Chemical Peels for Acne Scars: Your Complete Guide

Even after you’ve recovered from active acne, your skin may still show the signs of it in the form of scars and discoloration. For many people, chemical peels can be an effective solution for these concerns. Not only can peels help with acne scarring, but they also address issues like hyperpigmentation and fine lines to revitalize your skin’s overall appearance.

Read on to discover the different types of chemical peels for acne scars and find out whether they might be right for you.

Types of Acne Scars

First, let’s go over the various forms that acne scars take and the viability of treating them with chemical peels.

Atrophic scars

Atrophic scars are depressions in the skin, often resulting from insufficient collagen production during the healing process of acne. They are categorized into three types: ice pick, rolling, and boxcar scars.

  • Ice pick scars: These deep, narrow, pitted scars penetrate deep into the skin. Due to their depth, ice pick scars are best treated with a TCA cross chemical peel (more on those later!) or another skin remodeling technique such as microneedling.
  • Rolling scars: Characterized by their rolling, wave-like appearance, these scars create an uneven skin texture. Medium chemical peels can help in reducing their appearance, as they promote collagen production and skin regeneration.
  • Boxcar scars: These scars are round or oval depressions with steep vertical sides. Shallow boxcar scars can be effectively treated with medium chemical peels, which help in resurfacing the skin and reducing the depth of the scars.

Hypertrophic scars and keloids

Hypertrophic scars and keloids are raised scars that form due to an overproduction of collagen. They are more common in certain skin types and body areas.

  • Hypertrophic scars: These raised, firm scars stay within the boundary of the original wound. Chemical peels may have limited effectiveness on hypertrophic scars. Treatments like steroid injections or laser therapy are often more suitable.
  • Keloids: Keloids are a more severe form of raised scars, extending beyond the original wound area. They are generally not responsive to chemical peels. Treatment usually involves a combination of steroid injections, laser therapy or surgical removal.

Post-Inflammatory Hyperpigmentation (PIH)

Post-inflammatory hyperpigmentation occurs when a healed pimple or acne blemish leaves behind a darkened area on the skin. This is not a true scar but a common aftermath of acne, especially in darker skin tones. Although PIH typically fades on its own within a year, you can speed up the process with a series of light peels or single medium-depth peel.

How Do Chemical Peels Work on Acne Scars?

Peels use a variety of chemical solutions to remove the outermost layers of damaged, scarred skin, thereby promoting the regeneration of new, healthier skin tissue. When applied to the skin, these peels cause a controlled injury at a specific depth, stimulating the body’s natural healing process. This leads to increased cell turnover and collagen production, essential components in repairing and improving the skin’s appearance. 

Over time and with consistent treatments, these peels can significantly smooth out the skin’s texture, reduce the appearance of both raised and depressed acne scars, and even out skin tone, especially in cases of post-inflammatory hyperpigmentation. 

Types of Chemical Peels for Acne Scars

Generally, these cosmetic treatments are categorized based on their depth of penetration. 

Superficial peels

Ideal for mild acne scarring, PIH and skin tone unevenness, a light peel typically contains mild forms of alpha-hydroxy and beta-hydroxy acids. They gently exfoliate the outermost layer of skin, promoting new skin cell growth. In addition to improving the appearance of acne scars, these peels tackle minor discoloration and fine lines to give your skin a refreshed appearance. 

Superficial peels are a popular choice because they offer noticeable results with little downtime, making them an excellent option for a regular skin care routine. 

Medium peels 

These peels go a bit deeper and are effective for more noticeable acne scars and hyperpigmentation. They may contain trichloracetic acid (TCA), higher concentrations of glycolic acid or blends like Jessner’s solution. Medium peels can require 3–4 weeks of recovery involving extensive redness and peeling, but they offer dramatic results.

TCA Cross

The TCA Cross technique, which stands for Trichloroacetic Acid Chemical Reconstruction of Skin Scars, is a specialized treatment primarily used to address atrophic acne scars, particularly deep and narrow ice pick scars. The method involves applying a high concentration of TCA directly into the scar, which induces collagen production and effectively lifts the scar’s depth, thereby making it less noticeable. 

What’s the Best Chemical Peel for Acne Scars?

The most effective treatment for you depends on what kind of scarring you have and your desired results. But whether you opt for an in-office or at-home solution for your acne scars, you’ll definitely benefit from one or more of the following active ingredients. These power players in the world of skin rejuvenation are found in skin care products and professional peel solutions alike.

Glycolic acid

Glycolic acid, an alpha-hydroxy acid (AHA), has a small molecular size that allows it to penetrate deeply into the skin, effectively exfoliating the outermost layer. This process removes dead skin cells, promotes new cell growth and can significantly improve the appearance of superficial acne scars while also tackling concerns like sun damage and melasma.

Salicylic Acid

Salicylic acid, a beta-hydroxy acid (BHA), is an effective option if you’re still dealing with active lesions in addition to acne scars. Its oil-soluble properties let it penetrate pores, clearing out the excess sebum and dead skin cells that lead to breakouts. 

As a scar treatment, salicylic acid reduces inflammation and redness. Its exfoliating action also aids in diminishing the appearance of post-inflammatory hyperpigmentation, a common aftermath of acne, making it a valuable component in a chemical peel for acne-prone skin.

Trichloroacetic Acid (TCA)

TCA is known for its ability to reach deeper layers of the skin compared to other acids. This makes TCA peels highly effective for more pronounced acne scars. TCA promotes skin regeneration by causing controlled damage to the older skin, prompting the body’s natural healing process to generate new, smoother skin tissue. 

Additionally, TCA is effective in reducing hyperpigmentation, which often accompanies acne scarring. Its deeper penetration can lead to significant improvements in skin texture and tone, making it a sought-after ingredient for those with severe scarring.

Lactic acid

Lactic acid is another type of AHA, derived from milk, gently exfoliates the skin without compromising the epidermal barrier. It’s an excellent option for individuals with darker skin tones, as it reduces the risk of post-inflammatory hyperpigmentation, a concern often heightened with more aggressive treatments. 

Lactic acid helps in lightening dark spots and improving skin texture, making it beneficial for treating hyperpigmented acne scars. Its mild exfoliating action can help even out skin tone and texture without causing undue irritation.

Mandelic acid

Mandelic acid, a gentle yet effective alpha-hydroxy acid (AHA) derived from bitter almonds, has a larger molecular size that allows slower, more even skin penetration, reducing the likelihood of irritation. This characteristic makes mandelic acid particularly suitable for sensitive skin types and those prone to inflammatory acne. 

Mandelic acid accelerates cell turnover, helping to shed the outer layers of the skin more rapidly. If you have sensitive skin or are experiencing active acne alongside scarring, mandelic acid can be an effective ingredient in a chemical peel. It not only aids in reducing the appearance of scars but also possesses antibacterial properties that can help in preventing future breakouts.

Phenol

Phenol, a potent ingredient in chemical peels, can play a transformative role in the treatment of acne scars. Phenol penetrates into the lower dermal layers of the skin, making it highly effective for severe and older acne scars. When applied, phenol causes a deep exfoliation, removing damaged layers of skin and triggering a profound healing response. This response leads to significant collagen remodeling, improving the skin’s texture and firmness. 

For individuals with deep-set acne scars, phenol can help in flattening raised scars and softening the appearance of pitted scars. However, due to its intensity, deep peels with phenol are generally reserved for more severe scarring cases and require careful handling by experienced professionals. It’s essential for individuals considering a phenol peel to be aware of the longer recovery time and potential side effects, balanced against the potential for significant improvements in severe acne scarring.

Side Effects of Chemical Peels for Acne Scars

The severity of side effects you may experience largely depends on the type of peel and your skin’s sensitivity. Common side effects include:

  • Redness
  • Dryness
  • Flaking
  • Stinging
  • Burning sensations

More intense peels, like those containing TCA or phenol, can lead to swelling, scabbing, and an increased risk of post-inflammatory hyperpigmentation, especially in darker skin tones. 

To minimize these effects, it’s crucial to follow a proper pre-treatment skin care routine as advised by your skin care professional, which might include using specific skin care products such as retinol. Post-treatment, keep the skin hydrated with a gentle moisturizer, avoid direct sun exposure and use a broad-spectrum sunscreen. Refrain from picking or peeling flaking skin to avoid scarring or infection. In the case of deeper peels, your provider may prescribe specific aftercare products or topical medications to aid in healing and reduce the risk of complications. 

It’s also important to have realistic expectations and understand that while side effects are a normal part of the skin renewal process, they are usually temporary, paving the way for clearer, smoother skin.

Opting for another cosmetic treatment alongside your chemical peel can help fast-track your way to smoother, scar-free skin. 

Microneedling, a procedure that uses fine needles to create micro-injuries on the skin, stimulates collagen production and can enhance the effects of chemical peels. If you have widespread unevenness, microneedling can help smooth your skin with relatively low downtime.

Laser treatments and laser resurfacing are also excellent options. These advanced techniques target deeper layers of the skin, helping to reduce acne scars and improve overall skin texture. Ablative laser resurfacing treatments vaporize the top layer of skin and thus require significant downtime, but fractional lasers only impact a tiny amount of the skin’s surface while still breaking up scar tissue and non-ablative lasers deeply heat the skin from within to encourage remodeling. 

Takeaway

If you’re struggling with acne scars, chemical peels can offer a transformative solution. They not only improve the appearance of scars but also enhance overall skin tone and texture. Remember, every skin journey is unique, and what works for one person might not be the best option for another. We encourage you to consult with a dermatologist, licensed aesthetician or other skin care specialist to receive personalized advice and treatment options. It’s the first step in empowering yourself on your path to healthier, more radiant skin.

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