Derm-it Trotter! Don't Swear About Skincare.
Feeling frustrated or overwhelmed with everything skin? Does the skinformation overload make you want to swear about skincare? Join Dr. Shannon C. Trotter, board certified dermatologist, as she talks with fellow dermatologists and colleagues in skincare to help separate fact from fiction and simplify the world of skin. After listening, you won’t swear about skincare anymore!
Derm-it Trotter! Don't Swear About Skincare.
Not Your Mom’s Chemical Peel
Chemical peels have come a long way. Forget the burning and peeling—today’s treatments are gentle, effective, and rooted in cutting-edge science. Board-certified dermatologist and skincare formulator Dr. Jennifer Linder explains how modern peels work with your skin, not against it.
Instead of relying on harsh damage, today’s formulations use optimal acid blends and skin-friendly pH levels to target acne, pigmentation, fine lines, and even cellular aging—without pain or downtime.
“You don’t have to feel the burn to get results,” says Dr. Linder, who emphasizes that comfort no longer means compromise. These new peels are safe for all skin tones, customizable, and effective year-round.
From teen breakouts to stubborn melasma, the right peel can transform your skin—minus the sacrifice. Connect with Dr. Linder on Instagram @JenniferLinderMD to learn more.
Carefully chosen once in a lifetime, intense post-op and care. Vinegar is an acid. Um, you know, apple juice is essentially like a type of acid. It's all about, again, choosing. What matters is the right percentage, the right type, each different kind, and we tend to use fruit acids, some of the most commonly used ones.
Speaker 2:But it's interesting you comment because I think it goes against my own mindset. You know, I'm one of these people like psychologically, like I like feeling that burn is and people are like that's just sick, only used once. But it's interesting you comment because I think it goes against my own mindset. You know, I'm one of these people like psychologically, like I like feeling that burn and people are like that's just sick. I'm like no, there's people like us out there, like we feel like if you're not appreciating, I tell the patients to expect it to be a pretty easy experience.
Speaker 4:Welcome to Dermot Trotter. Don't swear about skincare. We're host Dr Shannon C Trotter. Don't Swear About Skin Care. Where host Dr Shannon C Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.
Speaker 2:Welcome to the Dermot Trotter Don't Swear About Skin Care podcast. I have a special guest on here today, dr Linder. She's a board certified dermatologist and fellowship trained skin cancer surgeon using Mo's micrographic technique. Prior to founding Linder Health, dr Linder founded and served as chief scientific officer for PCA Skin. She has been a medical advisor and trainer for multiple fillers, biostimulators and neurotoxins. She's also published and lectured on a broad spectrum of topics including aesthetics, dermatology, product development and, of course, skincare, and we brought her on the podcast today to talk more about chemical peels. So welcome to the podcast. It's great to have you with us. Thanks for having me, of course. Of course you know chemical peels are things you know. Patients always want to get more information about. You know they're talking. You know to their friends about them. They read about them in a magazine or maybe even gone in to talk to their dermatologist. Can you kind of just explain? You know what exactly is a chemical peel.
Speaker 1:So, in the simplest terms, a chemical peel is a way of harnessing some of your body's natural ability to trigger cell turnover.
Speaker 1:When we're babies, our cells turn over like every two weeks, and then when you go into your 30s, it's about once a month and as you get a little bit older, like myself, in that plus 50 range you're down to like even like as long as every 90 days, sometimes even as many as long as 120 days. So as that cell turnover process slows down, that means the new baby cells aren't rising from the bottom up to the top. So one of the things that a peel can do and this is what we kind of thought it primarily did was actually get those new cells to go from the bottom to the top. And when you do that, you're bringing new young cells to the surface at the same time as doing cell turnover in terms of pigmentation, bringing collagen in elastin, all these different things. But you're also harnessing the wound healing process and we now understand you're doing more things as well, and that's kind of where the science has gotten more interesting in the last couple of years.
Speaker 2:Very cool but also depressing the way you mentioned how this goes down over time and that cell turnover for us is not something that we maintain like we would like to, but good news that we have chemical peels to maybe help with that. Like you said, you know when you think about chemical peels you mentioned this a little bit and kind of like who you know would be maybe a good candidate or what type of skin needs are we addressing with peels. So somebody comes into your office and says, hey, I need a chemical peel. When you're assessing them, what types of things are you thinking a peel may help you with?
Speaker 1:So it really is. Everything from acne is one of my actually favorite things to do it for, so I love having teenagers, young adults, come in. Even those patients come in as often as every two weeks because we're really trying to get the cell turnover open up the pores, get the skin to heal, but the most common situation is just overall skin health, anything that is preventative, that whole anti-aging category. And then the thing that really I think is the real absolute sweet spot of chemical peels is anything related to pigmentation, whether it is pigmentation from sun damage, so, unfortunately, like too much sun. That's one of the things that usually is.
Speaker 1:The first sign of aging is pigmentation, whether or not it's brown spots or something like melasma, which is that we used to say called the mask of pregnancy but really is. It can actually even happen in men, but it tends to have a hormonal component to it, where people end up with kind of brown patches. You can almost take an outline of them on their cheeks or foreheads. Actually can be anywhere on the body. But peels really are the one thing that does better than even peels I mean even better than laser when it comes to lifting hyperpigmentation.
Speaker 2:And that's something a lot of people come in and complain about. You know, the hyperpigmentation like you mentioned, sun damage or, you know, maybe genetic factors play a role for that too, and very frustrated too, especially the lack of response, you know, with using a topical cream that they may have exhausted for months and not seeing much of any result. But when you think of then, of somebody coming in for a peel, are there certain patients that you would look at or skin types that it's, you know, more difficult to do a peel on, or just need to know the right way to peel their skin, because everyone gets a little cautious. You know I've had somebody had a peel. They turned out they got more dark marks or they got too light of marks on their skin. How do you handle that for a patient that's coming in and asking about a peel in their skin type?
Speaker 1:Well, it really does come down to, of course, educating yourself as a physician or caregiver and the patient themselves, because peels are as broad as saying laser. Right, you can have something that is designed to be basically peel all the skin off laser, almost like a full ablative laser, resurfacing where it is taking deep, etched in lines out. Now, those patients you want what we call a fit to tactic one to three, which are paler patients like you and me. You've had a lot of sun damage, a lot of etched in lines, carefully chosen. Once in a lifetime, intense post-op and care. Once in a lifetime, intense post-op and care. That's one far spectrum.
Speaker 1:The other, spectrum is literally can be done in everybody, whether or not you are type one and have red hair and freckles, or you have deep, dark ebony, melanated skin, and can be used on anybody in that spectrum. What matters is the right peel is chosen for the right patient, just like we do anything in medicine. It's understanding that choice that makes all the difference.
Speaker 2:And I think it's good for patients to understand that, because a lot of people sitting out there like well, I know my friend, she got this peel and it worked fantastic for her. I went and did it and it didn't really accomplish anything I was looking for. So I really like how you highlight it's really individual to the patient, based on their needs, potentially also skin type and what might be appropriate. So I think people kind of just assume a chemical peel is a chemical peel, right, and we know as dermatologists you can really cater to the patient and what you're trying to accomplish. So now that we're kind of diving into that a little bit more on the chemical peel level, do you mind going over and I know there's a lot to this question just some basics of the different types of chemical peels that are out there?
Speaker 1:I'd be more than happy to. So one of the peels I've mentioned was the deeper peels. Those are the things that tend to have like phenol or TCA in them and basically a chemical peel is what is the one consistency across all the different kinds are acids, and acid can sound scary it's a word that can sound a little bit daunting, but don't forget that. You know vinegar is an acid. You know apple juice is essentially like a type of acid. It's all about, again, choosing. What matters is the right percentage, the right type, each different kind, and we tend to use fruit acids, some of the most commonly used ones. Different things have different capabilities. I like to say it's much like cooking. You can take the same ingredients. You know, eggs, butter, salt, flour, sugar, and you can make a million different types of baked goods. It's all about how it's put together, how you actually cook with it. Right To make different delicious things. And peels are like that too, and that's sort of where I get is my like personal sweet spot is thinking about the product development side. How do I take different ingredients, and I personally love to do blends of ingredients. Those are actually the type of peels I recommend.
Speaker 1:The things I'm going to be talking that I think are the most useful in general are what we used to define as being superficial chemical peels. I don't want people to think that means it's not doing much. Matter of fact, I think they do a lot. We tend to do those more in series, even though you can see a great result in just one treatment rather than having. But series are often. What is the way you get your sort of best case scenario Versus if you're doing like a medium or a deep chemical peel, that tends to be a one time, maybe even just one time in your lifetime kind of thing, and that's you know, that's when you're really taking out the top layers of the skin. So let's just decide we're going to talk about more of that kind of what we refer to as superficial cochemical peels, because those are the things that in general are best for everybody and can do treat the widest swath of, whether or not it's anti-aging or different disease processes.
Speaker 1:So in general, most things tend to be fruit acids and those fruit acids some of the ones that sort of became really known during the 90s were glycolic acid. You might have heard about that Sometimes you'll see it in washes even, and the higher the percentage. Often with those, the lower the pH is, and the lower the pH often means it goes deeper and might sting more. So with those situations the glycolic acid molecule is a sugar molecule and it's really small, but that means it goes quite deep quickly. It's the reason why glycolic acid tends to tingle and burn and kind of feel funny. Now, during the 90s, this was the first one we started using, but now we understand that glycolic acid can actually be quite dehydrating. So I like to say that if there's one thing people take away from my entire talk, please remember glycolic acid should only be used for oily or acne prone patients, whether or not it is in a cleanser or if it's in a peel. Just remember that. Glycolic acid, the science from the nineties, we've been able to improve it and please just save it for that situation.
Speaker 1:Now, on the opposite end of the spectrum, is something called lactic acid, and lactic acid is a molecule that is what we call the natural moisturizing factor of the cell, which is almost you can think about it like the sponge inside the cell that holds onto water. So that is an ingredient where you actually, by choosing that type of acid, is actually going to hydrate the skin from the inside, so the opposite of glycolic acid. So one is dehydrating and drying the skin and works on oily prone skin and lactic acid is hydrating. So I love to use lactic acid anytime I'm dealing with somebody with more mature skin, or basically most of us actually want to have our skin be in a healthy place, and lactic acid anytime I'm dealing with somebody with more mature skin or basically most of us actually want to have our skin be in a healthy place, and lactic acid is a great reason for doing that.
Speaker 1:Then the next thing you think about in terms of choosing ingredients is what else am I wanting to do? And if I'm wanting to think about acne or I might want to be thinking about, what qualities do I want a peel to have? We often have found now that patients don't want the downtime of the skin sheeting off and being like a snake. So if you can get the skin to come off in tiny little bits same amount comes off, but it can come off like dandruff instead then most people like the experience better. So to do that, you actually choose an acid that has what's called an aromatic ring and it just sort of chops up the desmosomes in a different way, those little things that glue the skin cells to each other.
Speaker 1:And to do that you do one of two things.
Speaker 1:You either do salicylic acid, which is one of the main ingredients in aspirin, so it's also non-inflammatory.
Speaker 1:Or you choose an ingredient like mandellic acid, which is one of the main ingredients in aspirin, so it's also non-inflammatory. Or you choose an ingredient like mandelic acid, which also has the same aromatic ring, also works great on acne, because it's going to go. It has a lipophilic quality, so it's drawn to oil and so it can get inside clogged pores. And so, for everybody, salicylic acid and medallic acid will open up the pores, make the skin look more glowy, be anti-inflammatory and, as a just lifestyle thing, it chops up the little peel flakes in tiny little bits. So those are. By thinking about all these different ingredients, you can combine them together so that you can have a less acidic, so essentially a higher pH, closer to skin's natural pH. Capture what the ingredients are doing without being inflammatory, and get the cell turnover, get the working on the acne component, the lipophilic component, as well, as there's all these kind of sexy new things we can talk about down the line that are anti-aging in turn to senescent cells and also going after mitochondrial health.
Speaker 1:There's just all these new things that peels can do. So that was a very long-winded answer. I think I might've even forgotten what the question was as I was talking, but to simply say that peels can kind of do everything for the skin, as long as you understand what the ingredients are and what the goal is. And then that's where the skincare specialists or the dermatologist decides okay, this is the one that I think will work best for you, based on what's going on for you, and that's where I love the consultation. Right, I think that's what makes us special as doctors is we look somebody in the eye, look at their skin and go okay, today this is the thing to do, and you know what, in two weeks, when you come back, there might be even something different that I want to do. Also, don't underestimate what just one treatment can do, but if someone is really wanting to go after something like melasma, which is that more difficult to treat pigment often, then we're thinking about more of a series.
Speaker 2:So kind of jumping off of what you said throughout there. So it sounds like it's possible maybe to have your cake and eat it too. From the standpoint, you don't necessarily need a ton of irritation to get results from peels, is that right?
Speaker 1:That is spot on and that is really where the science has changed. So, you know, I've been formulating with chemical peels for 25 years. I, you know, I founded one company, sold that. Let it grow off and become its own. It's like having a kid go off to college you realize they're going to make mistakes, they're going to have their own successes.
Speaker 1:But then during COVID I got super obsessed with what was going on in the longevity space and really understanding like, oh my gosh, if we can think about mitochondrial health, if we can control inflammation, if we can think about senescence, then we can do a better job. And by thinking about okay, we don't have to do the most aggressive amount of wound healing to see a response. We can actually get better wound healing by controlling inflammation. So that led to thinking about okay, let's get the pH closer to the natural skin pH, use lower percentages of ingredients and then combine things together to get the best result and by doing that you can actually have non-inflammatory chemical peels. Which is a completely different way of thinking about it in the last, let's say, five years compared to what we were doing for the last 30 years, because really the science hadn't really changed that much in the last 30 years, and before that it had been 75 years or 100 years since changes happened.
Speaker 1:And cool things is peels have really been around since at least Cleopatra's time. She kept a herd of doggies because she was doing using lactic acid milk baths to keep her skin looking fresh. She'd take a bath every day and sour milk so like the girl knew what was going on.
Speaker 2:Yeah, there may be somebody out there that's going to try that now. Just so you know. You know what?
Speaker 1:If they're up for keeping a herd of donkeys, go for it.
Speaker 2:Have at it right. Well, it's interesting you comment on it because I think it goes against my own mindset. You know, I'm one of these people like psychologically, like I like feeling that burn and people are like that's just sick. I'm like, no, there's people like us out there, like we feel like if you're not appreciating that sensation or maybe seeing those big sheets come off at once, we're sitting there wondering, hmm, is this people doing anything? And I think it's just important to highlight that because it's going against that mantra. I think it's just important to highlight that because it's going against that mantra.
Speaker 2:I think of how some of us were trained, or just psychologically I'm that person. It doesn't bother me. In fact, I think psychologically it convinces me something's happening. So I think there's going to be some people that will have to convince that you can have both the best of both worlds. It's just like you know I love cleansers, that lather. If I don't appreciate a lather, it doesn't feel clean to me, where a gel cleanser for some people they love that. You know they don't care if it lathers. So I think in dermatology for you know, people going in to see their dermatologist the fact they can get the best of both worlds is really going to be a game changer for patients in the concept of a chemical peel, because that scares a lot of people off. You've probably met some patients once traditionally things we used to offer and thinking they're going to go through that discomfort. Thinking they're going to go through that discomfort, they're like feel not for me, but this opens a whole new world for those patients for sure.
Speaker 1:Yeah, it's like you know, it's like that. It's a whole new world. You know the whole, like Disney song. It really is a game changer, because I think you are probably almost normative, Like in terms of I think we've been telling patients for so long that if it's hurt, it's doing something.
Speaker 4:You've got to feel the burn right.
Speaker 1:It's like exercise. But we also know like with exercise you do too much, you actually hurt yourself. And it's potentially the same thing that actually by understanding the chemistry and I think this has been the big thing is like actually thinking about the chemistry rather than just thinking about okay, what result am I trying to get to. It allows us to actually take advantage of science and do it better.
Speaker 1:And so we can do it. And I, you know, I've always used this idea of when you're treating a patient, tell them on a scale of zero to 10, you know zero being nothing and 10 being super uncomfortable where are they? And then, as long as you could get to a, you know you'd say like, oh, as long as there are five or lower, you could do another layer. And the nice thing about this is because I mean most of the time, the first time you treat somebody, they might be like a one or two, that's all they're feeling, versus like these peels I've been doing for my entire lifetime was like, oh, okay, there's a little fire to start. Like, just like, hold on through the pain, you're using fans and everything else on them and that's just not necessary anymore. And so you really do have to and then convince somebody like, oh, no, this actually works, it feels great. And then I think all they have to do is see the results the first time and you have somebody bought in.
Speaker 1:And it has such advantages because it means that, like an acne patient let's be honest, teenagers they are not coming back to see you again if it hurts, like they, just they are not going to do it. So now I can get these kids to come in regularly, and they are, and they are asking their mom to come back. But the other thing by not having inflammation and not having it hurt is with this new generation of chemical peels and I like to call them basically the next generation and burn and you would not tolerate it versus with these, I can do it the same day as the appointment. Just moments later I do it myself, even because I can do it so quickly. And then their experience is. The last thing I've done with them is beautiful hands on them and they're walking out with a glowing, beautiful skin rather than being like, oh my gosh, this woman stuck needles in my face.
Speaker 1:It's worth it, but, gosh, it hurt. Instead it's like oh no, I look fantastic and I can do it in concert with IPL, intense pulse light. I can do it with the non-ablative lasers or even microneedling, as long as it's just pinpoint, because it doesn't hurt and because it's non-inflammatory. So I can get more out of procedures that myself or my staff have been doing for a long time and can get an even better result. So it's added this flexibility that allows my patients to get to an endpoint faster, and it's also expanded the armamentarium of my staff so that they can accomplish more as well.
Speaker 2:So if somebody comes in then and they're wondering, okay, I'm ready to appeal, do you warn them then that there will be some discomfort depending upon the type of appeal or just variable based on pain response, or do you really reassure them that this could potentially be painless for you and still get the good result?
Speaker 1:I tell most of my patients because primarily the peels I'm doing in my office now are these peels that I formulated, unless I'm specifically going after doing like a phenol-based peel or doing a deeper TCA peel, which is a totally different thought process, right? So I tell my patients to expect limited discomfort. Maybe it's like a little tingling kind of, almost like that little itching sensation, more so than anything else, and I have an exceptionally low pain threshold. I mean exceptionally low.
Speaker 1:Like Botox needles make me, just I have to. Really I put numbing on myself for all Botox, just just to give you an idea of how bad I am and this does not bother me and the least versus.
Speaker 3:I used to really have to like fan and everything else when I was doing even superficial chemical meals before, so I tell the patients to expect it to be a pretty easy experience.
Speaker 1:And that just makes it. I think then they're just like, oh my gosh, all of a sudden it becomes more like the experience of getting a facial. It's actually something they look forward to and can relax, because I do think one of the things that makes this great at what we do is that hands-on piece, the fact because I do believe that hands-on looking somebody in the eye, listening to them, communicating with them is a big piece of the healing component, and I think the more we can do to have it be a better experience with them, with a hands-on experience, it lets them feel better about themselves, increases that level of trust, gives them hope. That I then do think has a huge factor in the skin actually getting better and actually healing, and so I think it allows for more of that, and I think that's one of the things that is my favorite component of doing these peels.
Speaker 2:Well, you can definitely feel and see the passion that you have for chemical peels and you kind of alluded to this earlier. But tell me a little bit more about your chemical peels you developed and what makes them unique.
Speaker 1:So the number one factor, so the I mean it's kind of one of those things where I was during COVID, instead of baking bread, started playing with chemistry and many of my old friends that were with my old company and some of my scientists and chemists and everything. This is what we do. Is we? You know, we're all geeks, right? This reason why we went into dermatology et cetera is that you know, pubmed is what we read for fun, and it came out that peels can have benefit on senescent cells, actually can be a senolytic that can actually help with mitochondrial support, as well as all the traditional things that we know about peels in terms of collagen, elastin, all these different things. So by the number one thing that's different about the Linder Health peels and my favorite one is called Hero is that it is anti, it's a non-inflammatory peel. That is the number one takeaway from this whole thing is that it gives that flexibility to be able to do it in concert with other things to be able to work on pigment anti-aging, actually get the skin healthier overall after multiple factors of what we call the 12 hallmarks of aging. And then the other thing is because of the fact that you don't have to prep for them and you don't have to limit patients from what they're doing. They can actually, with sunscreen on, go out into the environment, go to their kids' soccer game, basketball game. They can even be outside where it's hot.
Speaker 1:It used to be that with peels, we'd have to limit them to the colder months because you didn't want people in the sun and you didn't want them to get hot.
Speaker 1:But with this peel, because it's non-inflammatory, you can actually do it year-round. And what that means for myself and my staff means that we can actually assume that when somebody is coming in, that we can do a peel the same day. So that means consult and treatment automatically can happen without having to change somebody's routine, and it just makes that whole process simpler. So I think that's one of the biggest differences is that I really wanted to think about okay, what are the pain points for both the patient and the clinician?
Speaker 1:You know we all want to keep challenging ourselves in the spaces we love, and so that is what it kind of came down to is like okay, can we make it non-inflammatory? Can we make it work better for longevity? How do we make it simpler? And then the other thing that makes me crazy is is when something is expensive to the practice, literally to the practice. These peels are not expensive, which means they're not, they don't have to be expensive to the patient as a result. It just makes the whole process better across the board, because all of us have the same goal, which is get patients healthier.
Speaker 2:Wow, I mean, I think today's conversation is really going to open our listeners' eyes to the fact that a chemical peel might be something they can consider For those scared about the pain factor you've helped re reeducate that's not necessarily the case and the fact that you know they're versatile right, they can accomplish a lot of goals that sometimes I think we kind of go, oh, chemical peels, and they kind of get put further down this totem pole of how well they truly can work for things that we want to actually treat in the skin. But you really illustrate that they can be impactful and, like I mentioned before, you can have your cake and eat it to get the results without the pain. So thank you so much, jennifer, for coming on today. This is a fantastic conversation for our listeners. If they want to find you, do you mind sharing where they can locate you? Sure?
Speaker 1:You can find me at at Jennifer Linder, l I, n, d, e, r M D that and. Or you can find the uh, myself and my company, and obviously I do lots of things with that at at Linder Health. So well, thank you again. Please DM me ask questions.
Speaker 2:Yes, such a great time, and I know there's many people out there looking to get a chemical peel now and probably specifically asking for yours. So thanks again for kind of teaching us more about chemical peels and stay tuned for the next episode of Dermot Trotter. Don't Swear About Skin Care.
Speaker 4:Thanks for listening to Dermot Trotter. For more about skincare, visit DermotTrottercom. Don't forget to subscribe, leave a review and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.
