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We can provide cover for chemical peels within your medical malpractice insurance policy.
If you are looking for insurance to cover chemical peels, please contact the team on 0800 6343881 or email cosmeticsales@hamiltonfraser.co.uk.
Who Hamilton Fraser covers for chemical peels varies dependent on the type of chemical peel.
For all chemical peels excluding phenol lip and eye, jet peel and biorevitalisation peels, Hamilton Fraser will cover doctors, nurses, dentists, therapists, dental hygienists, beauticians (NVQ level three), podiatrists, dental nurses, pharmacists, paramedics, operating department practitioners and physiotherapists.
For Easy Phen light chemical peels, Hamilton Fraser covers doctors only.
For cosmo peel (any peel with Phenol up to ten per cent), perfect peel and VI peel, Hamilton Fraser covers doctors, dentists and nurses only.
A chemical peel for the face is a treatment in which a chemical solution is applied to the skin to remove damaged skin cells, reduce wrinkles, and correct scars and sunspot discolourations. Chemical peels can be performed alone or combined with other cosmetic procedures.
Chemical peels contain different types of acids that can be performed at varying depths, from light to deep. There are many options depending on the patient’s needs and how sensitive their skin is.
There are three types of peels: light, medium and deep. Alpha hydroxy acid (AHA) and beta hydroxy acid (BHA) peels are classified as light chemical peels, whereas trichloroacetic acid (TCA) peels are defined as medium depth peels, and carbolic acid (Phenol) peels are labelled as a deep peel.
● Light chemical peel – a light (superficial) chemical peel removes the outer layer of skin (epidermis). It is used to treat fine wrinkles, uneven skin tone, dryness and acne. It is usually recommended for patients to have a light peel every two to five weeks
● Medium chemical peel – a medium chemical peel removes skin cells from the epidermis and from portions of the upper part of the patient’s middle layer of skin (dermis). It is used to treat wrinkles, acne scars and uneven skin tone. Patients may need to repeat the procedure to achieve or maintain the desired result
● Deep chemical peel – a deep chemical peel removes skin cells even deeper and may be used for deeper wrinkles, scars or pre-cancerous growths. The patient will not need repeat procedures to get the full effect
A chemical peel is a facial resurfacing technique that uses a chemical solution which removes the skin’s damaged outer layers to result in a smoother, more rejuvenated appearance. It involves the application of toxic chemical solutions including AHA, BHA, TCA and Phenol to the skin in a controlled manner, producing controlled tissue death and resulting in a superficial wound. As the tissue damage is repaired by the natural healing process, the skin’s appearance is improved.
Chemical peels can help skin conditions such as:
● Fine lines under the eyes or around the mouth
● Wrinkles caused by sun damage, ageing and hereditary factors
● Certain types of acne and acne scarring
● Sun spots, age spots, liver spots and freckles
● Uneven skin colouring
● Pre-cancerous scaly spots (actinic keratosis)
● Rough skin and scaly patches
● Dull complexion
● Mild scarring
● Dark patches (melasma)
Chemical peels are generally suitable procedures for patients with all types of skin colours and textures, although patients with lighter skin colours tend to have the best results. There are many benefits of chemical peels for patients with skin concerns such as wrinkles, dullness, hyperpigmentation, acne and scarring.
Generally, superficial peels can be used on all skin types. However, patients with darker skin tones have a greater risk of experiencing a darkening of the skin post-treatment – a condition known as post-inflammatory hyperpigmentation. If patients have a naturally darker skin tone, it is worth discussing other less aggressive treatments to reduce the risk of hyperpigmentation.
Patients with sags, bulges, deep scars and severe wrinkles may be better suited to other treatments such as laser resurfacing, a face lift, brow lift, eye lift or dermal filler.
Chemical peeling may also not be recommended for patients who:
● Have a history of abnormal skin scarring
● Have extra colouring in their scars
● Have skin conditions or take medications that make their skin more sensitive
● Are unable to stay out of the sun during the healing period
The results of a chemical peel depend on the type of peel used for treatment. Light peels typically last around one to two months but with regular top ups, up to six months. Medium peels can last for two to four months, and up to six months after repeated treatments. Deep peels can last decades at a time and sometimes even a lifetime, however, the recovery time is much longer than light and medium peels.
Following a patient consultation , a chemical peel treatment will begin with the practitioner cleansing the patient’s skin to remove excess oils and any make-up. A chemical solution such as AHA, BHA, TCA or Phenol is then applied to the patient’s skin. The chemicals cause a controlled injury, penetrating through to a different skin depth, then peeling away to reveal a new layer of skin. The application method may be different depending on the chosen chemical.
Liquid solutions may be applied using a brush, cotton tip applicator or gauze swab. For gels, a wooden or plastic spatula is usually used. The peeling agent is initially applied to areas with more skin, such as the cheeks, forehead, nose and chin. It is then spread to the other areas of the face using firm, even strokes in the same direction. How long does a chemical peel take? Most treatments take around 30 to 60 minutes, depending on the depth of the peel.
The patient may feel a warm to hot sensation that will last a few minutes, followed by a stinging sensation. To relieve the sting, a cool compress may be applied to the patient’s skin. The chemical is then washed off and/or neutralised.
A chemical peel can cause various side effects – milder peels have more temporary side effects, whereas the side effects from deeper peels last longer. Common side effects include:
● Peeling of the skin
● Stinging / burning sensation
● Redness (lasting a couple of weeks for medium peels and three to four months for deep chemical peels)
● Skin crusting
● Skin irritation
● Flaking and peeling
● Changes in skin colour (hyperpigmentation)
The recovery time from a chemical peel varies depending on the depth of the peel:
● Light peels – treated areas take about one to seven days to heal after a light chemical peel. New skin might temporarily be lighter or darker than normal and patients are advised to stay out of the sun for 24 hours. Patients can return to day-to-day activities straight away and can usually wear makeup the next day
● Medium peels – patients are likely to experience redness and swelling following a medium peel, with the recovery time between seven to 14 days, however redness may last for months. Patients should use ice packs and ibuprofen or paracetamol to ease any discomfort
● Deep peels – patients will experience severe swelling and redness, along with stinging and throbbing sensations. The practitioner will apply a surgical dressing to treated skin and they may prescribe painkillers. The patient will need to soak the treated skin and apply ointment several times a day for about two weeks. Treated areas will develop new skin within about two weeks after a deep chemical peel, however redness might last for months. Once new skin completely covers the treated area, after about two weeks patients are able to apply make-up. They should wear high SPF sunscreen every day
There are dozens of training courses available from numerous providers offering training in chemical peels, from foundation level training to advanced. The foundation level is the standard training course required to treat milder skin concerns or address appearance improvements including anti-ageing. The advanced level covers chemical peels for more severe skin conditions and is more suitable for experienced practitioners who have a greater understanding of skin anatomy and therefore require a medical background. Our guide to training in aesthetics contains more information on how to get the most out of training and the importance of making sure it meets the eligibility criteria required for the purposes of insurance.
As outlined above in the section, ‘Who does Hamilton Fraser cover for chemical peels?’, depending on the type, strength, and PH content of the chemical peel, the treatment may only be performed by an authorised healthcare professional. Superficial peels can generally be performed by a licensed aesthetician or beauty therapist, whereas deeper peels require a licensed medical professional.
If practitioners are performing chemical peels for acne on patients aged 11-14, this will carry an increased excess of £1,500.00.
As with any treatment, all known side effects must be explained to the patient in the consultation and the patient must sign a consent form which outlines that they understand the risks, prior to the procedure.
An example of a claim scenario we’ve received involving a chemical peel is that a patient has visited a practitioner for a peel, with the aim to brighten up the skin and reduce some minor acne scarring. The consultation and consent have taken place in line with best practice, and following this the agreed course of action has been to apply a light peel, as this would be sufficient to achieve the desired results. A few days after the consultation, the treatment was carried out as planned. Following the treatment, the patient suffered extreme redness and soreness to the skin, so a review took place, and it transpired that the wrong peel had been used. Rather than the light peel that had been agreed, a deep peel, which penetrates the lower part of the skin (the dermis) had been used and this had caused a burn to the skin. In this situation, the practitioner was held liable for the injury as the wrong peel was used and the consultation notes were not referred to properly during the procedure. The insurers picked up the claim, as the practitioner was negligent, paying the damages, which were awarded to the patient along with the associated fees.
In another example the patient again had a thorough consultation and signed consent for a peel to remove acne scars. The treatment went well and the patient was given written aftercare advice to take away, on top of the aftercare guidance that had been discussed verbally in the consultation. Three weeks after the procedure, the patient complained to the practitioner that they had pigmentation on their face. In the review, the patient was casually talking about how amazing their holiday had been and it transpired that the patient had not followed the aftercare advice. During their holiday they had exposed their skin to direct sunlight, sunbathing on the beach. The insurers could defend this matter as the patient had been warned of the risks and given both verbal and written aftercare advice, which was also noted on the patient file. This evidence meant that the patient could not make a negligence claim against the practitioner.
Claims top tip: Explaining the expected results and risks is just as important as the treatment itself. Take time to make sure the patient is aware of the pros and cons of the treatment and has fully understood any potential side effects and aftercare required. Remember, you can always refuse to treat a patient if you feel they are not suitable, as long as you explain the reason behind the refusal. Our guide on patient selection contains more information on this important topic.
