Are lip peels dangerous?

Several types of lip peels exist. Each has distinct advantages and disadvantages.

• Gentle peel, or superficial lip peel.

  Gentle peel, also called superficial peel, can be performed at home or by a professional. This procedure relies on an exfoliating treatment, usually fruit acids, such as glycolic acid, mandelic acid or lactic acid. Gentle peels promote removal of dead cells on the lips, by breaking intercorneocyte bonds, which frees corneocytes. Performing a gentle peel for the lips once a week helps remove dead flakes, which are bothersome and interfere with balm or lipstick application.

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

• Medium-depth lip peel.

  The medium-depth lip peel often uses trichloroacetic acid (TCA) and is recommended for visible lines around the lips. It penetrates deeper than a mild peel and can reach dermal cells. The TCA solution applied to the skin has a concentration between 10% and 50%, depending on the patient’s skin sensitivity and the depth of their lines. It is common to feel a burning sensation during application, and after the session the skin may show redness and swelling. That is why applying a dermatologist-prescribed soothing cream is necessary during the fifteen days before and after the treatment. Note that this type of peel is not applied directly to the lips but to their contour.

• Deep lip exfoliation.

  As the name implies, deep peeling works within the dermis. It provides a corrective effect on deep wrinkles and rolling scars that superficial and medium peels cannot address. Deep peels are used to remove barcode wrinkles, also called smoker’s lines. Phenol is used for this type of peel. This compound abrades the epidermis. The results last, but the procedure is extensive. A local or general anesthesia is required because phenol is cardiotoxic. Applying a medicated cream daily is necessary three to four weeks before the procedure. Postoperative follow-up is imperative to prevent aesthetic complications, such as loss or increase of pigmentation, or infectious issues like herpes development.

The risks associated with a lip peel depend on its type.

A gentle peel is not harmful and can be performed once per week. It offers several benefits and leaves lips smooth and supple. Note that you should pay attention to the composition of the surface peel you use, due to the risk of ingesting a small amount. Some products contain phenoxyethanol or butylated hydroxytoluene (BHT), chemical preservatives suspected of endocrine disruption. It is also not recommended to apply a peel containing fragrances, as these may irritate the sensitive skin of the lips.

Medium and deep peels carry greater risks and several complications may occur : abscess, inflammatory reaction, fever, pain, swelling, erythema, etc. A preprocedure consultation with a medical aesthetician or dermatologist is essential before these techniques. During this session the practitioner will assess your skin, determine if you are a candidate for a medium or deep peel, and guide your choice.

After the procedure, the skin is exposed and extremely fragile. It takes five days to see a thin epidermal layer form. Local care with occlusive emollients and dressings supports and protects the skin until healing is complete in eight to ten days. Pigmentation returns after one month and must not be stimulated by sun exposure to avoid hyperpigmentation. This is why deep peels are rarely performed in summer and why daily application of a broad-spectrum sun protection for one to two months after the procedure.

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

The case differs for medium and deep lip peels. These procedures are contraindicated in several cases, notably during pregnancy or lactation. During these periods, the skin is more fragile. Pigment spots or scars from treatment may become permanent. Epidemiological studies have linked prenatal exposure to phenol, the compound used for deep peels, to reduced fetal weight and viability and to an increase in some unusual neurological symptoms. For trichloroacetic acid, used in medium peels, safety data in pregnancy are scarce. Recent studies suggest it may be carcinogenic. As a precaution, we advise against medium lip peels during pregnancy.

It is also not recommended to perform a medium or deep peel on the lips if the area shows skin damage, such as a burn, open wound, active infection, or inflammatory skin condition, like eczema or psoriasis. In particular, the presence of labial herpes, even during remission, is a temporary contraindication. The peel could reactivate the virus and worsen lesions. Contact allergy to any component of the exfoliating solution – whether an acid, preservative, or fragrance – makes this procedure risky. A preliminary patch test or medical consultation is recommended to rule out known sensitivities before considering a chemical peel on this delicate 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).