What’s the Best Chemical Peel For Acne Scars?

Acne scars can significantly impact not only your skin texture, but also your self esteem. Thankfully, several cosmetic treatments can improve their appearance. Among the most powerful of them are chemical peels, a broad class of procedures that can be customized according to your type of scarring, willingness to undergo downtime and desired results. 

The best type of peel for your unique situation depends on these and several other factors. Want to learn more? Let’s dive in. 

Understanding Chemical Peels

Chemical peels involve applying a chemical solution to the skin to remove the top layer of skin, promoting the growth of new, smoother skin. They treat various skin conditions, including hyperpigmentation, dark spots, and the different types of acne scars.

Light peels contain acids like glycolic acid, mandelic acid, lactic acid and salicylic acid at low concentrations. These superficial peels primarily target the very top layer of skin. They are ideal for mild acne scars and pigmentation issues.

Medium peels typically contain trichloroacetic acid (TCA), glycolic acid at higher concentrations or Jessner’s solution, a combination of lactic acid, salicylic acid and resorcinol . They are more effective for significant discoloration and more pronounced scars.

Deep peels contain phenol and can penetrate the lower dermal layers. Deep peels are mostly a treatment of the past, as they carry an elevated risk of infection and serious complications.

What Types of Acne Scars Can Chemical Peels Treat?

Not all acne scars are created equal–but chemical peels can address most of them. Here’s a rundown of the most common types of acne scars.

Atrophic scars

Atrophic scars refer to any kind of scar that is lower than the surrounding skin. They form when there is a loss of tissue during the healing process, leading to depressions or indentations in the skin.

Rolling scars are characterized by their smooth edges and wavelike appearance, giving the skin a rolling and uneven texture.

Boxcar scars are depressions in the skin with sharp, well-defined edges, resembling the shape of a box.

Ice pick scars are deep, narrow, and pitted scars that extend into the dermis, giving the appearance of having been punctured by a sharp object.

Hypertrophic scars

Hypertrophic scars are scars that are raised above the skin’s surface. They develop due to an excess of collagen during the healing process, resulting in raised, thickened tissue.

Standard hypertrophic scars are raised and firm, but do not grow beyond the boundary of the original injury site. They may diminish in size over time but usually remain visible. 

Keloid scars are an aggressive form of hypertrophic scarring, extending beyond the original wound site. They are thick, raised, and often have a reddish-purple color, and can continue to grow over time.

While atrophic scars can benefit from chemical peels and collagen-stimulating treatments, hypertrophic scars may require different therapies such as steroid injections or laser treatments. Care must be taken to ensure that treatment of a keloid scar doesn’t result in it growing larger.

Post-inflammatory hyperpigmentation

Although not technically a type of acne scar, post-inflammatory hyperpigmentation (PIH) is a common concern among people who have recently healed their acne. 

When acne causes skin inflammation, melanocytes, the cells responsible for pigment, become overactive as part of the healing process. This overactivity leads to an excess production of melanin, the pigment that gives skin its color, resulting in darker patches or spots on the skin where the acne lesions had been. The severity of PIH often correlates with the intensity of the acne inflammation and can be more pronounced in people with darker skin tones.

Although most PIH fades within 6 months to a year, it can be treated with a chemical peel or peels to speed up the healing process.

Best Chemical Peels for Acne Scars

Now that we’ve covered the different types of chemical peels and acne scars, we can discuss how they can match up together for best results. 

Jessner peel

A Jessner peel contains a combination of salicylic acid, lactic acid, and resorcinol, which together help to remove dead skin cells and unclog pores. Available as a light or medium strength, Jessner peels are effective at treating mild to moderate atrophic acne scars, such as rolling scars or less pronounced boxcar scars, by evening out the skin texture. They’re also well-suited for addressing PIH.

The number of Jessner peels needed for optimal results depends on your skin type and the severity of the scarring or PIH. Most people undergo 3–6 peels scheduled as often as 4 weeks apart, if your skin’s condition allows it, until the desired results are achieved.

TCA peel

TCA peels are typically medium-strength peels that work by causing the top layers of skin to dry up and peel off over a period of several days to one week, revealing newer, less scarred skin beneath. The process stimulates the skin’s natural healing processes and collagen production to repair scarred tissue. 

TCA peels are particularly effective in treating more pronounced atrophic acne scars, including deeper boxcar and rolling scars, by smoothing out the skin’s surface and reducing the depth of scars. 

The number of TCA peels needed varies depending on the severity of the scarring and the skin’s response to treatment. Generally, 3–5 sessions spaced several weeks to months apart, depending on the acid’s concentration, are necessary to achieve significant improvement in the appearance and texture of acne scars.

TCA CROSS

Deep ice pick or boxcar scars are most effectively treated with targeted therapy rather than a full-face peel. The procedure is called TCA CROSS (chemical reconstruction of skin scars) and involves applying a high concentration of TCA directly into the scar itself. Over several weeks or months, new collagen will form in the treated area and the scar tissue will start to resemble and blend into the surrounding skin. 

Most people undergo 4–6 treatments spaced every 4–6 to see results; individuals with very deep scars may need more sessions.

How to Choose the Right Chemical Peel

A consultation with a skin health expert like a board-certified dermatologist or licensed aesthetician is the best way to determine the right course of treatment for you. They’ll look at factors such as:

Severity and type of scarring

Hyperpigmentation may benefit more from a light or medium peel, while ice pick or boxcar scars may require TCA CROSS.

Skin sensitivity

For those with sensitive skin or conditions like eczema, light peels with lactic acid or low concentrations of glycolic acid may be preferable. These peels offer gentle exfoliation with minimal irritation.

Skin type

Your skin type plays a crucial role in determining the type of peel and the frequency. For instance, lighter skin tones may tolerate stronger peels better than darker skin tones, which are more prone to post-inflammatory hyperpigmentation. 

Choose a provider who is experienced with working with your skin type and can recommend the appropriate type of peel and concentration to minimize this risk. They may start with a lighter peel and gradually increase intensity based on the skin’s response.

Chemical Peels for Acne

While the primary focus of this post is chemical peels for acne scars, it’s important to address their role in treating active acne. If you’re currently battling breakouts in the form of pimples, whiteheads, blackheads, nodules or cysts, making regular chemical peels part of your anti-acne regimen may be a game-changer for your skin.

How do chemical peels treat acne?

Chemical peels exfoliate the skin, meaning they help in removing dead skin cells that can clog your pores and lead to the development of acne. Particularly effective for acne-prone skin are peels containing salicylic acid, a beta-hydroxy acid that regulates oil production and is safe for all skin types.

Chemical peels can be part of a broader acne treatment plan, which might include facials, blue light therapy, topical retinoids or other acne medications.

What to Expect at Your Chemical Peel

At your first appointment for a chemical peel, you’ll undergo a consultation with your provider. They’ll assess your skin type, acne scars and skin conditions to recommend the best chemical peel. Once they’ve decided on the best course of treatment, you’ll usually be able to get your first peel at the same appointment.

For the procedure, your provider will cleanser your skin and apply the peel solution using a brush or cotton pads. Some peels, like the Jessner peel, involve applying multiple layers to the skin. The peel will stay on your skin for either a specific duration or according to your comfort. Then, depending on the type of peel, it will be neutralized, washed off or allowed to stay on the skin overnight.

Recovery & aftercare

The healing process varies depending on the depth of the peel. Light peels may only cause mild redness and flaking lasting a few days. Medium peels can result in more pronounced peeling and require a longer recovery period of 1–3 weeks.

Follow these tips for a smooth recovery:

  • Avoid picking at peeling skin, which can cause scarring
  • Stay hydrated by frequently applying a gentle moisturizer to your skin and drinking plenty of water
  • Avoid sun exposure to prevent damage and hyperpigmentation to new skin cells
  • Protect your skin from sun damage with a high SPF broad-spectrum sunscreen
  • Don’t use any harsh skin care products like exfoliants, scrubs or retinol 
  • Follow all other aftercare instructions given by your provider

Alternatives to Chemical Peels for Acne Scars

Chemical peels aren’t the only effective treatment for acne scars. If you have large areas of scarring in the form of rolling scars or boxcar scars, one of these procedure may help you achieve smooth skin without significant downtime.

Microneedling for acne scars

Microneedling, also known as collagen induction therapy, involves using a device equipped with fine needles to create tiny punctures in the top layer of the skin. This process activates the skin’s natural healing response, stimulating collagen and elastin production. The increase in collagen can help fill in and smooth out the texture of acne scars, particularly atrophic and rolling scars which are characterized by lost tissue. 

Compared to chemical peels, microneedling targets the deeper layers of the skin and can be more effective for deeper, more pitted scars. While chemical peels work by removing the outer layer of skin to reveal new, unscarred skin underneath, microneedling works by actively promoting new tissue growth within the scar.

Laser resurfacing for acne scars

Today’s non-ablative laser resurfacing utilizes concentrated light beams to heat deep layers of the skin, encouraging the growth of new, healthy skin cells while damaging as little of the skin’s surface as possible. Lasers are effective for various types of acne scars, including rolling, boxcar, and ice pick scars. The intense light targets and breaks down scar tissue, promoting the regeneration of healthy skin. 

In contrast to chemical peels, which exfoliate the top layer of skin, laser resurfacing provides a more targeted approach with the ability to reach deeper layers of the skin. Laser resurfacing typically involves 10–21 days of downtime, with best results achieved after 3–4 treatments for most acne scars and a single treatment for PIH.

Dermal fillers for acne scars

Dermal fillers are injectable treatments used to fill in and smooth out atrophic acne scars, where they add volume and lift the indented scars to the level of the surrounding skin. Fillers can provide immediate but temporary improvement in the appearance of acne scars. 

While chemical peels remove the damaged skin and stimulate new cell growth, fillers work by physically filling in the scarred area. This makes fillers a good option for deep and narrow scars that peels may not adequately address. However, the results of fillers are temporary, lasting 3–6 months on average.

Takeaway

Chemical peels for acne scars offer a promising solution for those looking to improve their skin’s appearance. The best peel for you depends on the type and extent of your scarring along with your skin type and sensitivity level.

By working closely with a dermatologist or other skin care professional, you can safely and effectively treat acne scars and enjoy a smoother, clearer complexion. Remember, each journey to skin rejuvenation is unique, and chemical peels can be a pivotal step in achieving your desired skin health and aesthetic goals.

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