Chemical peel risks are fairly minor compared to the risks associated with invasive cosmetic surgery procedures. However, this does not mean treatment is risk free. Chemical peel complications and poor results can occur for a number of reasons. Here are some of the ways things might go wrong:
- The patient’s skin is not prepared for the peel
- The chemical peel is not a good match for the patient’s skin tone
- The peel is too strong or too weak
- The peel is not applied correctly (for example, some solution is dripped on the wrong area)
- The chemical solution is not neutralized and removed at the right time
- The patient has a sensitivity or allergy to an ingredient in the chemical peel
- The patient does not follow post-operative instructions carefully
- The patient has unrealistic expectations about the level of improvement offered
Normal Chemical Peel Risks
The common side effects associated with chemical peels are unpleasant; but they almost always resolve over time. Your cosmetic surgeon will discuss each potential side effect and how long it should last based on the depth of your peel. These issues can include:
Be sure to keep any follow up appointments with your plastic surgeon. If the symptoms are severe or do not heal in a reasonable amount of time, this can be an indication of a serious complication.
Potential Chemical Peel Complications
Serious complications are rare. These include:
This problem is most likely to occur with a deep chemical peel. Delayed wound healing, open sores, foul smelling pus and excessive scabbing are indications of a potential bacterial infection. This complication must be treated right away to control the infection and minimize scarring. Patients who carefully follow post-operative instructions for cleaning their skin are least likely to experience wound infection.
Scarring can be the result of mistakes in the procedure (such as using a solution that is too concentrated). However, some individuals are simply genetically prone to scarring. This problem is most common with the deepest peels. Patients who show signs of scarring during healing may be treated with steroids. Silicone scar reduction sheeting and pulsed dye lasers are additional options for addressing scars caused by a chemical peel.
Patients with darker skin tones tend to be most at risk for uneven or blotchy results from a chemical peel. They may experience permanent lightening of some areas of skin. These patients should only undergo chemical peels that are considered safe and effective for darker skin. This includes some light peels and some medium depth peels. Not all cosmetic surgeons agree on which peels are best. Yours will probably recommend one based on personal experience treating patients with dark complexions.
Individuals of all skin tones may experience hyperpigmentation (darkening) of the skin in patches. This can happen due to sun exposure, medications or sensitivity to ingredients in the peel solution. Hydroquinone or other creams may be prescribed to even out these areas. The most common cause of this chemical peel complication is failure to follow post-procedure instructions for sun protection.
Deep Chemical Peel Complications
Application of phenol carries the most significant chemical peel risks. Phenol can cause organ failure if too much of the chemical is absorbed into the patient’s system during treatment. A deep peel performed with the patient under general anesthesia carries additional risks associated with the anesthetic. Because of these risks, deep peels are only offered by medical professionals in a hospital or plastic surgery center and are not available in spa settings.
Factors That Increase Chemical Peel Risks
- Patients with darker skin tones are at greater risk for unsatisfactory outcomes from chemical peels due to uneven results.
- Individuals with a tendency toward keloid scarring (raised scars) may experience permanent scarring – especially with deeper peels.
- Patients who have very sensitive skin or a history of dermatitis (skin rashes) may be particularly prone to swelling and irritation after a peel.
- Certain medications such as oral contraceptives can increase the risk of unwanted pigment changes.
- Smoking can interfere with normal healing after a medium to deep peel.
- Patients who have had a cold sore in the past may break out in blisters that leave permanent scars after a mid-level or deeper peel.
- Individuals with severe acne or other active bacterial skin infections have a higher risk of poor wound healing.
This is actually one of the more common chemical peel risks. Not all patients respond well to a chemical peel. They may expect to see a greater degree of improvement and be disappointed with the results. Or, they might think the peel should have longer lasting results. The fact is that light and medium peels usually don’t have their full effect after just one session. These peels are designed for repeated application over a series of treatments for maximum impact. A deep peel is the only type that is done just once and that has effects that last for many years.