buckets of is sunscreen - 365 days a year, no matter what. Replenix Sheer Physical Sunscreen Spray, in case any one out there is looking for an AWESOME Zinc Oxide sunscreen with antioxidants that WON'T leave you white. The thing is, results from skin care - and that includes extra procedures - are cumulative, so you have to keep at it always. So far I've drawn the line at any sort of injections, but that's only because I am hesitant about staring something with frequent, expensive upkeep. I leave the door open, I might change my mind as I get older. All this is really individual - I say do what makes you keep feeling good!

  • August 6, 2015

    by tracy

    I've never done an derm office peel, but I've bought medical strength peels via Amazon (20% glycol/lactic solution). I do not recommend this, as you don't really know what you're getting.
    I turned out fine, no problems, and it definitely made a difference. I used them once a week, increasing the time I would keep it on. Sometimes I used a salicylic acid peel on top of it for a minute or two.
    My results were good, but I have very hardy, thick facial skin that can take a lot of acids without getting destroyed. I don't do them anymore because I've found my skin does best with everyday gentler doses of BHA and AHA, applied separately and with a wait time in between to let them go to work on my skin.

  • August 6, 2015

    by gloria

    HELLO,MARTHA. I MUCH PREFER THE NEO-STRATA PEEL PADS. YOU ONLY USE THEM ONCE A WEEK. IT IS ALSO A TWO PART SYSTEM. I LOVE THE WAY IT MY SKIN FEEL. AND I FEEL THERE IS NO OVER USE OF THE PRODUCT.

  • August 6, 2015

    by IMAJEAN

    I have done TCA 20% and I find them great I was a 30 yr smoker and a tanning bed gruru until my mid 40's I am 56 now my skin is much smoother and less wrinkles you'd think a person who did all that for so long I only do 1 or 2 a year than I use a retinol 1% every other day it helps greatly.
    Cant afford to go to the doctor so this is a much cheaper way for me it has helped the lines on my neck but not to a great degree sun tanning can really do a number on your neck.

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