Facial Chemical Peels

Our last discussion was about Body Peels.  Let’s change the focus and talk “face to face”.  Chemical Peels are a series of applications of acids or enzymes applied to the skin to remove layers of the Stratum corneum and encourage the remaining layers of the skin to refresh and remodel.  This will amp up the production of collagen and elastin which contributes to a smoother, more wrinkle-free appearance.  The production of collagen begins a downward production spiral about the age of 20.1  We lose about 1% per year and since collagen acts as a scaffolding, the structural support of the face diminishes.  By the time we reach our 40’s, 50’s and 60’s, the visible deficit cannot be denied.  We have taken a MedAesthetics seminar to use Botulinum toxin A to reduce the dynamic wrinkles and dermal fillers to substitute the structural support to reduce the static wrinkles and restore volume.  Another tool is to improve the appearance of the skin.  We will embark on a series of articles to add tools to our belt and help our clients become the best they can be and increase your confidence in helping them achieve their goal.



Categorizing the Skin

Some of the inf

ormation will be a repeat of what we discussed in body peels. For chemical peels of the face, we need to look at two important scales which help us decide the most effective peel and

very importantly, the s

afest peel we should consider for their skin type.  The skin is categorized based on its reaction to sun exposure and the level of wrinkling present.  The rating scale by Dr. Thomas Fitzpatrick groups fair and light skin up to darkly-pigmented brown skin.  This division is based on the client’s reaction to sun exposure—burning vs tanning.  The lighter skin tolerates stronger acids and the darker skin reacts with more adverse effects thereby requiring weaker acids.  The second scale is the Glogau Scale.  Dr.  Richard Glogau categorized skin aging by how UV skin exposure

changes our skin and wrinkling.  Chemical peels in Skin Types I through IV are based on need and level of improvement desired.  The presence of acne scarring may also play a role in the depth and type of peel.

Types of Chemical Peels

Classic options for peels are acids but enzymes, like pumpkin, are also popular.  Peels are divided into the level of the skin that the peeling agent descends.  These layers are superficial, medium and deep.  Some peels can bridge groups depending on how many coats of the chemical are applied.  Superficial peeling agents are Alpha Hydroxy Acids (AHA) like Glycolic Acid from sugar cane, Lactic acid from sour milk, Citric acids from fruits and Malic acid from apples.  Beta Hydroxy Acids (BHA) like Salicylic acid from willow tree bark are popular and effective but contraindicated in allergies to aspirin.  We need to establish if the “allergy” is gastrointestinal irritation or a true allergy or anaphylaxis.  Trichloroacetic acid is an analogue to vinegar and it can go deeper into the skin layers if the percentage in the peel is higher.  Retinoic acid is a Vitamin A product and present in Retin A™ and many OTC creams and lotions to improve skin texture.  Retinols play a key role in turnover in skin cells and studies show that it may prevent and cause regression in actinic keratoses and non-melanoma skin cancers. 3,4 The deepest-descending agent is Phenol, an aromatic alcohol acting as a weak acid.   Resorcinol is a substituted Phenol and popular in combination peels in low concentration.  Deep peels are relegated to procedure rooms with sedation and cardiac monitoring.  Superficial through medium level peels are safe for office-based and some concierge practices.  In our Chemical Peel Class, we discuss the different acids in more depth and start participants with a customized superficial to medium depth peel based on the client’s skin characteristics and needs.

Written by: Dr. Christy Bennett


  1. Schuster, et al. The influence of age and sex on skin thickness, skin collagen and density.  Br J Dermatol. 1975; 93: 639-43
  2. Women’s’ picture courtesy © 2017. All Rights Reserved.
  3. Skin Cancer Prevention Strategies: Tried, True and New.  RL Moy, S. Famini.  Skin Cancer Foundation.
  4. Retinoids for prevention and treatment of AK’s. Ianez, et al.  An Bras Dermatol.  2013, 88 (4):585-593
  5. Diagram: Edited/iStockphoto-ttsz.  Used with permission.

  • Christopher Dunn, DDS

    Christopher graduated from the University of Colorado with his undergraduate degree Bachelor of Arts and Sciences 1986, was accepted at University of Colorado dental school and graduated in 1990. He had a hospital position at Swedish Medical center in the head and neck trauma unit and has since been working in private practice since 1991.

    He enjoys cosmetic dentistry and the immense happiness a beautiful smile can provide for his patients. Patients frequently comment afterward, “ If I could just get rid of the wrinkles”, this led him to pursue adding the skills of Neuromodulators such as Botox and Dysport and hyaluronic acid based dermal fillers to complement the improved smile. He has a passion for sharing knowledge and techniques and feels continued learning and improvement is the hallmark of a good clinician. He enjoys reading and researching all areas of fitness, health, and the art of staying healthy and looking younger.



  • Hanieh Khorshidi NP-BC

    Meet our aesthetic provider, Hanieh Khorshidi NP-BC.  Hanieh graduated from George Mason University, in Fairfax, Virginia with her degree as a Board Certified Nurse Practitioner.  She has been practicing for over 10 years. Starting off as an Operating Room Nurse, Hanieh worked and trained among some of the best plastic & cosmetic surgeons throughout the Midwest and Northeast regions of the United States, gaining a profound appreciation for patient safety, advocacy, and education.  Her passion for patient safety and education extends to her career in aesthetics, as she has been awarded with Medical Aesthetics Certifications including Master Injector for her use of cosmetic injectables in both basic and advanced injection techniques.  Hanieh currently owns and operates a Practice in Arlington, Virginia.  She prides herself on having a diverse and well-rounded understanding of both the business, and aesthetics of the cosmetic industry. Her approach is admirable in its respect for the artistry involved in injectables. Hanieh believes in a personalized, natural approach to all aesthetic treatments ultimately producing outstanding outcomes for her patients in the safest manner possible.



  • Dr. Luis Linan, MD

    Dr. Luis Linan is a board-certified OB/GYN in El Paso, Texas.  He attended the University of Texas in Austin and graduated in 1982 with a BA in biology.  He went on to study at Texas Tech School of Medicine where he graduated in 1989.  After two years of general surgery residency, he completed his OB/GYN residency at Texas Tech University Health Science Center in El Paso.  From 1994-1995 he was clinical faculty at Texas Tech HSC in the department of OB/GYN.  Since 1995 Dr. Linan has been in private practice and in 2007 he began doing sclerotherapy treatments.  In 2011 his practice expanded to medical aesthetics where he now performs treatments for neurotoxins and fillers.



  • Erika Barry, NP-C, MSN, CCRN

    Nurse Practitioner

    Erika Barry received her undergraduate training from the University of Miami where she obtained a Bachelor of Science in Nursing and Health Studies, May 2006. She received her Master’s Degree from The Johns Hopkins University in May 2011. While completing her graduate degree at Hopkins she began to explore her interest in anti-aging and plastic surgery. After graduating from Hopkins in 2011 she moved to San Francisco, California to accept the coveted position as a surgical nurse practitioner at The University of California, San Francisco. At UCSF, she was fortunate to work with the urology and plastic surgery teams at UCSF Medical Center located at the Parnassus Campus in the heart of San Francisco.

    After four years as a surgical NP at University of California, Erika moved to DC to work in outpatient cosmetic surgery. She is now the lead injector at the elite Hela Medical Spa in Georgetown, DC. At Hela she is the “master” of Botox, dermal filler, and Kybella. She has trained over 200 nurses, physicians, physician assistants, and nurse practitioners in aesthetics and injectables. Her personal teaching moto, “safety always, always, comes first”.

  • Angela Coton, PA-C, MPAS

    Aesthetic Specialist

    Angela is a nationally board-certified and North Carolina state licensed Physician Assistant who has been practicing since January 2010. She graduated cum laude with her Bachelor of Arts in English Literature from the University of Illinois, Urbana- Champaign in 2000. After 10+ years working in both the corporate business environment and managing a medical aesthetics spa, she realized her true gift was in patient care. She returned to East Carolina University in 2007 to pursue her Master of Science in Physician Assistant Studies.

    After graduating from ECU in 2009, she relocated to the North Shore of Boston to study Facial Plastics and Otolaryngology with seven renowned surgeons. Her supervising physician Dr David Chrzanowski is a board certified facial plastic surgeon and she gained immense knowledge in facial anatomy and aesthetics in addition to skincare science. Angela’s background in facial plastics and the science of aging combined with her desire to make people feel good about themselves led her to pursue aesthetic medicine. Her favorite tools to improve patient’s natural beauty is through minimally invasive techniques of neuromodulators (Botox/ Dysport/Xeomin) and dermal fillers to prevent wrinkles and restore collagen loss. She is dedicated to maintaining the highest standards of patient safety and values the importance of educating her patients on the options that will allow them to be the most naturally vitalized and get the most for their money.

  • Jennie Kowaleski, PA-C

    Jennie attended Seton Hill University in Pennsylvania where she obtained her Bachelors of Science degree in Physician Assistant studies. She later completed her Masters of Science in Physician Assistant Studies, Education and Leadership, from A.T. Still University. Jennie began her PA-C career in Urgent Care and internal medicine, later developing a passion for aesthetics. She began working in the field of skin care and aesthetics in 2010. She has become very proficient in facial contouring and enhancement with various injectables such as botulism toxins, dermal fillers and Kybella. She has a vast knowledge and multiple certifications for use of state of the art lasers.

    Jennie’s philosophy to skin care and aesthetics is simple. She wants to achieve natural, beautiful results working in all levels of comfort and ability. Jennie works as a private trainer teaching other health care professionals in injectable techniques.

  • Meredith Harris, NP

    Meredith pursued undergraduate studies in Physiology and Neuroscience at the University of California and later completed a second undergraduate degree in nursing at Loma Linda University. In 1998, Meredith graduated Magna Cum Laude from the University of Pennsylvania as a Nurse Practitioner in Women’s Health. After years of caring for women, Meredith found her career niche in the sub-specialty of aesthetic enhancements.

    In 2017 Meredith was recognized with an Award of Excellence for the Best in Nursing by the American Health Council. As a member of the International Society of Plastic and Aesthetic Nurses and The National Academy of Dermatology Nurse Practitioners she continues to pursue advanced training and knowledge to keep her on the leading edge of the aesthetic market. Meredith travels extensively to teach and train new and advanced injectors throughout the country.

  • Mr. Waseem Garbia, PA-C

    Mr. Garbia graduated from George Mason University in Fairfax, VA. He then attended Jefferson College of Health Sciences in Roanoke, Virginia and graduated with his degree and certification in Physician Assistant studies and has been practicing for over 14 years. Waseem has worked in many different settings including general and plastic surgery, emergency medicine, critical cardiology and aesthetics.

    He is a certified master injector and is a national aesthetic medical trainer. Waseem has a vast knowledge in cosmecuticals, injectables and lasers and has a passion for long-term skin enhancement. Having experience with launching several medical spas, Waseem enjoys teaching and sharing his knowledge in technique as well as meeting business objectives.

  • Dr. Christy Bennett, DO

    Dr. Bennett is Board Certified in Family Medicine by the American Board of Family Medicine. She completed an Allopathic Internship & Residency in Family Medicine at the University of Oklahoma-Tulsa in 2000 and entered into a private practice. She received her undergraduate degree from the university of Tulsa in 1978 in Medical Technology. Dr. Bennett practices family practice medicine, operates a concierge injectable business and serves as Medical Director for a Medical Spa in Tulsa, OK.

    Dr. Bennett has been an instructor in aesthetic medicine for over 9 years specializing in the areas of Injectables, Sclerotherapy, Microdermabrasion & Chemical Peels. Dr. Bennett has authored numerous teaching materials & presentations in the areas of aesthetic medicine and has attended national and international symposiums on aesthetic medicine.

  • Dr. Jeffery Ayers, DO

    In 1985 Dr. Ayers graduated from Westmont College in Santa Barbara, CA with his BA in Biology. He then graduated from medical school in 1989 from Des Moines University. From 1989-1992 he completed his Family Medicine Residency at the US Naval Hospital Camp Pendleton. From 1992-1995 he served the US Navy in Sasebo, Japan as a staff family physician and chief of the family advocacy program.

    In 1995 Jeff and his family relocated to the Salt Lake City area where he continues to work with Intermountain Healthcare as a staff family physician. In 2005, Dr. Ayers added non-surgical medical aesthetics to his areas of practice. Today, Dr. Ayers practices family medicine as well as serving as medical director for the National Institute of Medical Aesthetics and Elase Medical Spas.

    Dr. Ayers also trains for the use of neurotoxins, dermal fillers and laser resurfacing.

  • Translate »