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Chemical peel


What it is: A chemical peel is a skincare procedure that involves chemical solution being applied to facial skin. A chemical peel is intended to remove damaged outer layers of skin and the blemishes that come with it. There are a number of different chemical peel concentrations typically classified as mild, moderate, or deep peel.



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Question

What's the best minimally-invasive treatment for hyperpigmentation caused by chemical peels?

What is the best treatment for hyperpigmentation?

I just did a TCA 20% chemical peel about 2 weeks ago and now how really bad hyperpigmentation in the areas where the doctor went deeper. I don't want anything too invasive since I are trying to get pregnant.


Asked by: plshelpme
Alhambra, CA

Answers (2)

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1
August 27, 2008

Dispigmentation after TCA peels

Richard W. Westreich, MD
Richard W. Westreich, MD
Board Certified
Facial Plastic Surgeon

Two weeks after a chemical peel is a very short period of time in relation to healing. The first thing I would recommend is patience in terms of the color variation. You should be using a sun block of at least SPF 30 during this time. Most physicians will not intervene for pigment problems until at least 4-6 weeks post-treatment. This rule is based on the natural time frame of wound healing.

Wound healing occurs in 3 stages:

  1. The immediate phase which lasts about a week
  2. The proliferative phase (where new cells and blood vessels come into the area) takes 4-6 weeks
  3. The remodeling phase, which may last up to 1 year

The timing of various treatments and interventions in plastic surgery are based upon this scientific principle. Oftentimes, the body does a better job of healing a problem than anything we can do medically.

That being said, the best treatment for you depends on whether the lesions are brown or red.

  • If they are red and it has been at least 4 weeks since the peel, then it is likely a problem called prolonged erythema (redness) due to increased blood flow to the areas in question. Certain lasers (such as a pulsed-dye laser) may be effective in treating that problem and are safe in pregnancy. In patients not currently pregnant and not actively trying to get pregnant, steroid cream treatment for 1-2 weeks often solves the problem.
  • If the areas are brown then it may be truly a problem of hyperpigmentation. Hydroquinone, with or without retin-A and a combined steroid (again, for non-pregnant patients only) is the best topical therapy. A variety of other lasers may also be effective.

At this moment in time, I would try to wait a few more weeks, be diligent about using sunscreen and staying out of the sun. If the problem persists, then rest assured there are multiple treatments to solve your problem.

2
August 25, 2008

Minimally-invasive treatments for hyperpigmentation after TCA peels

D.J. Verret, MD
D.J. Verret, MD
Board Certified
Facial Plastic Surgeon
Answer by D.J. Verret, MD

A good treatment for hyperpigmentation after TCA peels is the use of hydroquinone. Unfortunately, it is a pregnancy category C, meaning that the safety of the medication during pregnancy has not been established.

A safe alternative may be IPL treatments. These are safe during pregnancy but the use must be balanced against the healing skin and possible lack of efficacy.

I would suggest speaking with your physician about your concerns before proceeding with any other treatments.

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