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.

David Hansen, MD · Answer

With all chemical peels there is the risk of post inflamatory hyperpigmentation, which means blotchy, dark spots.  They occur when the skin gets irritated from too much rubbing makeup off or scrubbing off the exfoliating skin too early or sun exposure during the first 2 weeks when your skin is especially sensitive.
Regardless of how or why it occurred, it is fixable with either further lighter chemical peels to exfoliate the dark spots since they are usually superficial or prescription bleaching creams to bleach out the dark spots.
I like to use Jessner's solution peels or 10% TCA peels every 2 weeks  in addition to having  patients apply a triple bleach cream every other night to start with and eventually nightly sparingly. And of course, daily sunscreen use to protect from the sun.
After each peel, I have patients use a prescription cortisone cream or lotion, such as desowen, twice a day to prevent inflammation or irritation and take away redness faster.      Go back and continue your treatments to correct the dark spots but do expect to pay for each further peel or creams, since it is a normal risk you, yourself, have to take with all chemical peels.

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.

What can I do about hyperpigmentation after a chemical peel?

Answers (6)

Answer: Rare but possible reaction

Answer: Rare but possible reaction

Answer: You are not necessarily unusually sensitive.

Answer: You are not necessarily unusually sensitive.

Answer: Pigmentation after Chemical Peeling

Answer: Pigmentation after Chemical Peeling

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Answer: It's not a botched chemical peel job

Answer: It's not a botched chemical peel job

Answer: Post Inflammatory Hyperpigmentation

Answer: Post Inflammatory Hyperpigmentation

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What can I do about hyperpigmentation after a chemical peel?

Answers (6)

Answer: Rare but possible reaction

Answer: Rare but possible reaction

Answer: You are not necessarily unusually sensitive.

Answer: You are not necessarily unusually sensitive.

Answer: Pigmentation after Chemical Peeling

Answer: Pigmentation after Chemical Peeling

Recommended reading

Everything you need to know about Chemical Peel

Answer: It's not a botched chemical peel job

Answer: It's not a botched chemical peel job

Answer: Post Inflammatory Hyperpigmentation

Answer: Post Inflammatory Hyperpigmentation

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