REVIEW ARTICLE BJD British Journal of Dermatology Chemical peeling in ethnic skin: an update A. Salam, 1 O.E. Dadzie 2 and H. Galadari 3 1 Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, U.K. 2 Department of Dermatology and Histopathology, The North West London Hospitals NHS Trust, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, UK. 3 College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates Correspondence Hassan Galadari. E-mail: hgaladari@uaeu.ac.ae Accepted for publication 21 April 2013 Funding sources This supplement was kindly sponsored by L’Or  eal Research & Innovation and Beiersdorf. Conflicts of interest None declared. DOI 10.1111/bjd.12535 Summary With the growth of cosmetic dermatology worldwide, treatments that are effec- tive against skin diseases and augment beauty without prolonged recovery peri- ods, or exposing patients to the risks of surgery, are increasing in popularity. Chemical peels are a commonly used, fast, safe and effective clinic room treat- ment that may be used for cosmetic purposes, such as for fine lines and photo- ageing, but also as primary or adjunct therapies for acne, pigmentary disorders and scarring. Clinicians are faced with specific challenges when using peels on ethnic skin (skin of colour). The higher risk of postinflammatory dyschromias and abnormal scarring makes peels potentially disfiguring. Clinicians should therefore have a sound knowledge of the various peels available and their safety in ethnic skin. This article aims to review the background, classification, various preparations, indications, patient assessment and complications of using chemical peels in ethnic skin. What’s already known about this topic? • Chemical peels are efficacious therapeutic interventions for many skin disorders. • Many peels exist; however, not all are safe for use in ethnic skin. • Darker skin types have an increased risk of adverse events from chemical peeling such as pigmentary disorders. What does this study add? • This is an up-to-date review of the various peeling agents and their indications for use in ethnic skin. • It provides a summary of newer peeling agents. • It gives practical tips on performing chemical peeling safely and effectively in eth- nic skin. • Prevention and management of complications of chemical peeling in this cohort are discussed. The ethnic makeup of the world is rapidly changing. Of the 1Á5 billion people the world is predicted to have gained by 2020, the majority will be from Asia (56%) and Africa (16%). 1 The U.S.A. is predicted to have close to 50% of its population comprising people with skin of colour by 2050 (U.S. 2000 census), 2 and the U.K. has seen the proportion of Black Africans double between 2001 and 2011. 3 Despite turbulent economic climates, cosmetic procedures are at an all-time high with over 13 million procedures per- formed in the U.S.A. in 2011 (5% increase from 2010). Mini- mally invasive procedures, such as chemical peels, have increased by 123% since 2000, in comparison to surgical pro- cedures, which have increased by only 17%. 4 Given the simultaneous growth of people with skin of col- our and the demand for cosmetic procedures, dermatologists must appreciate the challenges of cosmetic procedures in those with darker skin types. On top of this, dermatologists must also appreciate the facial anatomy, ageing patterns and cultural © 2013 The Authors BJD © 2013 British Association of Dermatologists 82 British Journal of Dermatology (2013) 169 (Suppl. 3), pp82–90