Proprietary Blend for Facial Peel?

Am considering getting an "epi-peel"  to treat melasma and uneven skin tone. This medium depth peel is a proprietary blend (compounded by a pharmacy) of: 1% Retin-A; 14% hydroquinone; 6% azelaic acid; 7% kogic acid; and Vitamins A and C. It is a peel that I would have applied at the spa and leave on for 10 hours. Down time is about 10 days. Does this sound like a good blend for my problems? 

Doctor Answers 3

Concerned about the hydroquinone

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I agree with my peers but would also like to say that some people are actually allergic to hydroquinone. I do not recommend people use hydroquinone, especially at this strength for this extended amount of time, unless first making sure (by a spot test somewhere) that you are not allergic! If you are and you do the treatment without testing first, you will have severe PIH, peeling, scabbing, and possible infections. A peel like this should not be applied or used without a physician overseeing it, in case there are any problems.

Be Cautious

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This is an unconventional approach. All these ingredients help with melasma to be certain. However, the strengths are far greater than the usual custom. The problem that I foresee happening would be to turn melasma into post-inflammatory hyper-pigmentation. A few of these ingredients, especially the Retin A at 1%, and the Hydroquinoine at 14%, can cause irritation. Irritation can lead to post-inflammatory hyper-pigmentation.

I would be sure that the supervising physician is a dermatologist or a plastic surgeon with a good deal of expereince treating melasma. I would be sure that this peel has been done in this facility numerous times without a problem. Photographs would help. You also have to have confidence in the pharmacy that is formulating this compound. Is it well established.

In sum, I would not jump into this blindly. I am not sahying that you might not have an excellent result. I just think you should proceed with caution.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Need a full exam to tell you what kind of peel to get

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It is impossible for me to tell you what type of peel would work well for you without a full exam and a history of your skin problems.  Anyone who makes a specific recommendation without seeing you would be making a complete guess.  I would suggest meeting with a board certified plastic surgeon or a board certified dermatologist who in conjunction with their aestheticians can get you on a proper pre-peel/laser protocol, recovery protocol, and long term maintenance.  We have many options for skin these days including excellent products both prescription and non-prescription, peels both aesthetician applied and physician level, as well as multiple types of lasers.  Good luck!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.