Postinflammatory hyperpigmentation chemical peels

Chemical peeling can be a useful adjunct in treating cases of persistent postinflammatory hyperpigmentation and those unresponsive to topical bleaching agents... 

Very superficial and superficial depth peels are useful in Asian patients as they have lower postpeel complications. Medium-depth peels are done only in selected patients by experienced dermatologists as they can potentially cause postinflammatory hyperpigmentation. However, in dark-skinned individuals, deep chemical... 

Superficial peels are usually safe and well tolerated, with such undesirable effects as burning, irritation, and erythema [281]. With superficial peels, scarring and infection are rare. With medium and deep peels, demarcation lines (technique-related) may occur [281]. Deeper peels may have adverse effects of postinflammatory hyperpigmentation (PIH in dark-skinned individuals), infections, allergic reactions, improper healing, disease exacerbation, and complications secondary to improper application [281]. Chemical injuries may occur when glacial acetic acid is not properly used for chemical peeling [341]. 

Figure 5.6 Patient with pseudofolliculitis batbae and postinflammatory hyperpigmentation before (A) and after (B) a series of five salicylic acid chemical peels.

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