Proprietary Blend for Facial Peel?

Am considering getting an "epi-peel"  to treat melasma and uneven skin tone. This medium depth peel is a proprietary blend (compounded by a pharmacy) of: 1% Retin-A; 14% hydroquinone; 6% azelaic acid; 7% kogic acid; and Vitamins A and C. It is a peel that I would have applied at the spa and leave on for 10 hours. Down time is about 10 days. Does this sound like a good blend for my problems? 

Doctor Answers 3

Concerned about the hydroquinone

I agree with my peers but would also like to say that some people are actually allergic to hydroquinone. I do not recommend people use hydroquinone, especially at this strength for this extended amount of time, unless first making sure (by a spot test somewhere) that you are not allergic! If you are and you do the treatment without testing first, you will have severe PIH, peeling, scabbing, and possible infections. A peel like this should not be applied or used without a physician overseeing it, in case there are any problems.

Be Cautious

This is an unconventional approach. All these ingredients help with melasma to be certain. However, the strengths are far greater than the usual custom. The problem that I foresee happening would be to turn melasma into post-inflammatory hyper-pigmentation. A few of these ingredients, especially the Retin A at 1%, and the Hydroquinoine at 14%, can cause irritation. Irritation can lead to post-inflammatory hyper-pigmentation.

I would be sure that the supervising physician is a dermatologist or a plastic surgeon with a good deal of expereince treating melasma. I would be sure that this peel has been done in this facility numerous times without a problem. Photographs would help. You also have to have confidence in the pharmacy that is formulating this compound. Is it well established.

In sum, I would not jump into this blindly. I am not sahying that you might not have an excellent result. I just think you should proceed with caution.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.5 out of 5 stars 12 reviews

Need a full exam to tell you what kind of peel to get

It is impossible for me to tell you what type of peel would work well for you without a full exam and a history of your skin problems.  Anyone who makes a specific recommendation without seeing you would be making a complete guess.  I would suggest meeting with a board certified plastic surgeon or a board certified dermatologist who in conjunction with their aestheticians can get you on a proper pre-peel/laser protocol, recovery protocol, and long term maintenance.  We have many options for skin these days including excellent products both prescription and non-prescription, peels both aesthetician applied and physician level, as well as multiple types of lasers.  Good luck!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.