Recovery and aftercare chemical peel

Recovery and aftercare chemical peel

Early phase of the recovery (7-10 days)

What to expect?

The appearance on the first day can be quite impressive. The early phase of the recovery lasts 7 to 10 days as the skin gradually reepithelializes. Deeper peels may require 14 days.

  • Oozing—During this period, the skin is swollen, moist and oozing serous fluid which become crusts when drying up. Crusting may be uneven, and some areas may heal faster than others due to variable depth. Somewhere between two and seven days, you’ll probably wonder if it was all worth it. Be reassured, however, that you’re experiencing normal healing.
  • Swelling—Depending on the depth of the peel, you may be considerably swollen and generally unrecognizable.

What to do?

  • Take your medication—This medication will be given to you.
    • Ibuprofen—Narcotic pain medication is prescribed for postpeel discomfort. If properly managed, the peel should not be overly painful. Ibuprofen 800 mg administered three times daily is recommended
    • Medrol—To control the swelling the day after the operation we start a short course of Medrol, 4 tablets a day.
    • Antiviral medication—is to be continued until 7 days after the procedure (2 tablets a day)
  • Occlusive Antibiotic-Anesthetic ointment followed by paraffine-vaseline ointment— Keep the skin constantly moisturised with the ointment to prevent drying and crusting, apply the ointment several times a day, a thin layer is enough, but continuously shining. When the antibiotic-anesthetic cream is finished, use the paraffine-vaseline ointment we gave you during your preoperative consultation. As soon as the skin is nicely healed (after 7 – 10 days) the ointment becomes less necessary.
    Keep the skin constantly moisturised with the ointment to prevent drying and crusting
  • Washing the face—From day two onwards you can begin to wash the face gently. In the shower this means a very weak stream or deflecting the main thrust of the water with a hand and letting the water trickle onto the face. Use mild facial soap.
  • Soaked compresses—Gently press compresses soaked in water on the surface of scabs to clean the face and remove scabs (dried from oozing fluid). You can do this 3-4 times a day.
    Don’t pick the scabs to prevent scar formation. Never force scabs off your face.

Next phase of the recovery (about 2-3 months)

What to expect?

  • Redness—The next phase of the recovery is notable for redness due to revascularisation of the new skin, which predictably lasts between 8 to 12 weeks and is usually well tolerated with camouflage make- up. You can use makeup with a green foundation to neutralize redness. Intense erythema can be seen with deeper peels and can be improved with judicious short-term use of topical steroids.  Patients who have fared well in the first phase may now experience a paradoxical depression because they are eager to normalise their lives but may feel inhibited by the erythema.
    Avoid prolonged exposure to the sun until any redness has faded. Apply a sunscreen with a protection factor of at least 25, which has both ultraviolet A and B protection. Reapply often when in the sun. You should use sunscreen for at least six months after treatment. Always use foundation over sunscreen. Failure to do so can result in blotchy skin pigmentation requiring further treatment.

What to do?

    • Non occlusive moisturizer—After day seven to ten reepithalization is usually complete and the skin dries. You may apply an emollient free of fragnances and irratating products in areas where the skin feels really tight. The skin should be kept comfortable, not too dry, to avoid cracking, and not too moist, to avoid maceration of the skin. Occlusive ointment (parafine-vaseline) may be used on lips, around corner of mouth and corner of eyes as needed to prevent cracking.
    • Tretinoin—After two weeks you may start using the tretinoin ointment again as before the peeling. If you feel your skin cannot tolerate it yet, apply every other day until every day regime is tolerated again. Continue the use for one cycle of 6 weeks.
    • Hydroquinone—Idem as tretinoin.
    • Hydrocortisone—Use when you experience itching. Maximum one week in a row.
    • Sunscreen—Apply standard the sunscreen in the morning for 6 months. Sun avoidance is advised.
    • Makeup—Makeup can be used to cover up the redness.  Makeup with a green foundation neutralizes redness. Always use foundation over sunscreen.

The final result won’t be evident until the redness is gone.

 

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