Tuesday, May 17, 2022

Benefits, Efficacy, Side Effects & Cost

  • A glycolic acid peel is a chemical exfoliant that can effectively resurface the skin 
  • These peels can address a number of skin concerns including hyperpigmentation, fine lines and wrinkles, melasma and all types of acne, especially comedonal
  • Glycolic acid peels are safe for all skin types but are best suited for oily skin 
  • Side effects are expected and well tolerated, but increase with depth of peel 

A glycolic acid peel is a resurfacing treatment that seeks to address a number of skin concerns. It can treat acne and melasma, reduce the appearance of fine lines and wrinkles, and lighten hyperpigmentation. 

Glycolic acid is a member of the alpha-hydroxy acid (AHA) family, and is valued for its small molecular size which enables it to penetrate deeply into skin.  

Professional treatments are most commonly administered as very superficial, superficial and medium-depth peels depending on the severity of the skin concern and skin type. These two depths are the most commonly used with glycolic acid, and therefore avoid the significant downtime and potential risk of scarring and dyspigmentation of deep peels.

At-home superficial peels are also available with minimal side effects, but results will be minor.

What Is a Glycolic Acid Peel?

Glycolic acid peels are the most common among AHA peels and are well tolerated by all skin types with few associated side effects. It is used in concentrations of 20%–70% depending on the skin complaint and severity.

These peels have anti-inflammatory, keratolytic and antioxidant qualities to treat a number of concerns including acne, photodamage, hyperpigmentation and scars. They can be used solely or combined with other treatments such as laser or dermabrasion to achieve greater results.

Depth of the glycolic acid peel will depend on the concentration used, the number of coats applied and length of time it remains on the skin. In general, a superficial peel penetrates the top 1–3 layers of skin, a medium/deep peel 4–6 layers. 

Benefits of Glycolic Acid Peels

Glycolic acid’s small molecular size enables deep penetration to clear pores of excess oil, debris and acne-causing bacteria to help heal inflammatory acne and prevent future breakouts.

As a keratolytic, glycolic acid can soften and break down the outer layer of skin to deeply exfoliate and dissolve scaly, flaky skin. This action also improves the efficacy of topical agents as they can then absorb more easily into the skin.

Glycolic acid has also been shown to have a synergistic effect when combined with vitamin E and melatonin; data show that glycolic acid can strongly influence the antioxidant action of both compounds which enhances their photoprotective potential.

Anti-aging

A glycolic acid peel provides multiple benefits as an anti-aging tool, and has been demonstrated to have minimal risk for all skin types.

Peels provide a form of controlled damage in order to prompt skin regeneration and remodeling. As part of the healing process, elastin and collagen production accelerates to firm, plump and strengthen skin which results in a rejuvenated appearance.

Glycolic acid peels have the advantage of penetrating deeper within skin for superior results: reducing sun damage, evening skin tone, improving texture, and softening fine lines and wrinkles.  

Acne

All types of acne can be effectively treated with a glycolic acid peel; it is especially effective in clearing blackheads and whiteheads, or comedonal acne, due to its strength in clearing pores of debris and material.

Several studies have demonstrated that this acid suppresses the expression of key genes to inhibit an inflammatory response.

In one study, researchers found two glycolic acid peels were significantly effective in reducing mild-to-moderately severe acne.  

Another study demonstrated that a 70% peel was effective in treating patients with comedogenic acne, papulopustular (average of 6 applications) and nodulocystic acne (8–10 applications). The most rapid improvement was seen in comedogenic acne along with a significant improvement of superficial scarring.

In addition to providing exfoliating benefits that can help prevent and treat acne, a glycolic acid peel can penetrate pores to dissolve and eliminate acne-causing oil buildup. This, in turn, helps reduce the size of enlarged pores.

Hyperpigmentation

Hyperpigmentation refers to dark spots or patches of skin that can develop due to a number of causes, and include melasma, postinflammatory hyperpigmentation and sunspots.

Melasma

Melasma, is a genetic, chronic skin disorder, characterized by gray or brown patches on the skin and is notoriously difficult to treat. Glycolic acid is considered first-line treatment, and is typically performed in concentrations of 30%–70% over several applications.

With glycolic acid peels, discolored patches of skin can be noticeably reduced—especially with high concentrations—by removing these damaged cells and accelerating skin cell turnover, replacing them with healthy, normal cells. This action also primes the skin to better receive topical applications such as azelaic acid to further reduce discoloration.

Lastly, glycolic acid can interfere with melanin production, the pigment responsible for giving skin its color. It does so by inhibiting tyrosinase activity.

Postinflammatory hyperpigmentation

Skin can be marred by dark marks as a result of the skin’s healing process. A skin injury or inflammation can trigger an overproduction of melanin and cause hyperpigmented spots where the original injury occurred.

Of all skin types, skin of color is most at risk, as this type has greater levels of melanin. It is also  difficult to treat, as additional inflammation can result. However, very superficial to superficial peels are well tolerated and have been proven to be a gentle, yet effective solution when performed with care.

In one small study comparing the effectiveness of combination therapy using hydroquinone, glycolic acid gel and tretinoin versus combination therapy plus 6 glycolic acid peels, the latter group showed a faster and greater improvement in postinflammatory hyperpigmentation.   

Sunspots

Sunspots or solar lentigines are a very common outcome of chronic sun exposure and result due to an overproduction of melanin. This overproduction occurs in response to the skin attempting to protect itself from the sun’s harmful rays. 

In the same way glycolic acid lightens melasma and postinflammatory hyperpigmentation, the same is true for sunspots.

Ideal Candidates for Glycolic Acid Peels

Ideal candidates are people who want to heal acne, lighten dark pigmentation and fight the signs of aging. Skin that tends to be oilier will experience less irritation, as these peels are drying. 

For people with rosacea, skin sensitivity and dark skin tones, these peels can be applied but they must be performed by a professional who is experienced in treating these individuals.  

What to Expect During the Treatment

To begin, your provider will cleanse your skin and protect your hair and eyes. Pain medication is not required for a superficial peel; you will be provided with a sedative and painkiller for a medium peel. 

During the procedure, the acid will be applied to your skin with a brush, cotton ball or sponge. Some tingling is expected during a light peel with increased intensity plus burning for a medium peel. 

Glycolic acid peels are classified as very superficial at 30%–50% concentrations applied for 1–2 minutes; superficial at 50%–70% for 2–5 minutes; and medium-depth of 70% for 3–15 minutes. At this point the skin will be treated with a neutralizing agent to halt the peeling process.

Aftercare

Research has shown these peels are a well tolerated and safe treatment with expected side effects of redness, peeling and the sensation of pulling of facial skin.

The recovery time will differ depending on the depth of the peel and individual response; typically this will range from 3–14 days. 

After a peel, your skin will be very dry, red and irritated, and will gradually peel away. Avoid rubbing or picking at the skin as this could cause scarring. During the following week, it is important to drink plenty of water to help treat the drying effect of the peel, and to apply a thin layer of petroleum jelly to help skin recover.

To relieve discomfort, you can use a cold compress and take any prescribed painkillers and sleep aids. Over-the-counter medication such as ibuprofen can reduce discomfort, and Benadryl can relieve itching. 

Glycolic acid peels can cause skin to be very sensitive to the sun; as such it is important to wear a high SPF sunscreen for at least 6 weeks post peel. Wash your face with a gentle soap-free cleanser to avoid stripping skin of much-needed moisture and avoid retinol and salicylic acid until your skin fully recovers. 

Lastly, apply a rich moisturizer to counteract the dryness caused by the peel and to maintain healthy, comfortable skin; reapply throughout the day as needed.

How often should a glycolic acid peel be performed? 

You can safely have a glycolic acid peel every 4 weeks. Several treatments can be repeated over the course of 4–6 months to achieve your goal; each peel provides a cumulative effect.

At-home peels are not on par in strength with professional peels and so can be performed once a week.

Cost

The cost of a glycolic acid peel will depend on several factors including the depth and number of peels, location and fees of your provider. Because it’s considered a cosmetic procedure, it won’t be covered by insurance.

The average cost of a glycolic acid peel is $200 to $600. Often, the price can be reduced if you commit to multiple treatments.

At-home peels start as low as $17 and can go up to $200 or more. These products aren’t as effective as an in-office procedure, and may be riskier since a professional isn’t administering the treatment. 

Alternatives

There are a number of effective alternatives to glycolic acid peels, and each can treat the same skin issues by using different methods:

Takeaway

Glycolic acid peels are one of the most popular peels as they are effective, gentle and carry a low risk of adverse events. They can be used as a stand-alone therapy or as one part of combination therapy to achieve greater results.

Glycolic acid peels are administered in different strengths and allowed to rest on the skin for specific lengths of time to penetrate a specific number of layers of skin. The number of treatments received will depend on the skin concern and the severity.

These peels can effectively treat acne (especially comedonal), fine lines and wrinkles, melasma and hyperpigmentation. It is appropriate for all skin types but must be used with care on dry, sensitive and darker skin tones to avoid irritating or inflaming skin.

Sources

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