Aesthetic therapist and founder of Black Skin Directory Dija Ayodele explains the key considerations when performing peels on people of colour

Black Skin Directory Dija Ayodele

Chemical peels are among the most effective and efficient ways to maintain skin health for darker tones, but require a slightly different approach than with light skins. Developing the expertise to successfully and safely treat clients with skin categorised as IV – VI on the Fitzpatrick Scale (IV is defined as skin that rarely burns and always tans, and V and VI as never burns, always tans) will broaden your clientele and reputation as a skin specialist. Here are the six key things to remember when treating these skin types with peels.

1 Question around the risk of scarring

Darker skin is more prone to post-inflammatory keloid scarring, which is a contraindication for many treatments that cause trauma to the skin in order to influence regeneration and remodelling of collagen. Look at any facial piercings – is there a raised, shiny scar there? Look at the hands, where we often have cuts and nicks – is there any raised, fleshy scarring? If so, ask how it happened and how long it took for the scar to heal.

2 Ask about sunscreen use

Regardless of skin type, daily sun protection is vital, and even more so when undertaking a course of peels. The use of sun protection must be stressed to the client before treatment and, if necessary, retailed. This is vital, even if the client has very dark skin and thinks they don’t need to use it. A non-compliant client should not be treated with peels.

3 Find out if they wear a wig

If so, have they ever noticed any irritation to their skin after wearing it? Wigs have increased in popularity over the last few years, particularly among women of colour, and some are treated during the manufacturing process with dyes and washes that can cause irritation. This can indicate skin sensitivity that needs to be taken into account when considering a peel, as left unchecked it could lead to inflammation.

4 Start with a superficial peel

In my experience, this is the best route for Fitzpatrick IV – VI. Alpha and beta hydroxy acids such as glycolic, lactic, salicylic, mandelic or citric acids give good results either in a pure or blended formulation. Clients can have these superficial peels as part of monthly facial treatments to address hyperpigmentation, oil control, pore size, moisture balance, fine lines, radiance and dry, scaly skin.

I use lower percentage, high pH formulations until I’m sure the client can tolerate more. Following that, I can look at higher percentages and layering techniques for more efficient peeling. In addition, modifying the length of time the peeling agent is left on the skin is also helpful.

5 Prime skin for at least four weeks

This repairs the acid mantle before peeling, increases the effectiveness of the peel and avoids any complications. This is very important to avoid causing excess trauma to the skin and post-inflammatory hyperpigmentation.

6 Adjust your timings carefully

Often Fitzpatrick IV – VI skins don’t develop erythema during the peel, so it’s important to keep talking to your client throughout to understand the sensations they may be experiencing. Unless you’re working with a self-neutralising peel, using a “sensation scale” of one to ten is an effective gauge alongside your timer.

Explain to the client that one means “no sensation” and ten indicates “extremely uncomfortable”. This will help you judge a good halfway point to neutralise the peel. Generally, peels must be left on darker skin tones for a shorter amount of time than lighter. If left on the skin for too long and allowed to penetrate too deeply, you create the potential to affect melanin synthesis and distribution. PB