When it comes to skincare treatments, it often seems like it is always about what is new and trendy. However one of the most popular chemical peel treatments, the Jessner’s peel, has actually been around for over 100 years. This combination peel was available in different concentrations until the dermatologist Max Jessner set a standard formulation. The original formulation included salicylic acid, resorcinol, and lactic acid in alcohol. It has since been modified into numerous formulations and strengths while maintaining the same basic trifecta of salicylic/lactic/and a third ingredient.
What Can a Jessner’s Peel Do?
A Jessner’s peel may be used to treat the following skin conditions:
- Actinic Keratoses
- Post-Inflammatory Hyperpigmentation
Jessner’s has been shown to achieve a greater than 70% reduction in Melasma Area Severity Index (MASI) scores in women with Fitzpatrick skin types III and IV. It can significantly improve sun damaged skin and reduce acne. Jessner’s peel is known to improve the effects of TCA peels and the two are often applied together. The practitioner will apply Jessner’s peel in one or two layers (superficial peel) followed by the TCA peel.
Original Jessner’s Peel Ingredients
The Jessner’s peel is considered a medium-strength peel and includes three effective ingredients. The basic principle of the Jessner’s peel is that it removes the top layer of damaged skin to allow a new, undamaged layer of skin to grow. The combination of ingredients works to efficiently peel away dead skin and increase skin cell turnover.
Salicylic Acid: Salicylic acid is a beta-hydroxy acid that removes intracellular lipids which are covalently linked to the cornified envelope surround epithelial cells. In addition it helps enhance the penetration of other ingredients and has an antiseptic effect.
Resorcinol: Resorcinol is similar to phenol and disrupts the hydrogen bonds of keratin. It also has an antibacterial effect.
Lactic Acid: Lactic acid is an alpha-hydroxy acid that causes corneocyte detachment and subsequent detachment of the stratum corneum. It also helps maintain moisture in the deeper layers of the skin.
If you are a patient and not quite sure what some of this means, that’s OK! What is important to know is that the ingredients work together to shed the top layer of skin and promote the growth of new skin cells. The peel can help reduce the appearance of age spots, fine lines, scarring, acne, and more.
Dermatologists and pharmacists have offered modifications to the original Jessner’s formulation. Sometimes these modifications are because an ingredient is not available. Other times it is based on preferences or what the provider thinks will work best for a patient. Resorcinol availability has become more limited and there are some concerns it may result in allergic contact dermatitis, irritant contact dermatitis and skin discoloration. Woodland Hills Pharmacy makes Jessner’s solution with citric acid replacing resorcinol.
Citric acid, which is used in many skincare products, works by exfoliating the top layer of skin and sloughing off dead skin cells. Additionally like the other ingredients in Jessner’s it increases cell turnover, which promotes new skin growth that can help reduce the appearance of age spots and fine lines. Citric acid is an alpha hydroxy acid – which is the same class of acids as glycolic acid and lactic acid.
Common Formulation for Jessner’s (Modified): Salicylic Acid 17%, Lactic Acid 17%, Citric Acid 8%
Compounding the Jessner’s Peel
With the services of a compounding pharmacy, dermatologists are able to have the Jessner’s peel solution custom-made with the exact percentage of ingredients required. Compounding this solution in the office may be against regulations, which is one reason not to do it. A compounding pharmacy has the equipment, knowledge, and resources needed to make the solution with precision to maintain efficacy and safety of the formulation.
Application of a Chemical Peel
The Jessner’s peel should be applied by a practitioner with the proper training in applying peels to the skin. Medium-strength chemical peels are relatively safe but in untrained hands they can result in serious adverse effects. Even though there are stronger peels than the Jessner’s peel, it is still a medical-grade treatment that uses prescription-strength ingredients.
The strength of a chemical peel is determined by the concentration of the ingredients, the length of time the peel is left on, and the number of layers that are applied. A Jessner’s peel can be made more superficial (affecting only top layers of the epidermis) by applying fewer layers, and stronger by applying more layers. Most chemical peels are applied in layers with neutralizing solutions applied in between each layer.
Careful instructions regarding preparation and post-treatment care must be followed. The preparation period can be as long as two weeks and involve applying certain products to the skin and avoiding others that may increase irritation. After a chemical peel, the skin will be red and raw. There may be swelling, burning, and stinging that continue after the treatment. There will be a few days of peeling skin (similar to a sunburn) followed by a reduction in redness and an improvement in the skin’s appearance over the next two weeks.
Complications and Side Effects
People with darker skin tones should always consult their dermatologist about the correct peel for their skin type. Using a chemical peel the wrong way on darker skin can result in pigmentation changes that are semi-permanent or permanent. Those with sensitive skin should also proceed with caution when considering a chemical peel. Chemical peels will always result in redness and swelling afterwards, however severe pain, swelling, and burning that does not subside should always be reported to your dermatologist.
A Comparison of the Efficacy and Safety of Jessner’s Solution and 35% Trichloroacetic Acid vs 5% Fluorouracil in the Treatment of Widespread Facial Actinic Keratoses – JAMA
Comparative study of effects by glycolic acid peeling and Jessner’s solution peeling on facial sebum secretion in patients with facial acne – SNU Medicine
Q‐switched Nd: YAG laser alone or with modified Jessner chemical peeling for treatment of mixed melasma in dark skin types: A comparative clinical, histopathological, and immunohistochemical study – Journal of Cosmetic Dermatology
Microneedling (Dermapen) and Jessner’s solution peeling in treatment of atrophic acne scars: a comparative randomized clinical study – Journal of Cosmetic and Laser Therapy