Scars can be caused by a variety of factors like acne, surgery, accidents, and more. They come in different shapes, sizes and depths. While some scars fade over time, deeper scars often persist and can leave an individual self-conscious about their appearance.
Chemical peels have become a popular way to improve the appearance of scars. They work by exfoliating the outer damaged layers of the skin so that new skin can regenerate and take its place. But can chemical peels actually get rid of scars completely? Here is an in-depth look at how chemical peels work on scars and their effectiveness.
How do chemical peels work on scars?
Chemical peels use chemical solutions to remove the outer layers of skin that are damaged or scarred. The solutions used in chemical peels contain acids that work to slough off this outer layer of skin. Some commonly used acids include:
- Glycolic acid
- Lactic acid
- Salicylic acid
- Trichloroacetic acid (TCA)
- Phenol
The concentration and strength of acid determines the depth of the chemical peel. Light peels use dilute acids and penetrate only the outermost layer of skin. Medium peels use slightly stronger acids and penetrate the epidermis or outer layer of skin. Deeper peels use stronger concentrations of acid and penetrate the mid-to-lower layer of dermis.
Here is what happens during a chemical peel procedure:
- The skin is cleansed and prepared.
- Chemical solution is applied to the scarred area.
- The acids start dissloving the bonds between skin cells, leading to exfoliation.
- Dead skin cells peel off over the next few days.
- New smoother and even-toned skin regenerates.
The removal of the damaged upper layers allows the deeper layers of the skin to regenerate new cells. The new skin that forms has an improved texture and appearance compared to scarred skin.
Are chemical peels effective on scars?
Chemical peels are considered an effective treatment for certain types of scars. However, the results can vary based on:
Type of scars
Chemical peels work best on surface scars that affect only the epidermis and upper layers of the dermis. Acne scars and other minor skin blemishes respond well to light to medium depth peels. Deeper peels may be used for pitted scars.
Scars that extend into the deeper dermis like hypertrophic, keloid or icepick scars are more difficult to treat with chemical peels alone. Though chemical peels can help improve their appearance, other treatments are also generally needed for deeper scars.
Skin type
Those with fair skin have the best results from chemical peels. Medium to dark skin tones may develop complications like pigment changes from higher strength chemical peels.
Realistic expectations
Chemical peels can improve the appearance of scars by smoothing and evening out skin texture. However, scars cannot be completely removed with just chemical peels in most cases. Multiple treatments are needed for best results.
On average, patients see about a 25% improvement in scar appearance with a single peel. With a series of peels, up to 80% improvement is possible depending on the scar.
What kinds of scars respond best to chemical peels?
Here are the types of scars that show the most improvement with chemical peel treatments:
Acne scars
Chemical peels are considered first-line treatment for acne scarring. They are effective at reducing the appearance of mild-to-moderate atrophic scars from acne. This includes rolling, boxcar and icepick scars. Deeper pitted scars also see improvement but may require deeper peels or additional treatments.
Fine lines and wrinkles
Chemical peels can reduce the appearance of fine lines, wrinkles and crepey skin. These superficial skin flaws respond well to light and medium depth peels.
Surgical scars
Surface scars from surgeries and wounds can be minimized with chemical peels. Deeper surgical scars like keloids may see some improvement but also need other scar revision methods.
Sun spots and melasma
Chemical peels are a popular treatment choice for pigmentation issues like sun spots, melasma and chloasma. The peels remove the pigmented upper layers and promote new skin formation.
Chicken pox scars
Mild atrophic scars left by chickenpox respond well to a series of light chemical peels. The chemical solutions help smooth out the uneven skin texture.
What types of scars do not respond well to chemical peels?
While chemical peels are suitable for a wide range of scars, some types of scars do not improve much with this treatment. These include:
Deep pitted scars
Scars with deep pits that extend into the mid and lower dermis get minimal improvement from light and medium depth chemical peels. Only deeper TCA or phenol peels may help but carry more risks.
Thick hypertrophic and keloid scars
Hypertrophic scars and keloids that are raised above the skin surface are challenging to treat with chemical peels alone. The thick fibrous tissue requires procedures like steroid injections or laser scar revision.
Broad depressed scars
Scars with a wide depressed appearance that span a large surface area show limited response to chemical peels. Other treatments like dermal fillers, microneedling or surgery may work better.
Very dark or thick surgical scars
Surgical scars that are extremely dark and thick in texture also do not respond well to chemical peels. These scars need other modalities like laser resurfacing and dermabrasion.
Results to expect from chemical peels for scars
While chemical peels cannot eliminate old, deep scars, they can significantly improve their appearance. Here are some of the results you can expect:
- Smoothing of skin texture – chemical peels improve uneven scarred texture
- Lightening of scar color – the acid treatment fades away dark scar pigmentation
- Even tone and complexion
- Reduced appearance of fine lines, wrinkles and creases
- Minimizing of acne pitted scars
- Softening of hypertrophic and keloid scars
With a series of peels done at 4-6 week intervals, up to 80% improvement in scar appearance is possible. Mild scars may become almost invisible while deeper scars diminish in size and depth.
However, severely deep old scars cannot be fully removed with chemical peels alone in most cases. Other procedures are needed along with peels for substantial improvement.
How many chemical peel treatments are needed for scars?
Multiple chemical peel treatments are usually needed to see significant improvement in scar appearance. The number of peels needed depends on:
- Depth of scars – Deeper scars require more treatments
- Type of chemical peel – Light peels may need 5-6 sessions. Medium peels need 3-4 sessions. Deep peels may show results from 1-2 treatments.
- Desired outcome – Minimal improvement needs fewer treatments than complete scar fading.
- Scar characteristics – Thicker, wider and pitted scars need more treatments.
- Individual’s skin – Those with fair skin and no complications see faster results.
On average, 4-6 sessions of chemical peels spaced 3-4 weeks apart yield good results for most scars. Maintenance peels may be needed once or twice a year after.
Acne scars – 4 to 6 light or medium depth peels
Minor surgical scars – 3 to 5 light or medium depth peels
Deep wrinkles – 3 to 6 medium depth peels
Keloids and hypertrophic scars – 5 to 8 deep peels along with steroid injections
Severely pitted scars – 4 to 8 combined deep peels and laser resurfacing
Chemical peel aftercare for treating scars
Proper aftercare after each chemical peel treatment is vital for getting good scar revision results. Here are some important aftercare tips:
- Avoid sun exposure – Stay out of the sun and use SPF 30 or higher sunscreen for at least 2 weeks post-peel.
- Use moisturizer – Apply fragrance-free moisturizer multiple times a day to facilitate healing.
- Cleanse gently – Use mild cleansers and avoid scrubbing for a few days.
- Stay cool – Avoid strenuous exercise, hot showers, swimming pools and overheating for a few days.
- Avoid irritants – Steer clear of retinoids, bleaching creams and harsh products until the skin heals.
The skin may be sensitive, red and flaky for around 5-7 days post-procedure. Avoid picking or scrubbing the peeling skin. Allow it to shed naturally for smoother results.
Risks and side effects of chemical peels
Chemical peels are generally safe when performed correctly by a trained dermatologist. However, deeper peels do pose some risks and side effects including:
- Redness, stinging and discomfort during the procedure.
- Prolonged redness for a few days or weeks after.
- Swelling around the eyes.
- Dryness, peeling, flaking and crusting of skin.
- Blistering in rare cases.
- Changes in pigmentation especially in darker skin tones.
- Scarring and infection when not performed properly.
- Allergic reaction or contact dermatitis.
Choosing an experienced provider, following aftercare instructions carefully and using sun protection can help minimize risks of complications.
Cost of chemical peels for scars
On average, chemical peel costs range from:
| Chemical peel type | Average cost per session |
|---|---|
| Light peel | $150 – $400 |
| Medium peel | $400 – $650 |
| Deep peel | $600 – $900 |
Since multiple sessions are required for scar treatment, the total costs for a full treatment series could range from $600 to $5000 based on the type of scar and depth of peels needed.
Some factors that affect overall chemical peel costs for scars include:
- Number of sessions needed
- Type and depth of peel used
- Doctor’s fees and location
- Extent of scarring
- Whether combined with other treatments
Conclusion
Chemical peels can lead to significant improvement in the appearance of certain types of scars. They work by controlled chemical exfoliation of damaged skin layers. Light and medium peels are effective options for treating acne scars, fine lines, uneven pigmentation and superficial surgical scars. Deeper scars may require stronger TCA or phenol peels sometimes combined with other procedures.
While chemical peels do not completely remove deeper dermal scars, they can visibly minimize their appearance. Realistic expectations, multiple treatments, proper aftercare and sun protection are key to getting optimal results from chemical peels for scarring.