Physician’s Guide to Treating Chemical Peel Burns
Chemical peels, or chemexfoliation or derma-peeling, are techniques to improve the appearance of the skin. A chemical solution is applied to the skin, causing it to “blister” and eventually peel off. The new, regenerated skin is smoother and less wrinkled than the old skin. A chemical peel can be performed in a doctor’s office or as an outpatient procedure. The skin is thoroughly cleansed with an agent removing excess oils. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol), are applied to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.
During a chemical peel, patients will experience a burning sensation that lasts about five to ten minutes, followed by a stinging sensation. Cool compresses may be applied to help alleviate the stinging. A deeper peel may require pain medication during or after the procedure. Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness, followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved. Medium-depth and deep peeling may result in swelling, as well as the presence of water blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to twelve months, if necessary.
Though the vast majority of chemical peels are performed without complication, burns may happen. Common reasons:
With certain skin types, there is a risk of developing a temporary or permanent color change in the skin after a chemical peel. Taking birth control pills, subsequent pregnancy, or family history of brownish discoloration on the face increases the possibility of developing abnormal pigmentation. Although low, there is a risk of scarring in certain areas of the face, and certain individuals may be more prone to scarring. If scarring does occur, it can usually be treated with good results. Also, there is a small risk of reactivation of cold sores in patients with a history of herpes outbreaks.
In some businesses without extensive clinical skin care expertise and protocols, such as some day spas, applicators are simply following a recipe, unable to diagnose skin care conditions and reactions. The most critical elements in chemical peels is preoperative assessment of the patient’s skin and protocol. A safety profile relies on a rigid preoperative and postoperative skin protocol and detailed preoperative assessment. This advanced knowledge can be missing at day spa, leading to conditions where chemical peel burns are more likely to occur.
This patient suffered burns from a chemical peel applied by a nearby day spa. An inexperienced clinician applied an aggressive 4% glycolic acid peel, without diagnosising the patient’s psoriasis.
- Immediately remove the burn’s cause. Take the chemical peel off and then rinse the affected area with cool water. Continue rinsing for at least 20 minutes.
- Remove any jewelry or clothing that has been contaminated. Wash well.
- Relieve pain by applying a cool towel or wet cloth to affected area.
- Protect the burned area by loosely wrapping the affected area, using a clean cloth or a dressing that is dry and sterile.
- Rewash the burn area
- Avoid popping blisters that may form. Gently apply aloe lotion to relieve the pain.
Scarring and pigment changes from peeling can be improved, but there is no one solution. The patient will need to be evaluated by a good dermatologist to determine treatment options. There are interventions that can help varying, such as laser, steroid cream, aquaphor healing ointment (over-the-counter version), and injections.
- Set expectations. Redness and irritation are expected after a chemical peel. The skin is likely to appear dry and flaky as the top layers begin to peel away. This dryness and peeling generally lasts for a few days for light peels, and up to four weeks for deep peels.
- Wash the skin, using a gentle cleanser. Choose a highly hydrating cleanser free of abrasive detergents. The skin will be incredibly sensitive following the peel, so avoid harsh cleansers.
- Use cool water to rinse the area. Do not use hot or warm water, since the heat will further irritate burned skin.
- Moisturize the skin. Use a rich moisturizer to deeply hydrate the burned area, utilizing one that is free of added dyes and fragrances to avoid irritating the area further.
- Drink ample water. Burned skin needs to be moisturized from the inside. Consume at least 80 ounces of water daily to nourish dehydrated skin.
- Avoid sun exposure. After a chemical peel, the sun’s damaging rays can injure skin. If the patient must be outside, use a high level SPF sunscreen that protects against both UVA and UVB rays. Wear a wide-brimmed hat and large sunglasses.
- Do not touch the treated area. While it’s tempting, do not peel away flaking pieces of skin. This can seriously damage your skin and lead to permanent scarring.