Are lip peels hazardous?

There are several types of lip peel. Each has its own advantages and disadvantages.

• The mild peel, or superficial lip peel.

  A mild peel, also known as a superficial peel, can be performed at home or in a clinic by a professional. This procedure relies on applying an exfoliating treatment, based on fruit acids, such as glycolic acid, mandelic acid or lactic acid. Mild peels promote the removal of dead cells on the lips, by breaking intercorneocyte bonds and releasing corneocytes. Performing a mild lip peel once a week helps to remove small dead skin flakes, which can appear unsightly and interfere with the application of a balm or lipstick.

  The difference between a superficial lip peel performed by a professional and an at-home cosmetic peel is the product concentration. At a dermatologist’s office, the glycolic acid content can reach 70%, while it cannot exceed 10% in a cosmetic formula.

• Medium-depth lip peel.

  A medium lip peel often uses trichloroacetic acid (TCA) and is recommended for visible wrinkles around the lips. It penetrates deeper than a mild peel and reaches dermal cells. The TCA solution applied to the skin ranges from 10% to 50% concentration, depending on patient skin sensitivity and wrinkle depth. A burning sensation is common during application and redness and swelling follow the session. This is why a dermatologist-prescribed soothing cream is necessary for 15 days before and after the session. Note that this peel is not applied directly to the lips but to their contour.

• The deep lip peel.

  As its name suggests, the deep peel acts deep within the dermis. It provides a corrective action on deep wrinkles and depressed scars that superficial and medium peels cannot address. Deep peels address 'barcode' or smoker's lines. Phenol is a common agent for this type of peel. This compound has a potent abrasive effect on the epidermis. Results are visible and lasting, but the procedure is intensive. A local or general anaesthetic is required, as phenol is cardiotoxic. Daily application of a medicated cream is necessary three to four weeks before the procedure to prepare the skin. Post-operative follow-up is essential to prevent aesthetic complications such as hypo- or hyperpigmentation, or infectious complications such as herpes outbreaks.

The risks of a lip peel depend on its type.

A mild peel is not harmful and can be performed once a week. It offers several benefits and leaves lips smooth and supple. Pay attention to the composition of the superficial peel you use due to the risk of ingesting small amounts. Some products contain phenoxyethanol or butylated hydroxytoluene (BHT), chemical preservatives suspected of acting as endocrine disruptors. Avoid peels that contain fragrances, as these may irritate the sensitive skin of the lips.

Medium and deep peels present greater risks and several complications may occur : abscess, inflammatory reaction, fever, pain, oedema, erythema, etc. That is why a pre-operative consultation with an aesthetic doctor or dermatologist is essential before these procedures. During this session, the practitioner will assess your skin and ask questions to determine whether you can undergo a medium or deep peel and guide your choice.

After the operation, the skin is exposed and extremely fragile. A thin epidermal layer forms after five days. Local care using occlusive emollients and dressings supports and protects the skin until complete healing, achieved in eight to ten days. Pigmentation begins to reappear after one month and must not be stimulated by sun exposure, at the risk of developing hyperpigmentation. This is why deep peels are rare in summer and why daily broad-spectrum sun protection must be applied for one to two months following the operation.

There are no specific contraindications for a superficial lip peel, unless specified by the product supplier.

The situation differs for medium and deep lip peels. These procedures are contraindicated in several cases, notably during pregnancy or breastfeeding. Indeed, during these periods the skin is more fragile. Pigment spots or scars from the procedure may become permanent. Epidemiological studies have linked prenatal exposure to phenol—the compound used for deep peels—to reduced foetal weight and viability, and to a higher incidence of certain unusual neurological symptoms. For trichloroacetic acid, used in medium peels, safety data during pregnancy are limited. Recent research suggests it is carcinogenic. As a precaution, medium lip peels are contraindicated for pregnant individuals.

It is inadvisable to perform a medium or deep peel on the lips if the area shows a skin alteration, such as a burn, an open wound, an active infection or an inflammatory skin condition, such as eczema or psoriasis. In particular, labial herpes, even in remission, is a temporary contraindication, as the peel could reactivate the virus and worsen lesions. A contact allergy to any component of the exfoliating solution—acid, preservative or fragrance—makes the procedure risky. A patch test or medical consultation is recommended to rule out any known sensitivity before considering a chemical peel on this fragile area.

• Phenol: developmental/reproductive toxicity data summary. Office of Environmental Health Hazard Assessment (2002).

• TEDESCHI A. Chemical peeling for the lip and the eye regions. Nonsurgical Lip and Eye Rejuvenation Techniques (2016).

• BRODY H. J. & al. Augmentation and eversion of lips without injections: the lip peel. Journal of the American Academy of Dermatology (2019).

• BRODY H. J. & al. Advanced chemical peels: phenol-croton oil peel. Journal of the American Academy of Dermatology (2019).