As non-medical chemical peels increase, here’s what physicians should look out for

By MDLinx staff

Published April 3, 2025

Key Takeaways

Industry Buzz

“I have never been more scared in my life. I just posted a video talking about my first-ever chemical peel gone wrong, and it has gotten significantly worse.” — injured patient, Kayla Nicole

Find more of your peers' perspectives and insights below.

A recent Instagram Reel posted by internal medicine and pediatric physician Tommy Martin, MD, highlighted a severe post-peel reaction in a patient treated by an esthetician. While chemical peels are a proven dermatologic tool, they carry risks—especially when performed outside a medical setting. Physicians are seeing more cases of burns, post-inflammatory hyperpigmentation (PIH), and scarring from med spas and salons where providers lack expertise in patient assessment, acid strength selection, and post-peel care.^[]

What’s happening in the real world?

As non-medical chemical peels rise in popularity, so do complications. Here’s what physicians are seeing more of:

Burns or delayed healing from improper acid strengths or too much exposure. About 2.3% of patients experience complications like crusting or delayed healing after superficial chemical peels.^[]
Hyperpigmentation (PIH), especially in darker skin tones, when pre-treatment steps get skipped.^[]
Scarring from deeper peels that weren’t done under medical supervision.^[]
Infections or HSV flare-ups from skin damage and poor aftercare.^[]

A lot of patients assume these treatments are safe because they’re done in a “professional” setting. But many estheticians just aren’t trained to handle complications.

Where physicians come in

Physicians are in a unique position to help both prevent and treat these issues. Start by educating your patients. Let them know the difference between superficial, medium, and deep peels and why it’s so important to have medical oversight, especially for people with acne, melasma, or sensitive skin.

Advocate for better regulation, like requiring estheticians to work under a doctor’s supervision for deeper peels. Guide patients toward board-certified dermatologists for their chemical peel treatments. Help combat misinformation on social media that downplays the risks.

And, lastly, treat complications as they come up.

Here's how:

Burns and irritation: Recommend topical steroids and ceramide-based moisturizers. In more severe cases, systemic steroids might be needed.
Hyperpigmentation: Use treatments like hydroquinone or tranexamic acid and make sure they’re following a strict sun protection routine.
Scarring: Once the skin heals, things like silicone-based therapy, fractional lasers, or microneedling can help.
Infections/HSV flare-ups: Prescribe antibiotics for bacterial infections and antivirals for HSV outbreaks.

Bottom Line

Dr. Martin’s reel shines a light on the growing number of patients experiencing serious side effects from non-medical chemical peels. Physicians have a crucial role to play in educating patients, managing complications, and advocating for stronger regulations to keep these treatments safe.