What is the best sequence to get medium depth chemical peel and Botox?

Question

Is there a preferred order in which to do a medium depth chemical peel (VI melasma pee) and Botox? And should I space them apart? I’ve read that doing a chemical peel after the Botox can interfere or cause adverse results to the Botox.

Anna Chacon, MD, FAAD · Answer

This is a great and very common question—and you’re right to think about timing, because sequence does matter for best results.

In general, Botox should be done first, followed by the chemical peel, with a short spacing in between.

Here’s why:

Why Botox comes first

After Botox, the toxin needs time to bind to the nerve endings and settle into place. During the first few days, pressure, massage, or vigorous manipulation of the skin could theoretically cause it to migrate or reduce its effectiveness. A medium-depth peel involves active exfoliation, skin stretching, and inflammation, which isn’t ideal immediately after Botox.

Doing Botox first allows:

More precise muscle relaxation

Reduced dynamic movement, which can actually enhance peel results, especially for fine lines and pigment

Lower risk of disrupting the Botox placement

How long to wait

A safe and commonly recommended interval is:

Botox → wait 7–14 days → chemical peel

By one week, Botox is well on its way to fully binding, and by two weeks it’s fully settled. At that point, a VI Peel (including the melasma protocol) will not interfere with Botox or cause adverse effects to it.

What about doing the peel first?

You can do a chemical peel first and then Botox, but spacing still matters:

After a medium-depth peel, the skin barrier is compromised and inflamed

Injecting Botox too soon can increase irritation, sensitivity, or bruising

If you go this route, it’s best to:

Wait until the skin has fully re-epithelialized, usually about 10–14 days, before Botox

Bottom line

The most predictable and skin-friendly sequence is:

Botox

Wait 1–2 weeks

Medium-depth chemical peel (VI Peel)

This approach minimizes risk, protects your Botox results, and allows your skin to heal and respond optimally.

What is the best sequence to get medium depth chemical peel and Botox?

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