Hyperpigmentation after phenol peels

Complete sun avoidance and effective sun protection is a must for 2 or even 3 months (see Chapters 2 and 3). Post-inflammatory hyperpigmentation (PIH) is not at all uncommon, even after a phenol peel. After the immediate post-peel period, which requires close and almost daily monitoring, it is advisable to see patients again after 15 days, 30 days and 2 months and to warn them of the need to treat any early signs of hyperpigmentation immediately. It should be noted that PIH frequently resolves itself without treatment after a phenol peel. 

Phenol peels do not always produce the results hoped for, but fortunately it is rare that the results are so inadequate as to require extensive touch-ups or a complete re-peel. An extensive touch-up can be done 6 weeks after the peel. Fintsi reported an incidence of 30% of local touch-ups after Exoderm . In his study, 21 cases out of 558 had to be given more extensive touch-ups 20 times for acne and once for a hyperpigmentation problem. 

In principle, the texture of their skin makes them good candidates for phenol, as they get wrinkles sooner than darker skin phototypes and do not often suffer from post-inflammatory hyperpigmentation after a medium or deep peel. All the freckles will disappear, however, leaving the skin depigmented and a demarcation line on the neck. Red-haired patients are the ones most at risk of complete... 

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