In the land of exfoliation there are so many options to choose from. In this soapbox episode, I will break down one branch of your choices.
The two main branches of exfoliation are mechanical and chemical.
Mechanical exfoliation includes things like scrubs, microdermabrasion, and dermaplaning. These are procedures and products that physically rough up the skin to get cells to dislodge.
A chemical type of exfoliation is one that uses a chemical process to breakdown either the skin cells themselves, or the glue that holds skin cells together.
There are so very many different kinds of chemical peels. SO. MANY. I say this because I want you to understand that chemical peels/treatments are a very large topic that is so often misunderstood, even by a vast amount of professionals.
The theory behind a peel is that the peel makes a superficial wound to the skin, inciting the wound healing process which in turn will cause the skin to correct the condition you're working on.
So the number one important thing is that you know EXACTLY what condition(s) you're wanting to see change in your skin, because different peels do different things and you'll need different levels of damage to correct different conditions. (Keep this in mind, we're going to come back to it in a little bit.)
Now, enzymes vs chemical peels.
First off I'd like to point this out. Enzymes ARE chemical processes, just like chemical peels. They create a chemical reaction in the skin. Why are they not listed under chemical peels? Because we like to think they're a more "natural" treatment. Are they a more natural treatment? Sometimes. But most the time that's just green-washing.
Why is this often said? (Beyond the product line's desire to get someone to buy it over another line.) The idea is that enzymes cause less damage to the skin because it is a naturally occurring process. And it absolutely is. You have enzymes in your body right this second causing chemical reactions. They break down your food, your skin, your hair, literally anything with protein. That is what enzymes do, and you need them to exist.
But here's the caveat. The enzyme products used in professional treatments/peels must be manipulated in order to cause enough damage to trigger a wound healing reaction.
Think real quick about it. Some of the strongest fruit enzymes are pineapple and papaya. Crush up a papaya and make a facial mask. Wear that all day, e'ry day, and it will not cause a wound healing process. Its just not strong enough. Doesn't mean it's not beneficial to your skin, it just means we're not getting the reaction we need to manipulate the change we're looking to see in the skin.
So in order to get a "professional strength" enzyme, it must be extracted and made stronger in some way.
Does that mean enzymes in their natural state are useless? Noooooo. Not at all. I personally love me some enzymes because they are useful on every single skin type. There's a fruit enzyme for you my friend, we just have to find out which one.
Enzymes work by breaking down keratin, which is a protein that bonds your skin cells together. This is a very gentle process that naturally occurs in your skin, however when you apply an enzyme this process is sped up. This is why enzymes can be used on even exceptionally inflamed skin, like skin experiencing cystic acne or rosacea flare ups. The process reduces inflammation instead of causing it, like many other acids do.
Enzymes are the best choice to treat acne, rosacea, rough skin, and fine lines. Some fruit enzymes, like blueberry also have melanin inhibiting properties that help reduce hyperpigmentation.
Many of the professional enzyme treatments you'll receive are combined with light acid peels, which we'll discuss next.
Chemical (Acid) Peels
Just for the sake of simplification, I'm going to call these acid peels, because as I said above enzymes are chemicals too. And I know we don't like to call them acid peels because acids is a scary word, but we're gonna put on our big girl panties today and understand that they are all indeed acids.
When we think of acid on faces, we see melting horrors of skin just sliding in rivulets down someone's face. And that can absolutely happen if you buy that 80% glycolic acid treatment off of Amazon for $16 and PUT IT DIRECTLY ON YOUR FACE, SARAH! Don't do that.
But in a professional setting, where a properly trained skin expert is attempting to correct conditions present in your skin, we actually need some skin to work with, so we try real hard to keep it adhered to your body.
When choosing what acid peel would be best for you, there are a few things your professional needs to take into account.
Strength: This is the percentage of acid in the formula. A professional level peel is usually somewhere between 10-60%. But that is still a number that doesn't mean a lot unless you know the acid you're working with. A 10% lactic can be found in over the counter moisturizers, but a 10% TCA is a professional level peel, because TCA is a much stronger acid than lactic. So in order to compare apples to apples, you need to be talking about the exact same acid.
PH level: The pH level of a peel is a good determiner of the amount of damage the peel will inflict on the skin cells. Skin naturally sits at a 5.5 pH. Yup, your skin is naturally acidic, and it needs to be acidic to be effective in its job. (You alkaline lovers out there using baking soda on your skin, you're ruining your skin and your immune system. Stop it.) Now peels are usually anywhere from a pH of 1-4. The lower the pH, the more acidic the peel, therefore the more acidic burning you'll get. Lower pH's tend to have more "tingle" (some downright burning) to them. The pH of a peel doesn't have a huge amount of weight on the end result of the treatment. You can get very good results from peels that don't have a very low pH. A super low pH is actually a bad idea for people treating acne, rosacea, melasma or even sun damaged hyperpigmentation since it can cause strong inflammatory reactions. So the pH is a very important number to know, but not for determination of results, more for determination of whether its an appropriate choice for your skin.
Effects of the acid: Each acid has different benefits. There isn't a one size fits all when looking at peels. Back in the day, like the late 90s and early 00s, glycolic was pretty much used as the standard go-to cure all for peels. It's readily available (since its derived from the sugar beet plant), its cheap, it works on everything! (But not really). Before that, in the 80s and into the 90s phenol was the peel typically administered in a doctors office. Today, phenol isn't used that much. It's extremely strong and can easily create scarring. We've also found that consistent phenol peeling can thicken the epidermis and create that leather-y feeling we're all not going for.
Here's a list of some of the commonly used acids, where they're from, and what their pros and cons are.
Glycolic acid: Comes from the sugar beet plant. It is easy to get ahold of, pretty cheap in relation to other choices, and causes actually peeling even at some low percentages because of its small molecule size. Glycolic acid has actually fallen from grace because of its small molecule. See a lot of clients (maybe even you) really feel like if their skin isn't actually peeling, the peel isn't working. Nothing could be farther from the truth. Peeling skin doesn't denote successful correction of the condition, and could even be exacerbating the condition. The small molecule size makes glycolic difficult to control. Sometimes you'll get great, even penetration with some people. Sometimes the penetration will be too deep in some areas. The small molecule size also causes more inflammation, which is something we want to limit as much as possible. Glycolic also doesn't contain any melanin inhibitors, so if you're trying to change hyperpigmentation, it doesn't have any real benefits for that condition beyond the exfoliation itself.
Lactic Acid: Lactic acid is a larger molecule, and therefore less irritating to the skin. It's main extra benefit is it is a skin brightener, which means it's a great ingredient when treating hyperpigmentation. It's not typically used in high percentages and it doesn't have s really low pH. It can be derived from many sources, including cow's and goat's milk, blueberries, or even corn starch. Most of the time however, it is a synthetic version that is used in a peel. Lactic acid is best for clients suffering from melasma and post-inflammatory hyperpigmentation from old acne scars.
TCA: Trichloroacetic acid is a long name, so we just call it TCA. TCA is a stronger acid and can be used anywhere from 10-60%, though anything above 30% tends to be a physician only level, and anything above a 35% can result in scarring if applied improperly or for the wrong client. TCA is one of the acids that tends to initiate actual peeling of the skin at almost any strength on almost any skin. But remember, peeling does not equal desired results automatically. TCA is a naturally occuring crystal and is formulated for peels by adding water. TCA is great for resurfacing the skin, so reducing scarring, fine lines, and does have good effects on sun damage spots.
Mandelic Acid: Mandelic acid comes from bitter almonds and acts very similarly to glycolic acid, except with a larger molecule. This means that it does all the benefits of glycolic, without causing as much inflammation. It can be used on a wider array of clients because of this.
Salicylic Acid: Salicylic is a unique acid that comes from willow trees. It is typically used in peels for acne or rosacea sufferers because it inhibits comedones (breakouts) from being formed. It actually has anti-inflammatory properties too, which makes it great for those skin conditions as well as clients that have higher fitzpatricks. It affects the fibroblasts that help keep the structure of your skin without actually wounding them. This makes it great for scarring.
Vitamin C: Vitamin C has healing properties for sun damage, and in a concentrated form like a peel will exfoliate. It also accelerates the production of collagen and elastin. Vitamin C tends to be mixed with another acid since its not exceptionally strong on its own, but it does have a lot of benefits for sun damaged skin.
Vitamin A/Retinoic: Retinol can be used in a peel strength for a variety of conditions. It increases cell turnover and does have a slight plumping effect on the skin. Its downsides are that it can be really irritating for some skin and cause inflammatory responses. It's best uses to resurface the skin, for fine lines and scarring.
These are peels used pretty comonly, but there are lots of different peel types out there. In addition, there are "designer peels" which means formulations created with several different peel types in them.
I like to use designer peels in my treatment room. For example, salicylic acid + lactic acid is great for treating acne with post-inflammatory hyperpigmentation. I use a TCA + lactic for my heavily sun damaged clients.
I hope that this article gives you a basic bit of information to go out and seek professional guidance. This article is not intended for you to go onto Amazon and purchase a 50% glycolic to slap onto your face. Not all acids will treat every condition and not all skin is suitable for any acid.
If you'd like a simple PDF to guide you further on what chemical peels would work best for you, sign up here to have mine emailed to you.