Do you think this mark after 50% TCA peel is PIH? (Photos)

Question

Hi, In March I ordered some 50% TCA peel, to use it on a mark on the leg: a slightly pigmented patch of skin -white inside and a kind of slightly brown circle. After the peel, It formed a scab that went away after 2 weeks. But it left a scar much bigger and more visible than the original. The pigmented areas have become reddish too. Do you think this is pih? I put some moisturizing cream on it every day since April. Do you think it will leave without another peel?

Anna Chacon, MD, FAAD · Answer

Thank you for reaching out with your concerns. Based on your description and the photos provided, it is possible that the mark left after your 50% TCA peel is Post-Inflammatory Hyperpigmentation (PIH). PIH is a common response to skin trauma, such as chemical peels, where the skin produces excess melanin as it heals, resulting in darker patches.

Here are a few considerations:

Healing Time: PIH can take several months to fade, and the time frame can vary depending on your skin type and the depth of the peel.

Moisturization: Continuing to apply moisturizing cream is beneficial, as it helps support the skin's natural healing process.

Sun Protection: Make sure to protect the affected area from sun exposure, as UV rays can worsen hyperpigmentation. Use a broad-spectrum sunscreen with an SPF of at least 30.

Topical Treatments: Over-the-counter products containing ingredients like niacinamide, vitamin C, and alpha arbutin can help lighten hyperpigmented areas. Prescription options like hydroquinone or retinoids might also be effective but should be used under the guidance of a dermatologist.

Avoid Further Peels: I would advise against performing another peel on the area until the skin has fully healed and the PIH has improved. Further peels could exacerbate the issue.

For a more tailored treatment plan, I recommend consulting with a board-certified dermatologist who can assess your skin in person and provide specific recommendations.

Do you think this mark after 50% TCA peel is PIH? (Photos)

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Do you think this mark after 50% TCA peel is PIH? (Photos)

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