Boston Cosmetic
Boston Cosmetic

















Boston Cosmetic

Chemical Peels

Chemical peel animation video from Dr. Ishoo on Vimeo.

Chemical Peels in Boston Cosmetic Specialists

Our skin is constantly under attack by sun exposure, hormones, medications, acne or other skin conditions, smoking, lack of adequate hydration, make up, etc. Common over-the-counter skin care is not adequate to undo the damage. Just as it is necessary to have your teeth professionally cleaned every 3-4 months to remove plaque, so does your skin need to have the damaged skin removed with the same frequency. Medical grade chemical peels are the most efficient and cost effective way to refresh and repair the skin.

shutterstock_111012569[1]Chemical peeling is a technique used to improve the appearance of the skin that is typically performed on the face, neck or hands. In this treatment, a chemical solution is applied to the skin that causes it to “blister” and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also temporarily more sensitive to the sun.

The skin care specialists at the Boston Cosmetic Specialists use various peeling agents for treating different skin conditions and skin types and are experts in performing multiple types of chemical peels. A thorough evaluation by a Dr. Ishoo and his experienced staff is imperative before embarking upon a chemical peel.

What is a chemical peel?

Sun exposure, acne or just getting older can leave your skin tone uneven, wrinkled, spotted or scarred. If you want your skin to look smoother and younger, consider a chemical peel, which uses a chemical solution to smooth the texture of your skin by removing the damaged outer layers.

In a chemical peel, a chemical solution is applied to the skin and allowed to soak in. Over the next 1 to 14 days, depending on how deeply the chemical penetrated the skin, the skin peels off. This procedure destroys parts of the skin in a controlled way so that new skin can grow in its place. The chemicals used are sometimes called exfoliating, dermapeeling or wounding agents. A chemical peel is one of the least invasive ways to improve the appearance of your skin. Although chemical peels are used mostly on the face, they can also be used to improve the skin on your neck and hands.

Why is a chemical peel done?

  • Superficial peels are used to improve the appearance of pigment changes in the skin, acne scars, mild sun damage, or fine wrinkles in all skin types. They can be done on the face and on other parts of the body. A superficial peel may also be used to prepare the skin for a deeper peel.
  • Medium peels are used to treat mild to moderate wrinkles, long-term sun damage, pigment changes, and precancerous lesions of the skin (usually caused by sun exposure). Medium peels are used most often on the face.
  • Deep peels are used to treat severe wrinkles, long-term sun damage, pronounced pigment changes, and lesions and growths on the skin. They are done only on the face. Deep peels are not done on darker skin types, because they bleach the skin.

What types of chemical peels are offered at the Boston Cosmetic Specialists?


We offer the following chemical peels:

Glycolic Acid Chemical Peel from Dr. Ishoo on Vimeo.

  • TCA peel
  • Alpha Beta Peel
  • Triplex Peel
  • Modified Jessner Peel

Chemical Peels FAQ

How does a chemical peel work?

Chemical solutions are carefully applied to your skin to improve the texture by removing damaged outer layers. The chemicals used are phenol, trichloroacetic acid and alphahydroxy acids. Each one has a different purpose. The formula used by your doctor will be adjusted to meet your particular needs.

Light chemical peel
Subtle improvements at first, but that healthy glow will increase with more treatments

If you have uneven pigment, dryness, acne or fine wrinkling, a light chemical peel might be the right choice. This kind of peel removes just the outer layer of skin (epidermis) in a light exfoliation and results in a healthier glow. Your healthcare provider will use a combination of alphahydroxy acids and beta hydroxy acids, such as glycolic acid, lactic acid, salicylic acid and maleic acid. All of these chemicals are the mildest choices. You can repeat these treatments weekly for up to six weeks to achieve your desired results.

Here’s how it works:

  • Your face will be cleansed
  • The chemical solution is brushed onto your skin and left for up to 10 minutes. You may feel some mild stinging
  • The chemical peel is then washed off and neutralized

Return once a month to maintain your vibrant new look.

Superficial Chemical Peel – Boston Cosmetic Specialists from Dr. Ishoo on Vimeo.

Medium chemical peel
Your skin will be noticeably smoother and fresher-looking

Acne scars, deeper wrinkles and uneven skin color can all be treated with a medium chemical peel. The chemicals used for this type of peel will remove skin cells from both the outer layer of skin (epidermis) and upper part of your middle layer of skin (dermis). Your healthcare provider will use trichloroacetic acid, sometimes used in combination with glycolic acid.

Here’s how it works:

  • Your face will be cleansed
  • The chemical solution is brushed onto your skin and left for just a few minutes. You may feel some burning or stinging
  • The treated area may turn a whitish grey color
  • The chemicals are neutralized with cool saline compresses
  • Your skin may turn red or brown in the days just after the peel. It may take up to six weeks for your skin to look normal

You may repeat a medium chemical peel every 6 to 12 months to maintain your glowing new skin.

Medium Chemical Peel – Boston Cosmetic Specialists from Dr. Ishoo on Vimeo.

Deep chemical peel
Results are dramatic, but recovery takes the longest

If you have deeper facial wrinkles, skin that’s damaged by the sun, scars, areas that appear blotchy or even pre-cancerous growths, deep facial chemical peels might be the right choice for you. Your physician will use the strongest chemical called phenol to penetrate down to the lower dermal layer of your skin. For this type of peel, you may need a local anesthetic and a sedative to manage any discomfort.

Here’s How it Works:

A deep chemical peel usually involves some sort of pretreatment for up to 8 weeks. This will prepare your skin for the peel and speed the healing process. Pretreatment may include use of Retin A – a prescription medication that’s derived from vitamin A. This works to thin out the skin’s surface layer, allowing the chemical solution to penetrate more evenly and deeply. If you can’t tolerate Retin A as a pre-treatment, Dr. Ishoo may prescribe another medication.

  • You will be given a sedative to relax along with a local anasthetic to freeze your face
  • Your face will be cleansed
  • Phenol is brushed onto the area and can remain from 30 minutes, up to two hours. The chemical is neutralized with water
  • After allowing your skin to rest for an hour, a thick coat of petroleum jelly is smoothed over your skin, covering the crust,which develops. The petroleum jelly must stay in place for up to two days. Sometimes your healthcare provider will opt to cover your skin with strips of adhesive tape with openings for your eyes and mouth, rather than the layer of petroleum jelly. Your doctor will choose this approach if you have severe wrinkling.

Deep 01 Deep Peel Introduction- Boston Cosmetic Specialists from Dr. Ishoo on Vimeo.

How is the discomfort managed during the peel?

Deep chemical facial peels will result in peeling, redness and discomfort for several days. Your doctor will provide painkillers to keep you comfortable. Although the swelling is likely to disappear in about two weeks, your skin may be red for up to three months.

One treatment with a deep chemical peel will produce long-lasting and dramatic results which can last up to 10 years.

What are the risks and special considerations of chemical peels?

You should understand that all chemical peels will carry some risks and uncertainties. It’s usually a very safe procedure when performed by a qualified and experienced plastic surgeon. It happens infrequently, but you could develop an infection or scarring from chemical peels.

For people with certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Birth control pills, getting pregnant, or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

If you have suffered from cold sores (herpes) in the past, there is a small risk of reactivation. Be sure to tell your doctor because she may prescribe medication before and immediately after a chemical peel to avoid an outbreak.

Inform Dr. Ishoo and the staff at Boston Cosmetic Specialists if you have a history of keloids (scar tissue overgrowth) or any unusual scarring tendencies.

Other considerations for each type of peel include:

Light Chemical Peel

You are likely to experience some redness, stinging, skin crusting and irritation from a light chemical peel. After repeated treatments these side effects will likely subside. Other risks include:

  • Hyper pigmentation. Your new skin may have too much pigment, which will turn to brown blotches in sunlight. Avoid this by always using a high-factor sunscreen.
  • Infection
Medium Chemical Peel

When trichloroacetic acid is used in a medium chemical peel, you’ll experience some redness, stinging and skin crusting just like a light chemical peel. And although these chemicals won’t bleach your skin, you may see some color changes. You’re advised to avoid the sun for several months to protect that fresh new layer of skin. Other risks include:

  • Hyperpigmentation (when too much pigment occurs, causing brown blotches) may result even if you use sunscreen.
  • Redness, which occurs in everyone after the peel, may last longer than a few months for some people.
  • Permanent scarring is another, infrequent, risk.
Deep chemical peel

The chemical used for this kind of peel, phenol, can lighten the skin that’s treated. Your skin tone may be a determining factor as to whether or not this is an appropriate treatment for you. With this kind of peel, your new skin often loses its ability to make pigment, meaning a tan. You will always need to protect your skin from the sun. Phenol also can pose a special risk for people with heart disease. Be sure to tell Dr. ishoo and the staff at Boston Cosmetic Specialists about any heart problems and include it in your medical history.

Other risks include:

  • A red face, which can last three to four months.
  • Cysts or white spots may appear with a deep peel and they can last up to several weeks.
  • Scarring is an infrequent risk.
  • Some areas of your skin may lose pigment permanently.
  • Hyperpigmentation (when too much pigment occurs, causing brown blotches) may result even if you use sunscreen.

A deep chemical peel requires that you have an adequate recovery time. You may return to work and some of your normal activities two weeks after treatment. At that point, your skin will be healed enough for you to wear makeup.

How should I prepare for a chemical peel?

Dr. Ishoo and his staff of skin care specialists can help you decide what depth of peel and what type of chemical solution is most appropriate, based on your skin type, which areas you want peeled, what kind of results you want, how much risk you are willing to take, and other issues. A small “test spot” may be peeled to get a better idea of the results, especially for people with darker skin.

Two to three weeks before the peel, you will need to begin preparing your skin by cleansing it twice a day, applying a special moisturizer or cream once or twice a day, and using sunscreen every day. In some cases, daily use of tretinoin (Retin-A), a topical medicine usually used to treat acne, is also recommended and may speed healing. This skin care regimen will help the skin peel more evenly, speed healing after the peel, and may reduce the chance of infection and other complications, especially uneven color changes in the skin.

For medium and deep peels of the face, you may be given a short course of medicine (such as acyclovir) to prevent viral infection. This is especially likely if you have had cold sores before, and the peel will be in the areas near the mouth or eyes.

What should I expect after a chemical peel?

Recovery time after a chemical peel depends on what kind of peel was done and how deep it was. With all types of peels, proper care of the skin after the peel is very important to speed healing, help results last longer, prevent infection, and avoid color changes in the treated area caused by sun exposure. Proper skin care after a peel is very similar to the care used to prepare for a peel and typically involves:


  • Cleansing the skin frequently with water or a special wash that your surgeon tells you to use.
  • Changing the dressing or ointment on the wound (for medium and deep peels).
  • Moisturizing the skin daily.
  • Avoiding any sun exposure until peeling has stopped and sunscreen can be used. After peeling has stopped, sunscreen should be used every day. New skin is more susceptible to sun damage.


Dr. Ishoo may recommend using tretinoin cream nightly for some patients, usually starting 2 to 3 weeks after the peel.

So, is a chemical peel right for me?

Now that you know what a facial chemical peel can do for your skin, it’s important to understand what they cannot do, such as:

  • Treat deep facial lines
  • Tighten loose or sagging skin
  • Stimulate collagen production
  • Remove broken capillaries
  • Change pore size
  • Remove deep scars

You may not be a good candidate for chemical peeling if you have:

  • A history of skin scarring
  • Abnormal pigmentation
  • Afro-Caribbean or Asian skin
  • Facial warts

Dr. Ishoo and the experienced staff of skin care specialists at the Boston Cosmetic Specialists offer effective peels for a wide range of skin conditions, skin types and budgets. If you are interested in a complementary evaluation of your skin and finding more about our various chemical peels, contact our office today at 1-508-861-7007.