NIC Esthetician Written ExamTreatment ProceduresMedium

A client with Fitzpatrick skin type III presents with concerns about uneven skin tone and hyperpigmentation due to sun exposure. She is interested in a series of light chemical peels. Which of the following peel types would be MOST appropriate to start with, considering her skin type and concerns?

  1. AJessner's peel
  2. BSalicylic acid peel
  3. CTCA peel
  4. DGlycolic acid peel
Show answer & explanation

Correct answer: D. Glycolic acid peel

Glycolic acid peels are alpha-hydroxy acids (AHAs) that provide superficial exfoliation, making them a good starting point for addressing uneven skin tone and hyperpigmentation on Fitzpatrick skin types III, with a lower risk of post-inflammatory hyperpigmentation compared to stronger peels.

Why the other options are wrong

  • A. Jessner's peel (a combination of salicylic, lactic, and resorcinol) is a medium-depth peel and can be too aggressive to start with for Fitzpatrick III, posing a higher risk of PIH.
  • B. Salicylic acid peels are beta-hydroxy acids (BHAs) primarily for oily and acneic skin, and while they exfoliate, glycolic is often preferred for general brightening and tone on non-acneic skin.
  • C. TCA (Trichloroacetic Acid) peels are medium to deep peels that carry a significant risk of complications, including PIH, on Fitzpatrick skin types III and above, and are not a starting point.

Chemical Peel Selection (Fitzpatrick III)

Choosing an appropriate chemical peel for Fitzpatrick skin type III, balancing efficacy for hyperpigmentation with minimizing risk of post-inflammatory hyperpigmentation (PIH).

  • Start with superficial peels (AHAs)
  • Glycolic acid is a common choice
  • Avoid strong peels initially to prevent PIH

Memory trick: Gentle acids first for medium skin, then assess for more.

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