Should I Repeat Obagi Blue Peel for Melasma Treatment?

Question

I had two-layer Obagi Blue Peel for melasma following a 12-week period of using the Obagi Nu-Derm products. While using the full line of products with the 0.1% tretinoin, I did not get much redness, irritation, or peeling. I have blonde hair and semi-fair skin. (I tan easily and rarely burn.) With the Blue Peel, my skin only became tight and somewhat flaky. My skin did not turn brown or peel whatsoever like most people's would, and it made my hyperpigmentation darker. Do I just have tough skin? Would repeating the peel and going deeper make a difference?

Raffy Karamanoukian, MD, FACS · Answer

The TCA Peel that you had may not have gone to the desired depth. I would advise you to undergo several weeks of pretreatment and then reschedule a medium depth peel that would reinvigorate your skin. The Blue peel would be ideal.

Shepherd G. Pryor, MD · Answer

It definitely appears that if only light flaking occurred then only a light penetration peel was used at a level of maybe 15%. Standard 20% peels typically see moderate to significant peeling within 5 days that last up to 9 days for full recovery. In a fair skinned patient you may have had someone with a more conservative approach treat you. I would definitely recommend another round of treatment to get the optimal results.

Joanne Lopes, MD · Answer

After attending a seminar by Dr. Obagi himself many years ago his suggestion is for several bluepeels . Melasma is a difficult problem. Usually the 20% tca stregnth peel should give you the peeling effect.Usingthe obagi products will help with the results.

Marcel Daniels, MD · Answer

Having a Blue Peel and only getting some flakiness leads me to believe that the strength of the peel was on the lighter side (15%) rather than the standard Blue Peel (20%). It would certainly be worth trying again but at the standard strength. Melasma can be very difficult to treat under the best of circumstances as the pigment may run too deep for the peel to effect or could return, especially if the causative factors are not mitigated (hormones, UV light). Be prepared to be on skin bleacher and sunscreen for the long term.

Mitchell Schwartz, MD - Account Suspended · Answer

The effectiveness of an Obagi Blue Peel depends upon many factors:

	1 Proper pretreatment of your skin with tretinoin cream for at least one month prior to the procedure.

	2 Proper degreasing of your skin before the blue peel is applied.

	3. The concentration of the acid used.

	4. The method of application of the acid to your skin.

	5. The number of layers of acid applied.

	It sounds as if your peel was not deep enough to get the desired result.

Should I Repeat Obagi Blue Peel for Melasma Treatment?

Answers (5)