Infection post-peel care

These are more common when patients have to undertake complex post-peel care themselves. The basic principles of sterility are not widely known by the public and require special training in order to be effective. The more patients have to take part in the post-peel care, the higher the risk of infection. 

Bismuth subgallate (BSG) is a yellow powder that makes post-peel care easier and spares patients having to apply complicated localized treatments themselves, which could cause infection (see also Chapter 34). A generous amount of BSG is sprinkled directly onto the moist areas of skin where the epidermis has been destroyed, ft can also be spread on with a gloved hand or sterile swab. 

Whichever technique is used instead of the occlusive mask, there is an increased risk of infection, injury, allergies or errors, and a transparent occlusive mask is recommended during the first 24 hours to improve the peel s effectiveness, reduce the need for patient participation in post-peel care and lower the risk of secondary infection. 

The risk of scarring after a TCA peel is also linked to the quality of the care surrounding it. Apart from some serious cases, scars do not form immediately, but are preceded by prolonged local erythema and/or infection that should be diagnosed and treated appropriately. Many problems (see below) can be avoided by proper patient selection, and post-peel monitoring can limit others. 

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