I Got a Chemical Peel About Two Days Ago and the Skin Around my Mouth Started to Peel. Is This Normal? (photo)

Yes, peeling is normal following chemical peel. Don't pick at the skin-wait till it starts to fall off. Once peeled, you will need to use hydrocortisone cream.

Hi Etoile,

  After most moderate to deep chemical peels (those that are not superficial and limited only to the upper layer of skin - the epidermis), patients do usually start noticing the peeling first around the mouth. This is because we are always moving our mouths when we talk, so skin here starts to peel first. 

  On a side note, you NEVER want to peel the skin off before it falls off (exfoliates) on it's own. It's incredibly tempting to do so - I know from personal experience. But, when you peel it off too soon, you expose raw skin to possible infection (which can lead to scarring), and/or, more commonly, inflammation that leads to DARKER areas of skin once it has healed (this is known as "post-inflammatory hyperpigmentation" or "PIH"). I encourage patients to use some clean cosmetic scissors to snip off any pieces of skin that are sticking out if they are bothering the patient and to do whatever is necessary to resist the urge to prematurely remove the peeling skin (this includes avoidance of aggressive scrubbing of the skin during the first week or so after the chemical peel). 

  From your photo, you appear to actually need a combined treatment approach to clear your acne. You have some inflammed acne nodules (the bigger, tender ones on your cheek) that could be best served by injecting a small amount of steroid directly into those - this will usually cause the inflammed lesions to clear within a day or two. This MUST be done with a well-trained dermatologist, as, if too high of a concentration of the steroid is used, you can get skin atrophy (thinning/"pock marks") following the injection(s). 

  Also, you should be on an aggressive topical regimen including - at the very minimum - a cream with retinoic acid, a topical with benzoyl peroxide, and one with salicylic acid. I also encourage the use of an exfoliating polish once a day while in the shower (to clear the "sticky" cells from clogging up your pores and resulting in more acne). Massaging a product such as an exfoliating polish into your skin once a day provides "mechanical" exfoliaton. Do NOT use a loofah - they are essentially cesspools for bacteria.

  Lastly, from your photo, you may benefit from a 5 month course of low-dose daily isotretinoin (20 mg/day) - one pill you would take with breakfast every morning. You need to see your doctor to ensure you are a good candidate first. For example, if you have a history of hepatitis, colitis, depression, or several other medical conditions, you may not be the right candidate. Also, you NEVER want to get pregnant while taking isotretinoin (all that is required is waiting one month after stopping the course of isotretinoin and then you can get safely pregnant - if you so desire). 

  Without a comprehensive, aggressive daily topical regimen for your acne, it's not going to clear with a simple chemical peel. Chemical peels can help, but, they should not be used alone (they must be part of a larger treatment plan). 

Hope this helps!

MK

What type of peel did you receive? Peeling is to be expected. Your physician likely tailored your peel depending on the state of your skin. I would recommend that you not manually peel the area (no picking), so as to not further traumatize the skin and potentially cause hyperpigmentation or open infection. Sunscreen is also very important. Best of luck.