Skin exfoliation is the process of removing dead cells from the surface layer of the skin to improve texture, appearance, and overall skin health. This procedure plays a crucial role in dermatology and cosmetology by promoting cellular regeneration and enhancing the penetration of active ingredients in cosmetic products. This article discusses various exfoliation methods, including mechanical, chemical, enzymatic, and physical exfoliation, examining their indications, contraindications, and potential side effects. The primary aim is to provide a comprehensive overview of modern exfoliation techniques and emphasize the importance of selecting the appropriate method based on skin type and individual patient needs. Further research is needed to explore the long-term effects of these procedures, particularly for specific skin conditions and types.
. Grajqevci-Kotori M, Kocinaj A. Exfoliative Skin-peeling, Benefits from This Procedure and Our Experience. Medical Archives [Internet]. 2015 Dec 1 [cited 2024 Aug 26];69(6):414–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720453/
Samargandy S, Raggio BS. Skin Resurfacing Chemical Peels [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2024 Aug 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547752/
American Association of Dermatology. How to safely exfoliate at home [Internet]. www.aad.org. 2022 [cited 2024 Aug 26]. Available from: https://www.aad.org/public/everyday-care/skin-care-secrets/routine/safely-exfoliate-at-home
Rajanala S, Vashi NA. Cleopatra and Sour Milk—The Ancient Practice of Chemical Peeling. JAMA Dermatology [Internet]. 2017 Oct 1 [cited 2024 Aug 26];153(10):1006–6. Available from: https://jamanetwork.com/journals/jamadermatology/article-abstract/2657249
Raafat M, Alaa R, Fouad ED. An Insight into an Egyptian Intangible Cultural Heritage Tradition: The Hammām [Internet]. 2021 [cited 2024 Aug 26]. Available from: https://ijhms.journals.ekb.eg/article_188742_ac9b6d9313e9ea0720df72caf7ce4d15.pdf
Pisanti S, Mencherini T, Esposito T, D’Amato V, Re T, Bifulco M, et al. The medieval skincare routine according to the formulations of Madgistra Trotula and the Medical School of Salerno and its reflection on cosmetology of the third millennium. Journal of Cosmetic Dermatology. 2022 Aug 9;
McMullen RL, Dell’Acqua G. History of Natural Ingredients in Cosmetics. Cosmetics [Internet]. 2023 Apr 29 [cited 2024 Aug 26];10(3):71. Available from: https://www.mdpi.com/2079-9284/10/3/71
Borelli C, Ursin F, Steger F. The rise of Chemical Peeling in 19th‐century European Dermatology: emergence of agents, formulations and treatments. Journal of the European Academy of Dermatology and Venereology. 2020 May 25;34(9):1890–9.
Brody HJ, Monheit GD, Resnik SS, Alt TH. A History of Chemical Peeling. Dermatologic Surgery. 2000 May;26(5):405–9.
Soleymani T, Lanoue J, Rahman Z. A Practical Approach to Chemical Peels: A Review of Fundamentals and Step-by-step Algorithmic Protocol for Treatment. The Journal of clinical and aesthetic dermatology [Internet]. 2018 [cited 2024 Aug 26];11(8):21–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122508/
Marta V, Maria T, Chisaki C, Benemond PH. Chemical peels: review and practical applications. Surgical & Cosmetic Dermatology [Internet]. 2024 [cited 2024 Aug 26];5(1):58–68. Available from: http://www.surgicalcosmetic.org.br/details/253/en-US/chemical-peels--review-and-practical-applications
Lin M, Ma Y, Liu Z, Ruan H, Yuan B. Modern techniques in addressing facial acne scars: A thorough analysis. Skin research and technology: official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) [Internet]. 2024 Feb 1 [cited 2024 Aug 26];30(2):e13573. Available from: https://pubmed.ncbi.nlm.nih.gov/38303407/
Shah S. Beautiful Canadian Laser and Skincare Clinic [Internet]. Beautiful Canadian Laser and Skincare Clinic. 2014 [cited 2024 Aug 26]. Available from: https://www.bclaserandskincare.com/2014/09/lasers-chemical-peels/?srsltid=AfmBOopxkCPWj3Y5F3PyqHrNOaRMvh55hiKqMMBnT7cto1Cn6JdKZmVj
Tam C, Khong J, Tam K, Vasilev R, Wu W, Hazany S. A Comprehensive Review of Non-Energy-Based Treatments for Atrophic Acne Scarring. Clinical, Cosmetic and Investigational Dermatology. 2022 Mar;Volume 15:455–69.
Ditre CM, Griffin TD, Murphy GF, Sueki H, Telegan B, Johnson WC, et al. Effects of alpha-hydroxy acids on photoaged skin: a pilot clinical, histologic, and ultrastructural study. Journal of the American Academy of Dermatology [Internet]. 1996 Feb 1;34(2 Pt 1):187–95. Available from: https://pubmed.ncbi.nlm.nih.gov/8642081/
Kligman D, Kligman AM. Salicylic Acid Peels for the Treatment of Photoaging. Dermatologic Surgery. 1998 Mar;24(3):325–8.
Rubin MG. Manual of Chemical Peels [Internet]. Google Books. 1995 [cited 2024 Aug 26]. Available from: https://books.google.bg/books/about/Manual_of_Chemical_Peels.html?id=AZBGIovfrlUC&redir_esc=y
Dinner MI;Artz JS. The art of the trichloroacetic acid chemical peel. Clinics in plastic surgery [Internet]. 2018 [cited 2024 Aug 26];25(1). Available from: https://pubmed.ncbi.nlm.nih.gov/9507796/
Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B. Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing. The Journal of clinical and aesthetic dermatology [Internet]. 2010;3(7):32–43. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921757/
O’Connor AA, Lowe PM, Shumack S, Lim AC. Chemical peels: a Review of Current Practice. Australasian Journal of Dermatology [Internet]. 2017 Oct 24 [cited 2024 Aug 26];59(3):171–81. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/ajd.12715
Sun HF, Lu HS, Sun LQ, Ping WD, Mao DS, Li D. Chemical Peeling with a Modified Phenol Formula for the Treatment of Facial Freckles on Asian Skin. Aesthetic Plastic Surgery. 2017 Dec 26;42(2):546–52.
Weissler JM, Carney MJ, Carreras Tartak JA, Bensimon RH, Percec I. The Evolution of Chemical Peeling and Modern-Day Applications. Plastic and Reconstructive Surgery. 2017 Nov;140(5):920–9.
Reserva J, Champlain A, Soon SL, Tung R. Chemical Peels. Dermatologic Surgery. 2017 Nov; 43:S163–73.
Chen X, Wang S, Yang M, Li L. Chemical peels for acne vulgaris: a systematic review of randomised controlled trials. BMJ Open [Internet]. 2018 Apr 28 [cited 2024 Aug 26];8(4):e019607. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931279/
Castillo DE, Keri J. Chemical peels in the treatment of acne: patient selection and perspectives. Clinical, Cosmetic and Investigational Dermatology [Internet]. 2018 Jul [cited 2024 Aug 26];Volume 11(11):365–72. Available from: https://www.dovepress.com/chemical-peels-in-the-treatment-of-acne-patient-selection-and-perspect-peer-reviewed-fulltext-article-CCID
Chikako Kaminaka, Yamamoto Y, Nozomi Yonei, Kishioka A, Kondo T, Furukawa F. Phenol peels as a novel therapeutic approach for actinic keratosis and Bowen disease: Prospective pilot trial with assessment of clinical, histologic, and immunohistochemical correlations. Journal of The American Academy of Dermatology. 2009 Apr 1;60(4):615–25.
Khunger N, IADVL Task Force. Standard guidelines of care for chemical peels. Indian Journal of Dermatology, Venereology and Leprology [Internet]. 2008 Jan 1 [cited 2024 Aug 26];74 Suppl:S5-12. Available from: https://pubmed.ncbi.nlm.nih.gov/18688104/
Truchuelo M, Cerdá P, Fernández LF. Peeling químico, una herramienta útil en la consulta. Actas Dermo-Sifiliográficas [Internet]. 2017 May 1 [cited 2024 Aug 26];108(4):315–22. Available from: https://www.actasdermo.org/es-peeling-quimico-una-herramienta-util-articulo-S0001731016303362
Starkman SJ, Mangat DS. Chemical Peels: Deep, Medium, and Light. Facial Plastic Surgery. 2019 Jun;35(03):239–47.
Roberts WE. Chemical peeling in ethnic/dark skin. Dermatologic Therapy. 2004 Jun;17(2):196–205.
Al-Waiz MM, Ddsc, Al-Sharqi AI. Medium-Depth Chemical Peels in the Treatment of Acne Scars in Dark-Skinned Individuals. Dermatologic Surgery. 2002 May;28(5):383–7.
Lee KC, Wambier CG, Soon SL, Sterling JB, Landau M, Rullan P, et al. Basic chemical peeling: Superficial and medium-depth peels. Journal of the American Academy of Dermatology [Internet]. 2019 Aug 1 [cited 2024 Aug 26];81(2):313–24. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0190962218330494
Landau M. Chemical peels. Clinics in Dermatology [Internet]. 2008 Mar 1 [cited 2024 Aug 26];26(2):200–8. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0738081X07001964
Costa IMC, Damasceno PS, Costa MC, Gomes KGP. Review in peeling complications. Journal of Cosmetic Dermatology. 2017 Mar 27;16(3):319–26.
Monheit GD. Medium-depth chemical peels. Dermatologic Clinics. 2001 Jul;19(3):413–25.
Kouris A, Platsidaki E, Christodoulou C, Efstathiou V, Markantoni V, Armyra K, et al. Patients’ self-esteem before and after chemical peeling procedure. Journal of Cosmetic and Laser Therapy. 2017 Dec 29;20(4):220–2.
Arif T. Salicylic Acid as a Peeling agent: a Comprehensive Review. Clinical, Cosmetic and Investigational Dermatology [Internet]. 2015 Aug [cited 2024 Aug 26];8(2015):455–61. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554394/
Packianathan N, Kandasamy R. Functional Plant Science and Biotechnology Skin Care with Herbal Exfoliants [Internet]. 2011 [cited 2024 Aug 26]. Available from: http://www.globalsciencebooks.info/Online/GSBOnline/images/2011/FPSB_5(SI1)/FPSB_5(SI1)94-97o.pdf