Chemical peels are a fast and effective treatment option for improving the complexion. For some, chemical peels are an entry way into cosmetic treatments as they are relatively affordable compared to more intensive procedures while still providing excellent results. While chemical peels are commonly used, it is important that the practitioner understand peel concentrations and application technique. Peels are relatively safe when used correctly but they can be painful as layers of skin are being burned off to allow new, unblemished skin to grow. A topical numbing cream with a combination of ingredients can provide effective anesthesia that makes chemical peels more comfortable or even painless.
Chemical peels involve the application of a chemical solution that peels off layers of skin. After the skin is peeled, new skin grows that is brighter and less blemished. Depending on the strength of the peel, it may be able to reduce wrinkles, treat hyperpigmentation and sun damage, and minimize the appearance of scars. Peels may be used to treat common dermatological conditions like acne and melasma as well.
Superficial, Medium, and Deep Chemical Peels
Most providers will divide chemical peels into 3 main categories: mild/superficial, medium, and strong/deep. Mild chemical peels are those that remove only the most superficial layers of skin and may include some over the counter preparations. This type of peel is equivalent to a gentle exfoliation. Medium strength peels remove more layers of the skin, are more painful, but also produce more significant results. Medium strength peels may be able to treat wrinkles, superficial blemishes, and uneven pigmentation. Deep chemical peels can penetrate to the middle layer of the skin and produce the most significant results but are also the most painful and have the longest recovery time.
After the numbing cream wears off there will likely be some mild irritation, burning, and swelling. During the recovery period for a peel there will be peeling of the skin, irritation, and inflammation. Skin may look tan, dark, and/or red similar to a sunburn. The actual peeling of the skin may start a few days after having the chemical peel. By the time the peeling starts the pain and irritation will have subsided. Using cool compresses, using moisturizer consistently, and avoiding sun exposure on the treated area can all help the healing process.
For deep peels, the recovery process may be more extended and the skin may stay red for weeks or even up to 2 months. Aftercare is especially important after a deep peel in order to prevent infection. In some cases, anti-infective medications will be prescribed as part of aftercare.
Pain Relief for Chemical Peels
There are numerous options for reducing pain after a peel including oral medication like ibuprofen to reduce swelling and topicals that can help the skin maintain moisture and provide itch relief. A provider may offer oral medication as well to reduce pain during the procedure. A numbing cream applied before a chemical peel, when used appropriately, can make the treatment almost painless for most patients.
Research has shown that there is a clinically significant reduction in the pain and discomfort of a chemical peel when a numbing cream is applied prior to the peel. Numbing cream should always be applied at least 15-30 minutes before the procedure and allowed to penetrate the skin before being washed off completely.
Some research has shown that numbing cream may enhance the depth of a chemical peel. Because of that, caution should be used when applying deeper peels (like high concentration TCA peels). The research on this is not conclusive however as some studies have shown no difference in the depth of the peel. It is important to completely remove all of the cream before applying the chemical peel solution so that it does not interfere with the treatment.
What is the Best Numbing Cream for Chemical Peels?
A variety of numbing creams are available over the counter that contain ingredients like lidocaine and benzocaine. These are the two most common topical anesthetic ingredients and they can effectively numb the skin before a variety of dermatological and cosmetic procedures. The concentrations of OTC formulations are usually less than 5% lidocaine and 20% benzocaine. A compounding pharmacy can make a numbing cream that includes benzocaine, lidocaine, and tetracaine in higher concentrations than can be sold over the counter. These prescription strength numbing creams are used by dermatologists throughout the U.S. to numb their patients prior to laser resurfacing, Botox and filler injections, and chemical peels.
An alternative option to topical numbing is local anesthesia with injectable anesthetic nerve blocks. Some doctors may even use a combination of topical and injectable anesthetic. In most cases patients prefer a topical to an injected anesthetic due to an aversion to needles. A powerful compounded topical anesthetic like BLT cream is usually sufficient for numbing the skin prior to a chemical peel.
Since multiple peels are usually necessary to get the best results, it is important that the patient has a positive first experience and comes back for the subsequent treatments. Using a strong topical numbing cream like BLT cream can help make the experience much more comfortable for patients, making them more likely to want to come back.