Can I Perform Chemical Peeling on My Back for Severe Pigmentation?

Yes, chemical peeling can be performed on various areas of the body. The thicker skin of the back and shoulders generally handles peeling quite well. However, from what you describe it sounds as though you are prone to what we call “post inflammatory hyperpigmentation” or “PIH”.

PIH occurs when the skin over-produces melanin as a part of the natural immune response to protect the cells and is much more common in people with darker skin tones. If this is the case, any type of resurfacing procedure could put you at risk for more PIH.

To achieve your goals, I would suggest beginning a regimen with a topical lightening agent prior to undergoing any additional procedures. A prescription strength lightener, such as hydroquinone, should improve this pigmentation, as well as protect the skin from developing additional PIH following future procedures. PIH will often resolve some on its own, but it can take up to 12 months. It would be best to wait at least a few months after the laser treatment to receive a chemical peel. Having said that, chemical peeling could further improve the issue when performed with the appropriate acids and there has been a satisfactory “resting period” for the skin.

Hope this helps
Nick Slenkovich MD, FACS

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

It usually takes several chem peels to even out the discoloration on the back.  Jessner's plus 20% tca is a common peel for the back every month for 4-5 sessions at 350-500 per treatment.

Chemical peeling is an excellent choice for skin discoloration. However in many people with darker skin, superficial peels repeated many times is a better choice than deeper, aggresive ones. See further discussion below.

Chemical peels are an excellent way of addressing hyperpigmentation on the body. As the skin is thicker, it may take more peels to get the results you want. The Vi peel is an excellent choice for hyperpigmentation on both the face and body.

It is possible to lighten pigmentation on the back with chemical peels but it does depend on the individual. To decide which treatment would be best you have to look at many factors. Some of these may include how long it has been there, if there is active acne still ongoing, skin color, sun exposure, genetics, etc. Once I determine the answers to these and a few other questions I can come up with a treatment plan for the best possible results. There are also several different chemical peels available now. Some are made specifically for acne and post inflammatory hyperpigmentation, others for sun damage discoloration, melasma, etc. There are times when a chemical peel may not even be necessary and the patient can be treated with other treatments, prescriptions, or medical grade skin care at home. It is important to do your research and go to the right doctor for your needs. My practice offers free consultations with our aestheticians to discuss all options available.

My first question is whether the acne is until control. In the approach to treating acne scarring and pigmentation, the acne itself must always be addressed first. As long as you continue to breakout, more scarring will be created. Once your Dermatologist has stopped the breakouts, your options for scar therapy can be addressed. A series of Jessner’s peels may be appropriate to help lighten the pigmentation, or the use of a physician prescribed corrective skincare program. Typically these programs include products containing hydroquinone and exfoliating agents to even out the skin tone, which are used over a period of four to six months for optimal results. It is imperative to keep the sun off of your back as any amount of sun exposure will not only contribute to more hyperpigmentation, but also darken the pigmentation you already have. Consult with an experienced Cosmetic Dermatologist in your area to determine the most appropriate treatment for your skin condition.

Intense Pulse Light, Medium depth chemical peels, fractional co2 resurfacing, skin care can improve back pigmentation. With Fraxel resurfacing the pigmentation could be at many different levels. More superficially, I would consider more aggressive skin care light lightening products (retinol, hydroquinone, hydrocortizone), 15% alpha and beta hydroxy lotion, at home glycolic peels.  Also for superficial pigmentation, lighter chemical peels 10-25% TCA (Tricholoroacetic Acid) peels, and active / deep fx could help.  For dermal pigmentation, active and deep fx could improve the pigmentation intense pulse light with varying filters could improve this, as well as different longer length lasers from 585-1064.  Dermal depths are deeper and not accessible to most superficial treatments.

Chemical peels can remove dark spots from the body. These peels should be light peels and repeated often so as not to further damage skin of the body.