Complications of Chemical Peeling

Chemexfoliation and Superficial Skin Resurfacing

“…Prolonged erythema, milia, pustulocystic acne, reactivation of latent herpes simplex infection, and superficial bacterial infection are all potential complications postpeel [20]. The incidence with superficial peels is significantly less than with deeper peels although not negligible.…”

“…Complications from superficial peeling agents are usually minor and reversible, including transient hyperpigmentation, prolonged erythema (<3 months), colloid milia, acne flares, reactivation of latent facial herpes simplex virus (HSV) infection, and superficial bacterial infection [44]. Scarring in the absence of supervening infection is highly unlikely [43].…”

“…Patients are routinely instructed to avoid significant sun exposure in the weeks leading up to and following a medium-depth peel. A sunscreen with a UVA/UVB block is to be worn faithfully, and some doctors recommend their patients abstain from oral contraceptives (2 months before and after peeling) because their use may incite pigmentary changes [52,44]. Pretreatment with retinoic acid and hydroquinone can reduce the risk of postoperative hyperpigmentation, but those with darker skin types and or those being treated for pigment problems are at even greater risks.…”

“…Pretreatment with retinoic acid and hydroquinone can reduce the risk of postoperative hyperpigmentation, but those with darker skin types and or those being treated for pigment problems are at even greater risks. If it arises, postpeel hyperpigmentation can be managed with retinoic acid, hydroquinone products, midpotency topical steroids, and follow-up peels (approximately 3-6 months later) until a lightening effect is achieved [44,52]. Postpeel hypopigmentation is less frequently a problem, but its treatment options are few and less reliable.…”

“…Postpeel hypopigmentation is less frequently a problem, but its treatment options are few and less reliable. Although previously thought only to be a complication of deep peels, hypopigmentation has been reported following blanching with 20% TCA and 35% TCA chemical peels [44]. In darker skin types, this potentially permanent side effect can be devastating.…”