Patients who have a skin problem should consult with a dermatologist about whether or not a chemical peel is the best option for treating their condition. It is important to search for a qualified physician who has experience performing the procedure. Qualified physicians will be able to choose the proper peeling agent based on the patient's skin type and condition. In some states, a medical degree is not required to perform a chemical peel.

Patients considering a chemical peel should also inform their dermatologist if they have a history of keloids (red, raised formations of fibrous scar tissue), unusual scarring, extensive x-rays or radiation to the face, or recurring cold sores.

Prior to the procedure, patients should follow any preparatory steps suggested by their physician. Patients may be asked to stop using certain medications or to prepare the skin for the procedure by applying certain preconditioning creams. Patients may also be advised to apply sunscreen with a sun protection factor (SPF) of 30 or higher during the days leading up to the procedure.

Chemical peels are usually performed in a dermatologist’s office on an outpatient basis. The patient’s skin is cleansed with an agent that removes excess oils, and the eyes and hair are covered to protect them from the chemical solution. Depending on the type of peel being performed – superficial, medium or deep – the solution itself is made up of a substance or combination of substances that may include glycolic acid, trichloroacetic acid (TCA), salicylic acid, lactic acid and phenol, or carbolic acid.

The solution is applied to the area of skin to be treated. A frosting of the skin may occur as the protein in the skin is coagulated when the acid is applied. This can last for several minutes.

Patients may feel a warm to hot sensation that lasts for five to 10 minutes and is followed by a stinging sensation. As the chemical begins to work on the skin, it produces a separation as the top layers of skin peel off and allow the new skin to appear. Some of the chemicals used must be rinsed with water after use. Other chemicals, such as salicylic acid and TCA, do not need rinsing.

Patients who have deeper peels will probably experience a greater level of discomfort due to the stronger chemical mix used in this type of procedure. Medications are available to help reduce the level of discomfort that patients feel. Emollients may also be applied to heal the skin quicker.

Recovery after a peel is dependent on which kind of peel was used. The use of sunblock is always recommended after any peel. After a series of mild chemical peels, there may be redness and a mild stinging sensation, similar to a sunburn. Patients who have undergone a medium peel or series or peels will experience greater skin discomfort that may include more scabbing, stinging and swelling. The use of sunblock is usually recommended for several months after the peel. Recovery after a deep phenol peel will take the longest and involve the greatest discomfort. These peels permanently bleach the skin, so lifetime sunblock use is mandatory. In addition, the procedure will likely be followed with a period of pronounced swelling, blistering and scabbing. In some cases, the patient's eyes might even swell shut temporarily, and surgical tape may be used to cover the new skin. Bandages are usually removed after several days. Patients should resist the urge to pick at any scabs, to reduce the risk of scarring.

Sun exposure is an important issue after any chemical peel. After mild peels, sunscreen and sunblock use is recommended, while after a medium peel, sunblock might be required for a period of months. These kinds of peels don't actually bleach the skin, however, and after healing is complete, melanin production will begin again and help protect against UV radiation. Deep phenol peels, however, bleach the skin permanently, which requires lifetime use of sunblock. Physicians might decline a phenol peel to patients who are unlikely to follow through with sunblock use.