The medium peel is a dermocosmetic treatment that involves applying a chemical solution to the skin in order to exfoliate the superficial and mid-layers. Unlike the light peel, which targets only the superficial layers of the skin, the medium peel penetrates deeper, making it possible to treat more pronounced skin concerns. It is often used to correct signs of aging, improve skin quality, and even out the complexion. This type of peel is generally performed with a laser or with acids such as trichloroacetic acid (TCA) at specific concentrations, tailored to each skin type and each concern.
The medium peel is an increasingly popular aesthetic-oriented medicine treatment for people who want to improve the quality and density of their skin. This treatment helps address various skin concerns such as wrinkles, pigment spots, acne scars, and other imperfections. This peel stimulates cell renewal to achieve smoother, more radiant skin.
Although the treatment involves a recovery period, the results are long-lasting and visible. Before undergoing this treatment, it is recommended to consult an experienced physician to ensure that the medium peel is suitable for the patient’s skin type and expectations.
The TCA peel is a medium peel if it is used at effective concentrations.
A chemical agent, trichloroacetic acid, is used to penetrate deeply, down to the mid-dermis.
There are several TCA concentrations : as its concentration increases, the depth of penetration into the skin tissue increases accordingly.
15% TCA is equivalent to a superficial peel, Dr. Romano prefers to use fruit acid peels for this indication.
20-25-30% TCA is a medium peel.
40% TCA is a deep peel. However, phenol is preferable for this indication.
The principle behind a medium peel is the application of a chemical agent (often trichloroacetic acid) that causes controlled exfoliation of the skin. This process removes dead skin cells from the surface and stimulates the production of collagen and elastin—two key elements for firm, elastic skin. During the procedure, the chemical solution penetrates the middle layers of the skin to eliminate damaged cells and boost cellular regeneration. A few days after the treatment, the skin begins to peel, revealing a fresh new layer of healthier, smoother, and more radiant skin.
The medium peel is recommended for patients who want to treat several skin concerns of moderate severity.
• Moderate wrinkles and fine lines : this peel is ideal for softening mild to moderate wrinkles, especially around the eyes and mouth.
• Pigment spots : it is effective in reducing age spots, sun spots, and post-inflammatory hyperpigmentation.
• Acne scars : superficial and medium-depth acne scars can be significantly reduced thanks to this treatment.
• Uneven or dull complexion.
• Improvement in skin quality, which becomes softer and more even.
• Premature skin aging : patients who want to slow down and treat visible signs of skin aging, often caused by prolonged sun exposure, can benefit from this treatment.
• Overall rejuvenation : the medium peel stimulates collagen production, and the skin appears younger and revitalized.
• Skin laxity.
• Radiance boost.
• Keratoses.
• Actinic keratoses : Dr. Romano prefers to leave the treatment of these precancerous lesions to fellow dermatologists.
• Enlarged pores.
In certain cases, a medium peel cannot be performed due to contraindications :
• Pregnancy.
• Wearing a pacemaker or cardiac defibrillator.
• Chronic illnesses such as diabetes or severe organ insufficiencies (e.g. renal or cardiac failure).
• Use of Isotretinoin within the past year.
• Ongoing acne treatments.
• Recent aesthetic procedures (surgery, laser, dermabrasion).
• Active skin infections or herpes.
• Dark skin phototypes.
• Contact skin allergies.
The medium peel can be performed on several areas of the body, although the face is the most commonly treated area. It is important to specify that there are several types of medium peels depending on the depth of penetration : medium-superficial peels, medium, and medium-deep. On the body, apart from the face, it is only possible to perform the medium-superficial peel.
• Face : to treat wrinkles, fine lines, acne scars, and pigment spots.
• Neck : to firm and even out the skin of the neck, often marked by signs of aging.
• Décolleté : this area, often exposed to the sun, may show pigment spots and fine lines that can be corrected with the medium peel.
• Hands : to rejuvenate the skin of the hands and treat age spots.
The medium peel takes place in a medical office and is performed by an experienced physician.
Before the medium peel session, a consultation makes it possible to assess the patient’s specific needs and ensure that this peel is suitable for their skin and aesthetic goals.
On the day of the peel, it is preferable to come to the office without makeup, without contact lenses, and without having applied cream to the face. Men should shave the evening before.
Before applying the peel, the skin is carefully cleansed to remove any impurities or residue.
The exfoliating agent, usually trichloroacetic acid (TCA), is applied evenly to the area to be treated. The patient may feel a slight tingling or temporary burning sensation. Depending on the chosen depth of penetration, local anesthesia may or may not be performed.
The number of passes and the application time depend on the skin type and the indication being treated.
The peel has an immediate effect : intense redness and a whitening of the skin (frost) appear.
At the end of the session, the skin is red and swelling sets in.
Dr. Romano then covers the area with a healing cream and gives you precise instructions on how to care for the skin during the healing period.
The procedure for a medium laser peel is similar to a chemical peel, but the exfoliation of the superficial and medium layers of the skin is achieved through the action of laser energy.
Dr. Romano prefers laser peeling over chemical peeling for several reasons.
• The heat generated during a laser treatment tightens the skin. The laser significantly improves skin laxity.
• With equivalent results, laser peeling leads to fewer complications and lighter after-effects than chemical peeling.
After a thorough cleansing of the area to be treated, the laser beam is precisely and carefully passed over the targeted surface, making it possible to adjust the depth of exfoliation according to the patient’s specific needs. This process stimulates skin regeneration by removing dead cells and promoting collagen production. Less invasive than a traditional chemical peel, it allows for faster recovery while providing visible results in terms of smoothing, brightening, and overall improvement in skin quality.
Skin preparation is mandatory before the procedure, as it improves and makes the penetration of the peel more even, and prevents possible post-peel pigment rebound.
In order to guarantee the effectiveness and safety of the treatment, therefore, certain precautions must be followed.
• Avoid the sun : one month before the session, it is essential to avoid any prolonged sun exposure and to apply a high-protection sunscreen.
• Skin preparation : apply a glycolic acid-based cream in the evening for three weeks before the session, and stop using any exfoliating products or performing any exfoliating actions (hair removal, scrubs, or laser treatments) during those three weeks.
After a medium peel, the skin is more sensitive and requires special care for a fast and optimal healing process.
• Taking prescribed medications : Dr. Romano prescribes antibiotics, herpes prevention, and a healing cream for ten days.
• Strict sun protection : sun exposure must be avoided for one month, during which a broad-spectrum sunscreen should be applied every day.
• Hydration : use the recommended healing cream to help maintain hydration and promote healing.
• Do not touch the skin : scabs or dead skin that form should not be picked off, in order to prevent scarring.
• Medical follow-up : a medical follow-up is planned; it will allow the patient to discuss with the physician and follow the advice given during consultations.
The results of a medium peel start to become visible about one week after the session, once the skin has finished peeling. The skin appears smoother, more radiant, and rejuvenated. Spots are reduced, fine lines are diminished, and skin quality is improved. Depending on the depth of the peel performed, the results can last for several years.
The after-effects of the treatment are characterized by the appearance of marked redness and swelling for about forty-eight hours. From the third day, the skin takes on a brownish tint, then peels over a period of about seven days, making way for a new, pink and firm epidermis. This pink coloration may persist for nearly one month.
As part of a true medium peel, it is recommended to plan for a social downtime period of about one week.
Complications, rare but possible, are :
• Edema, persistent redness, desquamation, or excessively significant peeling or exfoliation.
• Bacterial (impetigo) or viral superinfection (herpetic outbreak).
• An acne flare-up that may justify a specific treatment.
• Hyperpigmentation (darker spot) or depigmentation (white spot).
• Appearance of demarcation lines at the border of the treated areas (hairline, mandibles).
The cost of a medium-depth peel is generally between CHF 600 and CHF 1200 per session, depending on several parameters. The cost mainly varies according to the depth of the peel performed, the complexity of the skin issue to be treated (marked pigment spots, scars, laxity, keratosis), and the extent of the treated area.
Unlike superficial peels, the medium-depth peel acts deeper, which makes it possible to achieve the desired result from the first session. In most cases, a single session is sufficient. However, in certain specific situations, an additional treatment may be considered after evaluation.
A complete clinical assessment is carried out during the initial consulenza in order to define a tailored protocol and establish a precise and transparent quote.
The majority of patients who have opted for a medium-depth peel are satisfied with the results, particularly in terms of improved skin quality and reduced pigmentation. Many appreciate the quality of the skin rejuvenation achieved without resorting to invasive techniques.
However, there is a recovery period that can be relatively long (up to two weeks), during which the skin peels and is sensitive. The duration of this period is decided with the patient, depending on their aesthetic goals, which will determine the depth of the peel performed.
Yes, darker skin tones, up to phototype IV, can benefit from a medium-depth peel, but with caution. It is essential to choose suitable acids and to prepare the skin before the treatment to minimize the risk of post-inflammatory hyperpigmentation.
The medium-depth peel acts at the level of the superficial dermis, making it possible to correct pigment spots, fine lines, and minor skin imperfections. In contrast, the deep peel penetrates the deeper layers of the dermis and targets pronounced wrinkles, scars, and more severe skin alterations.
It is recommended to wait 5 to 7 days before applying makeup to the skin, allowing time for the epidermis to regenerate and for redness to decrease, in order to avoid any irritation.
No, due to the higher risk of side effects, especially scarring, medium peels are not recommended for other areas.
A medium-depth peel can be performed every 6 to 12 months, depending on the skin’s needs and the doctor’s recommendations. Maintenance sessions may be scheduled to prolong the results.
A medium peel can be adapted for sensitive skin with a gentle formulation and specific preparation. A prior skin assessment is essential to avoid adverse reactions and ensure a safe treatment.
