Chemical peels contraindications

It is important to obtain details regarding isotretinoin (Accutane, Roacutane) treatment and history of keloid or hypertrophic scar formation. Isotretinoin use necessitates a delay period of 6-12 months (depending on the skin thickness and oiliness) until chemical peel is performed. Active acne is not a contraindication for chemical peel. In these cases the peel is combined with systemic antibiotics for 2-3 weeks. It is always advisable to consider isotretinoin treatment after the peel to avoid acne flare and scar reappearance. 

It is important not to confuse an allergy with the skin s natural response to the chemical peel applied behind the ear. A highly localized and normal skin reaction to the peel will occur erythema followed by flaking. The appearance of any blistering or pruritus contraindicates any further contact with resorcinol completely and definitively. If a patient is allergic, Unna s paste causes reversible facial eczema, with no cosmetic benefit. 

The high risk of focal or widespread facial necrosis contraindicates a phenol peel immediately after a face-lift. If a face-lift and a deep peel have to be combined, the surgical face-lift must be done first and the chemical peel afterwards to avoid the demarcation line being surgically lifted to the cheek. Caution usually dictates a gap of 6 months between a surgical face-lift and a deep peel. It is of course possible to perform a face-lift without blepharoplasty and a phenol peel around the mouth and eyelids at the same time... 

In general, there are few conlraindicalions to salicylic acid chemical peeling. Salicylic acid peels are well tolerated in all skin types (Fitzpatrick s I through Vt) and all racial-ethnic groups. General contraindications... 

Absolute and relative contraindications to deep chemical peels inclnde [278, 280] ... 

In general, there are few contraindications to salicylic acid chemical peeling. General contraindications include salicylate hypersensitivity or allergy unrealistic patient expectations active inflammation/ dermatitis or infection at the salicylic acid peeling site acute viral infection pregnancy and isotretinoin therapy within 3 to 6 months of the peeling procedure. 

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