Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
Every peel is the same idea at different strengths: an acid is applied, left for a controlled time, and removed or allowed to self-neutralise. It dissolves the bonds holding dead surface cells together and, at greater depth, injures the living layer beneath enough to provoke repair. The skin that replaces it is more even in colour, smoother, and slightly thicker.
The important variable is depth, and it is what separates a treatment you can have at lunchtime from one that costs you a visible week. A light peel works within the dead surface layer: mild flaking, no real downtime, repeated every three to four weeks for a cumulative result. A medium peel reaches into the living layer: five to seven days of genuine peeling in sheets, and a change in pigment and texture that a course of light peels would take a year to approach.
It is also the treatment where preparation matters most, particularly on skin with more pigment. Skin that has been primed for four to six weeks with the right topical agents peels more evenly and is dramatically less likely to respond by producing patchy darkening afterwards. Anybody offering you a medium peel on unprepared skin at a first appointment is skipping the step that makes it safe, and on richer skin tones that step is not optional here.
Light and medium, side by side
Two treatments with one name, different in almost every respect that matters to you.
Light peel
Works within the surface layer. Mild stinging for a few minutes, pinkness for a few hours, and light flaking for two or three days that most people can conceal. Repeated every three to four weeks, six of them produce a clear improvement in brightness, texture and mild pigment. This is where almost everybody starts.
Medium peel
Reaches the living layer. Significant stinging during application, a tight bronzed look for two days, then five to seven days of peeling in sheets. One session achieves what a long course of light peels would, on pigment, sun damage, fine lines and texture. It requires a clear week and a commitment to staying out of the sun.
Which you should have
Almost everybody should start light, whatever they came in asking for. Skin needs to demonstrate how it behaves before anybody goes deeper, and the information from three light peels is what makes a medium peel safe. Thandiwe declines requests to start at medium regularly and she is right to.
What neither does
Neither lifts anything, fills anything or removes a deep scar. Peels change the quality and colour of the skin surface. Depth of scarring and loss of volume need microneedling, resurfacing or injectables, and we will say so rather than sell a course that cannot reach the problem.
Preparation, and why it is not optional on deeper skin
This is the part clinics skip and the part that prevents the commonest bad outcome.
Four to six weeks of priming
A vitamin A derivative and, where appropriate, a pigment-suppressing agent, used nightly before a medium peel. Primed skin sheds more evenly, heals faster and is far less likely to respond by over-producing pigment. It is the difference between a good result and a patchy one.
Why richer skin needs it more
Skin with more pigment responds to injury by making more pigment — that is what it is good at. Without preparation and without careful depth control, a peel can leave darker patches that last months. This is entirely manageable and it is managed by preparing properly rather than by declining to treat, which is what some clinics do instead.
No sun, before or after
Four weeks off strong sun beforehand and rigorous protection for months afterwards. This is the reason peels are booked between October and March here, and the reason we will move an appointment for somebody who has just come back from a holiday.
Cold sore cover
Anybody who gets cold sores will very likely get one after a medium peel. Antiviral cover starts before the treatment as routine. Tell us even if it has been years.
Risks and reasons we decline
Low for light peels, real for medium ones, and almost all of them are about depth and about sun.
Post-inflammatory pigment change
The commonest complication: darker patches appearing a few weeks after treatment. More likely on richer skin, on unprepared skin, and after any sun exposure. Usually resolves across months with pigment-suppressing treatment and absolute sun protection, and much better prevented than treated.
Uneven peeling
Areas that shed at different rates, which looks alarming and settles. Not picking is the entire management. Pulling a sheet of peeling skin that is not ready is how somebody creates a mark that outlasts the treatment by six months.
Infection and scarring
Uncommon, and largely a consequence of picking, of a peel taken deeper than intended, or of an unrecognised cold sore. Both are avoidable with correct technique and correct aftercare.
We will not treat
Anybody who has taken certain oral acne medication in the last six months; anybody pregnant, for medium peels; anybody with an active infection, sunburn or open skin in the area; anybody who cannot commit to sun avoidance; and anybody asking for a medium peel on skin we have not seen respond to a light one first.
Chemical Peels in western Queens
An acid applied for a controlled time to shed a controlled depth of skin. Depth is the whole game — a light peel is a lunchtime treatment you repeat, a medium peel is a genuinely peeling week and a real result.
Every treatment here starts the same way: a full hour at a table in a room with no treatment couch in it, a proper medical history, your skin looked at in daylight, and then a plain statement of what we think would achieve what you described. You are told what it costs, how many sessions it usually takes, how long it lasts, what the recovery looks like and what can go wrong — on paper, to take home and read somewhere other than a treatment room. If the honest answer is a different treatment, or nothing, or a dermatologist, that is what you get instead, and it costs exactly the same.
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
No before-and-after photographs, and no promised outcome. There are no before-and-after photographs on this website and there never will be. Every set you have seen somewhere else was chosen from a much larger pile, and the second picture is usually taken in different light, at a different angle, at a different time of day, often with makeup and frequently after retouching. Even an entirely honest pair shows you what happened to somebody else's face. What we publish instead is what a treatment typically changes, by roughly how much, how long it lasts, how many sessions it usually takes and how often people are disappointed. We do not guarantee an outcome, we cannot, and anybody who does is either guessing or selling.
The risks, plainly. Every treatment on this site has side effects and some carry real risks. The common ones are minor and short-lived — redness, swelling, tenderness, bruising, a day or two of looking like you have had something done. The uncommon ones matter more: burns, blistering and long-lasting pigment change from light-based treatment, which is a greater risk on deeper skin tones and on recently tanned skin; infection anywhere the skin is broken; and lumps, asymmetry and, very rarely, a blocked blood vessel from injectable filler, which is the one true emergency in this field. We screen for what makes each of these more likely, we tell you your own risk rather than the average one, and we decline to treat when the answer should be no.
What a med spa does not treat. We treat the appearance of healthy skin, hair and body. We do not diagnose or treat disease. If you bring us a mole, a changing mark, an unexplained rash, a sore that will not heal, skin that has become hard or numb, psoriasis, eczema, an autoimmune skin condition, or hair loss that came on suddenly or in patches, what you will get is the name of a doctor rather than a treatment plan. Aesthetic treatment applied on top of an undiagnosed skin problem can mask it, delay the diagnosis and occasionally make it worse. We would rather lose the booking.
Questions
Chemical Peels — the questions we are asked most
How much will I actually peel?
After a light peel, a little flaking around the nose and chin for two or three days that moisturiser largely conceals. After a medium peel, genuine peeling in sheets from about day three to day seven, preceded by two days of looking tight and bronzed. Plan a medium peel for a week when you can work from home if that matters to you.
Are peels safe on dark skin?
Yes, with proper preparation, correct depth and rigorous sun protection — and they are one of the most useful treatments available for pigment on richer skin, because unlike light-based treatment they carry no risk of a burn. What they do carry is a risk of post-inflammatory darkening if depth or preparation is wrong, which is why we prime for four to six weeks and start light.
Can I have a medium peel at my first appointment?
No. Skin needs preparation for four to six weeks first, and we want to have seen how yours responds to a light peel before going deeper. People ask for this regularly and are told no regularly. The information from the lighter treatment is what makes the deeper one safe.
Will a peel help my melasma?
It can help, and it needs care — melasma is stubborn, it recurs, and treatment that is too aggressive makes it worse. A course of light peels alongside pigment-suppressing topical treatment and absolute sun protection is the usual approach, and expectations should be managed rather than raised. Nothing available anywhere cures melasma.
What should I not do afterwards?
Do not pick, pull or exfoliate anything, do not use acids or retinoids until told, do not have a hot shower on your face for a day, do not exercise hard for two days, and do not go in the sun. The single biggest determinant of your result is whether you left the peeling skin alone.
How many will I need?
Four to six light peels three to four weeks apart for a cumulative result, or one medium peel repeated at six to twelve months if you want to. Assessed as you go, paid as you go, and stopped when you have what you wanted.
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Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.