Chemical peels are controlled acid resurfacing used to improve sun damage, uneven pigment, rough texture, and acne-related marks. Evidence supports clear benefit for mild-to-moderate acne and useful, sometimes secondary roles in pigment and sun-driven aging when depth matches skin type. Superficial peels offer modest cumulative gains with low downtime; deeper peels remodel more but raise lasting pigment and scarring risk. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Standardized facial photography | Comparable series; improved texture/tone vs baseline | Objective visual track of rejuvenation |
| Investigator/patient global aesthetic scales | Improvement of ≥1 grade when used | Captures overall success |
| MASI or equivalent (if melasma) | Downward trend vs baseline | Tracks pigment-focused peels |
| Acne lesion counts (if acne indication) | Reduced inflammatory and noninflammatory counts | Documents peel series effect |
| Fitzpatrick type (baseline classification) | Documented I–VI | Guides depth/PIH risk |
| Wound-healing status | Re-epithelialized without infection/scarring | Safety gate for next peel |
| Pregnancy test (when relevant) | Negative before elective peel | Avoid fetal/unknown risk exposure |
| Cardiac monitoring (phenol only) | Stable rhythm during procedure | Detect phenol-related arrhythmia |
Cadence: Healing check day 3–7 (superficial) or through re-epithelialization (medium/deep); series reassessment every 1–2 peels with photography; maintenance every 3–6 months