Chemical Peel on Neck Peeling Twice- Is This Normal? (photo)

Question

I had a chemical peel (Jessner with 25% TCA) on my neck and chest a week ago. It completely peeled but left two very red and sensitive spots on each side of my neck. Even though I have continued to keep the skin moisturized the red spots are crusting again. Is this normal for skin to peel twice in one session?

Thomas Fiala, MD, FACS, FRCSC · Answer

The combo peel you had was, in my opinion, a bit strong for this area. You should seek treatment from a local dermatologist or plastic surgeon, so as to avoid the potential for scar formation in this area. You may need some steroid treatments, as well as local wound care.

Stephen Prendiville, MD · Answer

As other posters have noted, a 25% TCA peel on the neck is extremely aggressive and is most definitely not a recommended treatment. The area of irritation is most likely early formation of hypertrophic scar tissue.  I recommend immediate follow up with a Facial Plastic Surgeon and sun avoidance in order to ameliorate the injury that has already occurred.

	As an aside, I have seen a number of patients who have obtained TCA over the internet and who have had self applied peels with disastrous consequences.

Kenneth D. Steinsapir, MD · Answer

You did not tell us if this was performed by a doctor, an aesthetician or yourself. A Jessner peel plus 25% TCA is a very aggressive peel for the very thin, poorly healing skin of the lateral neck. You are likely to have a permanent textural change in this skin as a result. Over a very long period of time it might be ok but not ideal. In my opinion, I think you need an assessment of what is going on by an chemical peel expert (i.e. dermatologist who does chemical peeling). I would attempt to modify the healing process with systemic steroids, and possibly topical steroids or injected 5-FU to modify the inflammatory cycle. There is no substitute for an actual physical examination and in person, the skin may look more worrisome or less worrisome. I would recommend getting this evaluated immediately.

Kimberly Lee, MD · Answer

A 25% TCA peel is quite aggressive. Please follow up with either a board certified facial plastic surgeon, dermatologist, or office which performed the peel for an in person evaluation of your situation.

Michael Bowman, MD · Answer

No, this is not expected. In general, the skin of the face is the only area where a deeper chemical peel like the 25% TCA/Jessner's can be be used. The skin of the face is able to heal from a deeper depth of injury, whereas the skin of the neck and chest is typically not peeled because healing problems can occur. It is not entirely clear from the pictures, but I would recommend evaluation ASAP by a different board certified physician (dermatologist, plastics, facial plastics) who uses peels on a regular basis. Aggressive treatments may help limit scarring and long term damage.

F. Victor Rueckl, MD (in memoriam) · Answer

The peel you mentioned is extremely aggressive and the neck and chest area are exceptionally sensitive and thin areas. I would recommend you see a dermatologist. You may need a kenalog shot to stop the inflammation and a topical steroid in ointment form (like Betamethasone) to apply several times a day. Hopefully there isn't any skin permanently damaged here, but you need to start addressing this now, with an experienced physician.

Chemical Peel on Neck Peeling Twice- Is This Normal? (photo)

Answers (6)

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