Definition & Overview
Chemical exfoliation is one of the many procedures used to treat acne. Exfoliation works by removing dead skin cells from the skin surface. It plays a key role in most facial treatments. Aside from chemical exfoliation, the process can also be performed through physical or mechanical means. In a mechanical exfoliation, the dead skin cells are removed by rubbing the skin with an abrasive material. Chemical exfoliation, on the other hand, is performed using chemicals that contain exfoliant agents or scrubs in them.
Who Should Undergo and Expected Results
Chemical exfoliation for acne can be recommended to patients who suffer from severe or chronic acne. Acne is a very common skin problem characterised by raised, inflamed spots on the skin. The spots typically appear on the face, back, and chest.
Acne comes in many forms, including:
- Blackheads – Black or yellowish bumps that release a whitish substance when squeezed
- Whiteheads – Firmer bumps that do not empty when pressed
- Papules – Small red bumps that are usually inflamed
- Pustules – Small red bumps with a white centre due to pus
- Nodules – Large, hard, and painful lumps that form under the skin
- Cysts – Large, pus-filled lumps that can cause scarring
Acne is linked to several possible causes, including:
- Hormonal changes – Some hormones cause glands near the hair follicles to produce larger amounts of sebum or oil. This causes bacteria to attack the skin and cause pus and inflammation. People experience hormonal changes during puberty, their period (in women), pregnancy, or due to disease.
- Genetics – Acne tends to run in families.
- Underlying medical conditions, such as polycystic ovarian syndrome
Once acne develops, it can continue to plague a person throughout most of his or her life. There are many treatments used for acne, such as topical ointments, oral medications, and hormonal therapies. Some treatments focus on the root cause of the condition, while others, like exfoliation, helps relieve symptoms.
Chemical exfoliation for acne can get rid or prevent blackheads, whiteheads, and other forms of acne from continuously forming by keeping the skin clean and fresh. The exfoliating agents can unclog pores and reduce excessive oil production. And while physical exfoliation only removes dead skin cells on the skin surface, chemical exfoliants can penetrate through the upper layers of the skin down to the pores. Thus, it provides deeper cleansing. By doing so, the risk of blackheads, whiteheads, papules, and pustules forming is significantly reduced.
How is the Procedure Performed?
Chemical exfoliation is performed using chemical exfoliants. Some of the most common that dermatologists use are the following:
- AHA or alpha hydroxy acids – These are molecules that penetrate the upper skin layers and promote cell regeneration. This means that the skin repairs itself faster after a chemical exfoliation using AHA. Examples are glycolic and lactic acids.
- BHA or beta hydroxy acids – Unlike AHA, BHA agents are capable of reaching deep into the pores. They are more effective for patients who suffer from sebum-related acne characterised by oily skin and frequent breakouts. An example is salicylic acid.
- Fruit enzymes
- Citric acid
- Malic acid
Chemical exfoliants are widely available. Patients can easily purchase them and exfoliate regularly on their own. However, for those suffering from chronic acne, it is best to consult a dermatologist for professional chemical exfoliation treatments. Chemical exfoliation for chronic acne may require repeated sessions to prevent breakouts and recurrences.
Professional exfoliation is safer and more effective. It can help in cases of severe acne where over-the-counter exfoliants no longer work. The dermatologist can also choose the most appropriate chemicals to use, apply them in correct doses and schedule, and watch out for complications.
An example of a chemical exfoliation procedure is chemical peel. Chemical peels can treat active acne as well as deep acne scars.
Possible Risks and Complications
Chemical exfoliation is a relatively safe procedure with minimal risks. The only serious risk related to it is over-exfoliation, which can remove too much skin too early. This means that instead of removing only dead skin cells, the procedure might also remove some healthy cells.
Skin cells need some time to regenerate. They usually do so at a cell turnover rate of 28 days for young people and 56 days for older adults. Patients should thus avoid undergoing chemical exfoliation too often.
Over-exfoliation can give rise to other risks, such as:
- Skin inflammation
- Weakened skin barrier, making the skin more vulnerable to infection
- Bacterial and fungal infections
Strong chemical exfoliation procedures, such as deep chemical peels, dermabrasion, and laser procedures, may also put patients at risk of:
- Hyperpigmentation, or the darkening of the skin
- Hypopigmentation, or lighter/whiter patches of skin
Rendon MI, Berson DS, Cohen JL, et al. “Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing.” J Clin Aesthet Dermatol. 2010 Jul; 3(7): 32-43. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921757/
Arif T. “Salicylic acid as a peeling agent: A comprehensive review.” Clinical, Cosmetic, and Investigational Dermatology. 2015 Aug 26; 2015(8): 455-461. https://www.dovepress.com/salicylic-acid-as-a-peeling-agent-a-comprehensive-review-peer-reviewed-fulltext-article-CCID