Preoperative Chemical Peel Instructions


Chemical peeling involves the application of an agent to the skin which causes it to separate and peel off after a few days. It will help REDUCE the signs of sun damage (fine lines, freckles, and uneven skin tone) or acne marks. Chemical peels typically do not go deep enough to work on most wrinkles – those are better addressed with microneedling, lasers or possibly filler or neurotoxin injections. No procedure guarantees removal of ALL blemishes or damage acquired by years of sun exposure.

The exact chemical and strength used will be determined by Dr. Salyards, and will be based on the extent of sun damage present, your skin type, and your goals of the procedure.

Chemical peels are not covered by most medical insurance plans because they are performed for cosmetic reasons. Nevertheless, chemical peels do offer medical benefit, as a single peel has been shown to reduce the formation of skin cancer by almost 40% for the 5 years following the treatment.

Before the Peel

  • Sunscreen: plan on using sunscreen daily, at least SPF 30. You MUST NOT GET SUN EXPOSURE following your peel or you may develop hyperpigmentation.
  • Antiviral medication: if you have a history of cold sores or fever blisters, you will start an antiviral medication the evening prior to the procedure, and continue it for one week.
  • Tretinoin: Most patients will benefit from using tretinoin (the active agent in Retin-A) for a few weeks before the peel, as it will speed up healing. This will be continued after the area has healed to promote
    new collagen formation. Not everyone needs this, and patients with very sensitive skin often skip this. It will be discontinued 5 days prior to your peel.
  • Bleaching agent: (hydroquinone) will be used in some patients to maintain an even skin tone following the peel. Patients who are naturally very fair skinned often will be able to skip this.

Day of the Peel

  • Please arrive with a clean face (wearing no makeup, sunscreen, or moisturizer) or arrive 10-15 minutes early to thoroughly remove these in the restroom. We will provide face cleanser.
  • Application of the peeling agent causes a fairly intense stinging which does not last long. As soon as the treated area “frosts” (it looks like a light white or pink glaze over the skin), cold compresses are applied to
    the area and left in place for several minutes. The stinging decreases in intensity; most patients describe it as a sunburn like sensation. Tylenol or Advil can be taken if necessary.

After the Peel

  • The pink frost will fade to a mild to moderate redness very similar to a sunburn. This “sunburn” period will last for about one day, and you are usually reasonably presentable.
  • The next stage is the damaged skin drying and separating. Your skin will take on a brown or bronze look and feel fairly dry and tight. As the old, sun damaged skin peels off, the fresh new pink skin will be revealed underneath. This is the period (usually a day or two) when your skin looks blotchy and uneven.
  • After the main peeling takes place, your skin will be fresh and somewhat pink, and you may resume makeup and cosmetics. Final fading or the pinkness will take a few weeks.