Peels That Soften Acne Scarring

A chemical peel runs on a schedule. There can be weeks of preparation at home, sessions spaced a few weeks apart, a recovery that looks like sunburn, and results that depend on the skin that follows. That schedule is the part most worth planning, since it has to fit around a real calendar and real time outdoors.

How peels work on acne scarring, how strengths and sessions differ, what recovery involves and where the limits are all appear in guidance from the American Society for Dermatologic Surgery and the American Academy of Dermatology. Timing, including the season, is something to settle with a dermatologist.

What a peel does to acne scars

The American Society for Dermatologic Surgery says chemical peels improve the appearance of acne scars by using a chemical solution to remove the outer layer of old skin, and that the new skin that replaces it is usually smoother and less scarred in appearance.

The American Academy of Dermatology says applying a chemical peel to the skin helps the body produce more collagen and elastin, and that when the skin has more of both, depressed acne scars tend to be less noticeable.

Both descriptions are about improving how scars look and not about erasing them. A dermatology society's page on chemical peels for acne scars covers the same ground in more detail.

Mild to strong, and how many sessions

The American Academy of Dermatology says peels are available in strengths ranging from mild to strong, and that your dermatologist will determine which strength best meets your needs. It says mild and medium peels often require more than one treatment session, and gives the example that a mild peel may need 3 to 5 treatments, given every 2 to 4 weeks.

The American Society for Dermatologic Surgery says light peels may be repeated in one- to four-week intervals, and medium-depth peels every six to 12 months.

Put those intervals next to a calendar. A course of mild peels can stretch across weeks or months, and each session is followed by its own recovery. Ask your dermatologist which strength is proposed for your scars, how many sessions that means, and how far apart they would fall.

Preparing the skin first

The American Academy of Dermatology says your dermatologist may give you instructions for pre-peel priming before a peel. Patients typically follow it at home for 2 to 4 weeks, it says, and it can help you get the best results and reduce possible side effects. Pre-peel priming can include taking an antiviral medication or applying a retinoid.

That puts the real start of a peel weeks before the first session. If you are planning around a trip or an event, count from the start of priming and not from the appointment. A dermatology academy's page on acne scar consultation and treatment lists the options a dermatologist may discuss, with peels among them.

What recovery looks like

The American Society for Dermatologic Surgery says that afterward, patients experience a reaction similar to sunburn in the treatment area. They may have redness, followed by scaling within three to seven days, and swelling. Blisters that will crust, turn brown and peel off within seven to 14 days may follow medium and deep peels.

Plan for a visibly healing face during that window. Ask your dermatologist what to expect for the strength proposed, what to put on the skin, how to protect it outdoors, and when you could reasonably expect to be back at work or at an event.

Side effects, and why the dermatologist matters

The American Academy of Dermatology says that in the hands of a doctor who has experience with chemical peels, side effects tend to be mild. It lists persistent redness that may last for months, temporary darkening of the skin, lighter skin color after medium and deep peels, and scarring, which it calls very rare when a peel is performed by a dermatologist.

The American Academy of Dermatology also says dermatologists have been performing chemical peels for more than 50 years, with an excellent safety record. It says even people who have skin of color can safely have a chemical peel, but they should see a dermatologist who has expertise using chemical peels to treat darker skin tones, since without that knowledge people with skin of color can develop permanent pigment problems.

If your skin is darker, ask how many peels your dermatologist has performed on skin like yours and what they would do differently. A dermatology society's overview of chemical peels is a good general reference to read before that conversation.

What results to expect

The American Society for Dermatologic Surgery says chemical peels improve the appearance of mild scarring by using a chemical solution to remove the outer layer of old skin, and that the new skin that replaces it is usually smoother and less irregular in appearance.

The American Academy of Dermatology notes that most results are not permanent because our skin continues to age. It says that if you have lots of sun-damaged skin or precancerous skin growths called AKs, you will likely continue to see new spots and growths on your skin.

The first point suggests asking whether your scarring counts as mild, since that is the group the society describes. The second is a reminder that skin keeps changing after treatment. Ask your dermatologist what maintenance they recommend and how to protect treated skin over the seasons ahead.

Bringing it together

Peels reward planning: priming at home, a strength chosen by a dermatologist, sessions spaced to the strength, a recovery that looks like sunburn, and results that need looking after. The questions to bring are short. Which strength, how many sessions, how far apart? What does priming involve? What will recovery look like? What should be watched for on my skin tone?

A dermatology society's page on acne scars is a sensible place to read about the range of scar types before you go. Then put your questions to a licensed dermatologist who can examine your skin.