What can I do about hyperpigmentation after a chemical peel?

Question

I had two chemical peels: first was 20% AHA peel + microdermabrasion, which went well; the second one, done 2 months later, was 30% Glycolic peel + Microdermabrasion, which left me with burns on my cheeks. It's been a month now and while there are no more swelling and scabbing, I'm left with brown patches and hyperpigmentation. Could this be a botched job or mishandling by the doctor? He said it's due to my skin sensitivity and I'm not the only case. Is this true? What recourse/redress should I take if it's indeed a botched job?

Gregory Turowski, MD, PhD, FACS · Answer

It is very rare to have burns after superficial chemical peels. Discoloration can happen as a result of not applying sunscreen or not following the post-procedure instructions.
Avoiding any exfoliating products before the peel is also very important. When the skin is hypopigmented, it takes up to six months for some of the pigment to restore in the skin.
Hyperpigmentation can be treated with hydroquinone, or a bleaching cream, but your doctor needs to decide if you are ready for that. Conservative IPL treatment or a mild microdermabrasion can also help with any brown pigment left from a chemical peel.

Kenneth D. Steinsapir, MD · Answer

A 30% glycolic peel with a microdermabrasion is still a relatively superficial treatment.  However, it is still possible to have a post-inflammatory hyperpigmentation.  As other physicians have noted, there are many options for dealing with this issue.  It is also not uncommon for the hyperpigmentation to resolve on its own.
However, I guess I am left wondering if you lack confidence in your treating physician.  Has there been enough break down in communication that your trust with this doctor is shot?  It might be a good time to seek out another physician to assist you if this is the case.  This does not mean that the first doctor 'botched" the job.  It really means that for whatever reason you have lost enough confidence that it is a good idea to seek help elsewhere.

Raffy Karamanoukian, MD, FACS · Answer

Chemical peels are effective in the treatment of aging skin including reduction of pigmentation, fine wrinkles, and acne scars.  Depending on skin type and complexion, patients may require pre and post-procedural treatment for hyperpigmentation.  Generally, Fitzpatrick skin type and ethnicity are factors to consider prior to performing a chemical peel.
If you are experiencing excessive pigmentation after a chemical peel, you should consider speaking to your physician about a post-procedural depigmentation protocol to control the extent and severity of skin pigmentation.   This may include a course of topical skin modulation with retinoids and/or hydroquinone.

Kirk A. Churukian, MD · Answer

Some darker skin types have more sensitive or fragile skin. A side effect of this condition, is that in the presence of heat (like a chemical peel), more pigment is produced. A treatment for this condition is Finacea and some mild 2% lactic acid peels. The pigmentation will lessen over time.

John P. Di Saia, MD · Answer

Hello,
It sounds like your skin is sensitive. Maybe you should try a series of very light peels without dermabrasion. Bleaching agents and Retin A before and after might help as well as well as sun avoidance.
 
Best Regards,
 
John Di Saia MD

What can I do about hyperpigmentation after a chemical peel?

Answers (6)

Answer: Post Inflammatory Hyperpigmentation

Answer: Post Inflammatory Hyperpigmentation

Answer: These are light peels. You must be sensitive.

Answer: These are light peels. You must be sensitive.

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Everything you need to know about Chemical Peel

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What can I do about hyperpigmentation after a chemical peel?

Answers (6)

Answer: Post Inflammatory Hyperpigmentation

Answer: Post Inflammatory Hyperpigmentation

Answer: These are light peels. You must be sensitive.

Answer: These are light peels. You must be sensitive.

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Recommended reading

Everything you need to know about Chemical Peel

Our mission is to create a world where every investment in modern beauty is Worth It.