Complications of medium depth and deep chemical peels

Abstract

Superficial and medium depth peels are dynamic tools when used as part of office procedures for treatment of acne, pigmentation disorders, and photo-aging. Results and complications are generally related to the depth of wounding, with deeper peels providing more marked results and higher incidence of complications. Complications are also more likely with darker skin types, certain peeling agents, and sun exposure. They can range from minor irritations, uneven pigmentation to permanent scarring. In very rare cases, complications can be life-threatening.

Chemical peels: A review of current practice

“…These include irritation, burning, erythema, pruritus, oedema and blistering. 11,52,62 Minor complications also occur in a delayed fashion appearing over days to weeks. These include the development of acneiform eruptions, infection (bacterial, fungal and viral), persistent erythema, demarcation lines and milia.…”

Chemical burn following 50% trichloroacetic acid for acne: Presentation of a case and a focused review

“…These factors preclude such patients from receiving deep peels, and warrant the use of great caution for superficial or medium peels, even by the experienced practitioner (Roberts, 2004;Salam et al, 2013). In addition, use of estrogen containing medications, photosensitizing drugs, and early exposure to sunlight all increase the risk for hyperpigmentation (Nikalji et al, 2012). In the case of our patient, skin type and improper self-administration of high strength TCA were the leading instigating factors.…”

“…Complications associated with chemical peels can be divided into immediate onset effects, which occur within minutes to hours, and late onset effects, which occur in days to weeks (Nikalji et al, 2012) (Table 2). Our patient's striking presentation following 50% TCA reflects hyperpigmentation in combination with persistent erythema.…”

“…Our patient's striking presentation following 50% TCA reflects hyperpigmentation in combination with persistent erythema. Hyperpigmentation is the most common complication occurring after a TCA peel (Nikalji et al, 2012). The mechanism underlying TCA induced hyperpigmentation may be related to the skin stress response system.…”

Emergency Management of Chemical Burns

“…The increased use of chemical peeling in the last few years created a new category of chemical burn cases who can have serious complications [6]. Other causes of chemical burns can be due to extravasation of some drugs from the intravascular compartment to the surrounding tissues with the result of sustaining burns to these tissues [7].…”