Postpeel Management

Similar to superficial peels, the postpeel regimen is geared toward maximizing the benefit and minimizing adverse effects. Postoperative day one, the patient is instructed to soak with 0.25% acetic acid solution four to five times a day and apply a bland emollient (petrolatum based) until re-epithelialization has occurred. After 24 h, a mild, nondetergent cleanser can be used on the face.At this point, the brawny desquamation that replaced the frosting is more visible and sloughs over the next 5–10 days, leaving behind bright erythema characteristic of new skin formation. The process of re-epithelialization is generally complete 10 days out, at which point the patient may discontinue the antiviral prophylaxis and begin to wear makeup, if desired. Again, many physicians counsel patients to avoid smoking in the postoperative period fearing that tobacco use may lessen the peel effect and increase risks [47]. Sun exposure should be avoided for 6 weeks postprocedure to reduce the risk of dyschromia and limited thereafter to minimize the recurrence of photodamage.