Chemical Peels Lesson 4: Side Effects and Complications

All forms of strong exfoliation like peels and microdermabrasion, as well as any product that contains alpha hydroxy acids, cause your skin to become photosensitive. This means that it burns and discolors easier with sun exposure. The duration and intensity of this effect depends on how strong the peel was. Skin can go back to normal within 2 weeks of a mild peel, but may burn easier for a few months after a strong peel. Stubborn discoloration can develop from any sun exposure, even on cloudy days, so you must be vigilant with sun protection. It is best to avoid peeling during the summer months.

Normal side effects for superficial peels are typically mild. There is often some redness from slight inflammation. The skin may be hot to the touch for a couple of days following the peel. Some people experience itching, though scratching should be avoided. The protective dead skin layer is usually translucent instead of brown or red, but it is often still plastic like and tight and gives skin a dull appearance. It can look and feel like a thin layer of glue has dried on the skin. The healing skin is usually red, which normally subsides within a week, but may take longer. Obviously peeling, flaking skin is to be expected if you’ve had an effective peel. Moisturizing is a good way to deal with these side effects. Barrier restoring creams are very helpful, as well as natural moisturizers containing soothing botanicals like aloe, oat, chamomile, lavender, or cucumber.

The normal side effects following a medium peel can be quite intense. This type of peel essentially produces a second-degree burn. The healing skin is often quite red, and the protective dead skin layer can be very brown. It is often uncomfortably inflexible and tight. It can crack and bleed around the mouth when talking or eating. Some people experience swelling from the intense inflammation, especially around the eyes. Discomfort for the first few days is normal. Some people experience weeping as the skin heals. After healing, the skin can be sensitive to active ingredients for a few weeks, with some people having sensitivities for several months. Redness usually resolves within a few weeks, but it can persist for 3 months or more. There is an increased risk of permanent discoloration with this type of peel, especially for darker skin tones or people who aren’t vigilant with sun protection. The discoloration can be dark splotches, or areas of lighter pigmentation that may not tan like the surrounding skin.

Complications after a medium peel may require medical attention. If the skin starts to blister or develops an infection, get to a doctor. Pus filled blisters are a sign of infection and will probably require anti biotic and anti viral medication. Although some redness and discomfort is expected, if you experience excess redness and stinging while the skin is healing you may be having an allergic reaction. If you’ve done the peel at home, be honest with your physician. If you had the peel done professionally and you aren’t satisfied with the treatment you’re getting from that doctor, see another one. Getting complications treated promptly is very important. They are likely to scar.

Other Interactions and Complications

Peeling skin should not be treated with any irritating or exfoliating active ingredients like retinoids or strong concentrations of Ascorbic acid (Vitamin C). Discontinue using these ingredients for a few days to a week before and after the peel. After the skin has healed, it may still be more sensitive than normal, so reintroduce your actives cautiously.
You should not use any chemical peel if you have used the medication Accutane (isotretinoin) in the past year. It can increase the risk of scarring. You should not use Accutane until a year after your peel. Be sure to tell your doctor about any peels you’ve done, or plan to do.

It’s a good idea to do a patch test at least 24 hours before the actual peel. Some people are allergic to the ingredients in chemical peels, especially TCA. Do the patch test on skin near the area you want to peel. Behind the ear is a good place if you are going to peel the face. Repeat the patch test before each peel; skin can develop sensitivity from exposure to a certain ingredient.

If you have oral herpes, you are at a greater risk for infection and scarring. You should get a prescription for anti viral medication to minimize the risk of a flare up.

Don’t use a chemical peel if you are prone to keloid scarring. Keloid scars are different than normal raised scars. They extend beyond the borders of the original wound and have a rubbery texture. If you’ve ever had a keloid on any part of your body, your skin may scar badly from the controlled damage inflicted by a chemical peel.

If you have active acne, it may flare up or spread after a chemical peel. Try to get your acne under control with very superficial to superficial salicylic acid peels before using a stronger peel.

Do not use strong chemical peels if you are pregnant or lactating without doctor approval.

If you have an aspirin allergy, do not use a peel containing salicylic acid. Be sure to do a patch test for all chemical peels.

Do not use a chemical peel on broken skin, or skin that is sunburned or wind burned.

Do not peel any area that has had a recent surgical procedure, such as a face lift.

Do not use a chemical peel if you have an auto-immune disorder or disease, eczema, psoriasis, seborrehic dermatitis, collagen disease, atopics, or have experienced prior skin sensitivities.

Do not use a chemical peel if you have recently had any radioactive or chemotherapy treatments.