I'm on blood thinners and am thinking of getting a peel. Will it be necessary for me to get off the thinners before the peel?

Question

Will it be necessary for me to get off the thinners before the peel? Is there any bleeding or bruising involved? I take Eliquis daily as the blood thinner.

Jason Emer, MD · Answer

If you are undergoing a deep peel I would suggest you stop the thinner.  However, light lasers are much safer and better for patients on blood thinners.  I suggest seeing a cosmetic dermatologist with specialty in lasers and knows how to manage this type of situation. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Blood thinners usually do not interfere with chemical peels. Deep peels such as a high strength TCA or phenol peel may require injections and you may want to hold off on the blood thinners. Best, Dr. Karamanoukian Los Angeles

Andrew P. Amunategui, MD · Answer

Peels, such as 35% TCA, are a wonderful method of rejuvenating sun damaged skin and improving fine lines. Results are often better than  "no down time" lasers. Down time is usually about 5 days and should not be associated with oozing and pain while at home.  Done in conjunction with fat grafting (transfer), results can be comparable to--or even better than--facelifting (and I am a BC plastic surgeon) in some patients! Most peels, including deeper peels, are usually not associated with bleeding (some lasers, such as erbium laser, may well be).   A more important question is: what type of anesthesia, if any, will you be getting.  Though most deep peels are performed under twilight anesthesia (usually we are doing concomitant procedures such as fat grafting and/or eyelid surgery), we commonly perform 35% TCA peel without "formal" anesthesia.   This can mean light oral sedation and/or local anesthesia.  This depends on both your doctor and whether you are more of an anxious or stoic individual.  Some patients have used NO sedation or local anesthesia other than numbing cream and/or ice and have driven themselves home--but this is not for the faint of heart!! good luck :)

Kenneth D. Steinsapir, MD · Answer

If it is a superficial chemical peel, then the anticoagulation is not an issue.  If we are talking about a deeper peel, this is altogether different.  Deeper peels generally require local anesthesia which means injections into the face that will be associated with signifiant bruising for individuals who are anticoagulated.   Intravenous sedation requires an intravenous line that can be associate with localized bruising from the intravenous line.  The choice to have a chemical peel under these circumstances needs to be carefully balanced with your health needs.  An ethical cosmetic surgeon should balance these concerns.

Michael I. Echavez, MD · Answer

There is normally not any bleeding or bruising involved with a chemical peel.  I would mention that you are on blood thinners to the physician who will be treating you though.

Benjamin Barankin, MD, FRCPC · Answer

For mild or medium depth peels, there is no need to stop your blood thinner. If you are having a deep chemical peel, then you definitely want to review this with your doctor.

I'm on blood thinners and am thinking of getting a peel. Will it be necessary for me to get off the thinners before the peel?

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