Aesthetic Dermatology MCQ - Superficial chemical peels

A 28-year-old woman with mild acne, comedones, and post-inflammatory hyperpigmentation is seeking a chemical peel with minimal downtime and the ability to safely repeat treatments every 2–3 weeks. Which of the following is the MOST appropriate example of a superficial chemical peel?

A. 50% Trichloroacetic acid (TCA)
B. Phenol (Baker-Gordon formula)
C. 20% Salicylic acid
D. 35% TCA combined with Jessner’s solution
E. Phenol-croton oil peel

Correct Answer:
C. 20% Salicylic acid

Explanation:
Superficial chemical peels act at the level of the epidermis (stratum corneum to upper granular layer) and are ideal for mild photoaging, acne, and dyschromias. They require little downtime, have low risk of complications, and can be repeated every 1–3 weeks.

Examples of superficial peels:

• Glycolic acid (20–50%) – Alpha-hydroxy acid

• Salicylic acid (20–30%) – Beta-hydroxy acid, metabolic action

• Mandelic, lactic acid, Jessner’s solution, low-strength TCA (10–20%)

Other options:

• A. 50% TCA: Deep peel (risk of scarring) — generally avoided.

• B. Phenol (Baker-Gordon formula): Deep chemical peel (reticular dermis).

• D. 35% TCA + Jessner’s solution: Medium-depth peel (up to papillary dermis).

• E. Phenol-croton oil peel: Deep peel used for severe photodamage and deep rhytides.

Key Point:
Superficial peels are safe, repeatable, and best suited for acne, PIH, and early photoaging, with very low downtime compared to medium or deep peels.