The Food and Drug Administration (FDA) has warned consumers not to purchase or use certain chemical peel products because they can cause serious skin injuries. No at-home chemical peel product has received FDA approval, but many are available for purchase online and in stores.

The agency stated that chemical peel products should only be used with professional supervision and that at-home peels may result in serious skin injuries.

“Many of these chemical peel products are sold in beauty product stores and online and marketed for purposes such as acne, discolouration, wrinkles, and collagen production. They contain ingredients such as trichloroacetic acid (TCA), glycolic acid, salicylic acid and lactic acid in varying concentrations that are too high to be used safely at home without supervision by a dermatologist or other licensed and trained practitioner,” the agency said in a statement.[1]

“Using products that contain high concentrations of these acids may lead to serious injury from chemical burns. The concentration, number of applications, and length of time a chemical peel product is left on the skin all influence how deeply it can penetrate skin layers and potentially lead to chemical burns.”

Joseph Zahn, MD, a Clinical Assistant Professor of Dermatology at George Washington University, says that chemical peels have a number of legitimate uses but should only be administered by trained professionals.

“Chemical peels have many different uses and when administered by a trained healthcare professional, [they] are safe and effective. Some of the reasons a healthcare professional may choose to recommend chemical peels for patients can range from photoaging, acne and acne scars, hyperpigmentation or pigment changes in the skin, [and] certain limited precancerous lesions on the skin, among others”

-Joseph Zahn, MD

When used properly, chemical peels create a controlled injury and remove the top layers of the skin. This skin then regenerates, which can lead to improvements in its appearance.

The dangers of using chemical peels incorrectly

But when used incorrectly, chemical peels can cause pain, severe chemical burns, infection, swelling, changes in skin colour, and disfiguring scars. [1]

Atieh Jibbe, MD, a Mohs and cosmetic surgeon at The University of Kansas Health System, says that patients need to be properly evaluated by a trained professional before chemical peels are used, as not everyone is an appropriate candidate for them.  

“Factors such as recent skin care products/treatments to the skin, the skin colour of the patient, history of infections such as herpes simplex virus, allergy information, history of cardiac arrhythmias, liver [disease], and/or renal disease can affect [whether] a patient is a candidate for a chemical peel. These factors can also affect when and how a chemical peel is applied,” Dr. Jibbe says.

“For example, pretreatment of herpes cold sores before chemical peel application is imperative in preventing an outbreak after the peel. Also, more aggressive deep chemical peels, such as those used to treat deep wrinkles and scarring, will have the patient remain in [the] office for the duration of the treatment for patient monitoring. Thus, is it imperative that a chemical peel is applied in a clinic with medical providers who are adequately trained and have a background in chemical peels,” she adds.

The FDA has issued warning letters to six companies for selling 14 chemical peel products that do not have FDA approval.[1]

These include peels that contain 80% salicylic acid, 90% lactic acid, 70% glycolic acid, and 100% trichloroacetic acid.

Treatment options for chemical peel injuries

When chemical burns or other injuries do occur as a result of at-home chemical peel products, it is important that healthcare providers take necessary steps to treat any short- or long-term damage, Dr. Zahn says.

“Healthcare providers should be ready to provide some immediate steps depending on the location, type, and extent of the injury. If residual chemical peel is present, the area should be washed thoroughly with saline immediately,” he notes.

“Other treatments for the lasting effects of a chemical peel can range from certain types of laser treatment for erythema (redness) or other dyspigmentation from a chemical peel to topical steroids for other types of injury or scarring. When in doubt, refer to a healthcare professional trained in the management of chemical peels and their complications.”

-Dr. Zahn

Disclaimer: This story is contributed by Elizabeth Pratt and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.