Phenol peels erythema

After a deep peel, the body takes 4-6 weeks" to regenerate a structurally normal skin. During these 6 weeks, the skin appears very red, as the many newly formed blood vessels are showing through an incomplete, thinned and pale epidermis. Six weeks is usually the minimum time that erythema lasts after a phenol peel. After this time, inflammation may persist and the skin can still appear red for several more months. 

The injection can also be given 8 days after the phenol peel, if not done beforehand. Injecting botulinum toxin during the post-peel period of erythema and edema increases the risk of the toxin moving as well as the risk of temporary cosmetic complications caused by the toxin. The duration of the toxin s effect does not seem to change much, however. 

Before (a) and after (b) a full-face phenol peel (Lip Eyelid formula) a combination of yellow skin, wrinkles, fine lines and lentigines in a patient who smokes. Thirty days after the peel the erythema is normal. The patient is not wearing any make-up. Botulinum toxin was injected 8 days before the peel (forehead, frown lines and crow s feet). 

Patients who absolutely refuse to wear make-up during the post-peel period are not the best candidates for a phenol peel, as the erythema and potential dyschromias, even if temporary, are best covered up with make-up. 

Phenol (Lip Eyelicf formula) if a full-face phenol peel does not produce adequate results, a second peel can be applied to the areas that did not respond to the first peel. The touch-up can be localized or full-face, if the condition of the skin permits and if there has been a long rest period. Skin regeneration after the second peel is much quicker, there is less edema and post-peel erythema is of a much shorter duration (2 weeks at the most). If a third phenol peel were indicated (in extremely rare cases of very thick skin, patients who smoke, or rapid resumption of facial expressions), it would most often be localized. The author has only once had to do a third phenol peel on the lip and cheek area after inadequate results on skin that was extremely oily and thick. Recovery was even faster after a third application of phenol and there was hardly any erythema. It should be noted that if a second phenol peel can boost inadequate results, a third phenol peel only brings a very slight improvement over the second. 

Normal erythema after a full-face phenol peel. 

Phenol peels are always accompanied by severe erythema (Figures 37.14 and 37.15). The erythema appears immediately around the edges of the frosting caused by the phenol and can then be seen on all of the treated area, as soon as the frosting fades. This immediate erythema results from inflammatory vasodilation that follows chemical injury and is normal. After 24 hours, the patient appears severely burnt, as can be seen in Figure 37.14. The classical phenol formulas often cause erythema that last more than 3 months, or sometimes even several years. It can be permanent (in some rare cases). Lip Eyelid causes erythema that lasts 1-3 months on average. 

Erythema is inevitable after a phenol peel (Figure 37.18). ft can sometimes be less severe and of a shorter duration if a corticosteroid is injected intravenously at the beginning of the peel. Its intensity varies from patient to patient, from light and imperceptible to severe and deep. Resorcinol is a potentially allergenic phenol derivative persistent, pruritic erythema after a resorcinol peel might be a sign of contact dermatitis. 

Corticosteroids by the systemic route will only be needed very rarely to treat erythema. They can be administered in a single and preventive injection at the start of a phenol peel. Promethazine can be recommended, at a maximum dose of six times 25 mg/day, when the erythema causes pruritus and reflex scratching that could lead to unsightly scars, infections or dyschromia. 

In a study of 46 Asian patients treated with a modified phenol peel (Exoderm), the most frequent side effects were postinflammatory hypapigmenta-tion (PIH) (74 %), temporary prolonged erythema, colloid, and milia. Hypopigmentation persisted for 6 months in a follow-up period. All these side effects were temporary and reversible, with the exception of hypopigmentation in one case [340]. 

I treated one case of candidiasis in a patient who received a phenolic peel from another practitioner a week before. She developed intense pruritus, perioral pustules and perleche in association with mild erythema. Pmritus is a common presenting symptom in patients with infectious processes and can occur in the absence of them. If 1... 

Phenol Face peeling antipruritic Milia persistent erythema skin pore prominence telangiectasia scarring pigment alterations (SEDA-7, 166)... 

Day 1 after a localized Lip Eyelid peel of the four eyelids. The upper eyelid tarsus was not treated with phenol it does not show any skin change, just edema and severe erythema. 

An intraepidermal peel is characterized by the following symptoms erythema without frosting after an AHA peel or erythema and maybe some pinpoint frosting after a TCA peel. Phenol is not indicated for this depth of action. 

A peel to the basal layer (Figure 37.22) is characterized by erythema and the appearance of pinpoint frosting after TCA or generalized erythema after AHAs. Phenol is not indicated for this depth of peel. 

Skin Side effects during deep peeling using phenol in treating atrophic post-acne scars were transient acneiform eruptions, transient erythema and hyperpigmentation, which resolved within 3-4 months. Two out of ten patients developed persistent erythema for 6 months, which had to be cured using topical pimecrolimus [81 ]. 

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