Chemical peel

Medium depth peels must be performed by a medical provider (MD, NP, RN, or AP Esthetician in certain states).

Alpha hydroxy acids can also be mixed with facial washes, serums or creams in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.

It was originally used on a clandestine basis by early Hollywood stars in the 1920s and was incorporated into mainstream practice in the 1960s by Thomas Baker and Howard Gordon.

[9][10][11] Resurfacing and restoring skin with chemical peel was introduced in the second half of the 19th century by the Austrian dermatologist Ferdinand Ritter von Hebra (1816–1880), founder of the Vienna School of Dermatology.

He used exfoliative agents, like phenol, croton oil, nitric acid in various caustic combinations for treating freckles and skin irregularities.

[1] Professional strength chemical peels are typically administered by certified dermatologists or licensed estheticians.

[citation needed] Medium peels such as trichloroacetic acid (TCA) are also performed in the doctor's office or in an ambulatory surgery center as an outpatient procedure and can cause more discomfort.

Early phenol peel solutions were very painful and most practitioners would perform it under either general anesthesia, administered by an anesthesiologist or nurse anesthetist.

Today it is more correctly referred to as a croton oil peel, since that has proven to be the active ingredient responsible for most of its effects.

[citation needed] Recent formulations allow more variation in the depth of treatment, and allow its use under sedation either orally or intravenously, usually in conjunction with local anesthetic injections.