Chemical peels: what's new and what isn't new but still works well

Chemical peeling is becoming increasingly popular for the treatment of skin rejuvenation where it can improve damaged skin and fine wrinkles. The basic procedure aims at obtaining a controlled chemical burn of the epidermis and/or dermis. This results in epidermal regeneration and postinflammatory collagen neoformation with remodeling of collagen and elastic fibers and deposition of glycosaminoglycans in the dermis. Various chemicals have been used as peeling agents, of which the most used are the alpha-hydroxy acids, such as glycolic acid, or beta-hydroxy acids, such as salicylic acid. The choice of the compound is linked to the different indications and to the depth of the desired peeling. Phenol is still the best agent for deep peeling but requires specific indications, prescription, and post-peeling care. Combination of different compounds is one innovation in the field of chemical peelings. Further controlled studies are necessary to set up specific guidelines.