Isotretinoin peels after

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. 

Fig. ii.2oa-c. Improvement of papulo-pustular acne (a) after 3 sessions pf 25% TCA peeling (b, c). This patient has been treated with oral isotretinoin 6 months before peeling procedure. 

Delayed re-epitheliaUzation exposes the damaged skin to mechanical injury as much as physical injury and infection, and there is a risk of hypertrophic, star-shaped scars on the cheeks that can form months after a peel has been carried out too soon after isotretinoin. 

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