A Very Uncommon Complication Of Chemical Peels

Swelling – usually lasting up to three days, but it is usually only associated with the deeper peels.

Pain – again, this is only really seen with the deeper peels and may last for a few hours only.

Redness – most superficial peels produce a mild amount of redness that persists for a few days only. Medium to deep peels can cause redness that can persist for up to a month.

Itchiness – This is only common after medium and deep chemical peels.

Ocular injury – Care must be taken during the procedure to avoid the peel from entering the eye.

Allergic reactions – uncommon, although peels such as the Jessner peel have a higher rate of allergy. Anti-histamines may be taken before, if an allergy is known, or after.

Folliculitis /acne – this occurs commonly as a result of the emollient creams used during healing. Antibiotics may be required to heal these eruptions.

Bacterial/fungal infection – is uncommon. It can, however, lead to scarring. This is usually only associated with medium to deep peels.

Herpes simplex recurrence – is common and needs to be treated with anti-viral medication to prevent spread and scarring.

Hyperpigmentation – dark patches over the peeled areas. This usually occurs over the deeper parts of the peel and is a result of inflammation causing release of melanin/pigmentation from the skin (post-inflammatory hyperpigmentation). This is usually temporary, although it can last for up to 2 years. Treatment usually involves a lightening agent such as hydroquinone.

Hypopigmentation – is a loss of pigmentation and usually occurs in darker skin types after peeling. This can be permanent sometimes.

Telangiectasia – are small red vessels under the skin and can become more prominent with peeling. The vessels are easily treated with lasers such as the Gemini laser.

Milia – this are small white cysts that form about 2 to 3 weeks after the skin has re-epitheliased (grown over). It can be due to blockage of the skin due to emoillent creams used after chemical peeling. They can be removed with a needle or lancet.

Demarcation lines – this is usually a result of medium to deeper peels, and the line of where the peel was used and the untouched skin is noticeable even after the skin has healed.

Scarring – a very uncommon complication of chemical peels. This is usually associated with a history of poor healing or keloid scarring. Scarring is more likely the deeper the peel. A early sign of scarring is persistent redness and itchiness. This needs to be treated with a topical steroid.