Complications Are Not Uncommon
Chemical peeling usually results in a different improvement in the quality of body skin, whether it is your face or any other part of the body. But this kind of treatment also has its potential complications. Complications are generally attributed to the depth of wounding, with deeper peels providing more marked results and a higher possibility of complications. Complications are a lot more likely with darker skin types and different peeling agents.
The condition of Erythema generally reduces within two months but may be prolonged and even be manifested as hyper pigmentation. Patients taking oral contraceptive pills, exogenous estrogens, or other photosensitizing medications are at a much higher risk. Application of topical hydrocortisone lotion or a short course of systemic steroids may take you back to the previous resolution. Other treatment options for hyper pigmentation include trans-retinoic acid, glycolic acid, or hydroquinone. Oral antihistamines can treat accompanying pruritus.
After a chemical peel is done, the skin stays very sensitive to the sun, which could also be a source of hyper pigmentation. Patients should be instructed to use sunscreen daily for about a year following a chemical peel. Patients should also be taught how to apply camouflaging makeup without damaging your skin. The reason for hypo pigmentation is the result of melanocyte inhibition or destruction. Melanocytes do not possess the ability to regenerate or to divide. Hypo pigmentation is very frequent when phenol is used as a peeling agent, which may lead to many abandoning phenol in favor of other agents. Hypo pigmentation is substantially more noticeable on patients with darkly pigmented skin.
Hypo pigmentation could be quite difficult to assess till the condition of erythema has subsided, at a point where the condition could unfortunately become permanent. The line of demarcation between treated and untreated skin is always quite noticeable. If you look at a person who hasn’t been treated yet, you will be able to see the wrinkles and the stray marks all over, and when the peel is done, suddenly everything looks so much clearer. The peel may be feathered at a line which demarcates a peel which is done with natural shadowing to create a smooth transition zone. This can be performed by using a less concentrated peel or by applying less of the peel in these areas. Camouflage makeup can also conceal these differences in pigmentation.
If the healing gets delayed, it may lead to hypertrophic scarring, a terrible complication requiring close follow-up and fast, early treatment. Topical or intralesional steroids, silicone sheeting, pressure application, and scar massage are possible solutions to improve outcomes. Even scar excision or dermabrasion may be necessary in a few cases of unsatisfactory results. Infectious complications are unusual but also demand vigilance constant monitoring along with oral and topical antibiotics. Pseudomonas infections are usually treated by washing the face with equal parts of water and distilled vinegar. Herpes exacerbations are checked with oral and topical acyclovir until it gets better. Most of these lesions respond quickly to such treatment and hardly cause any scarring.