Pigmentary changes prevention

Before any classic peel, steps must be taken to limit the risk of pigmentary changes. Preparing the skin with tyrosinase inhibitors (hydroquinone, kojic acid, azelaic acid, arbutin, Morus Alba, licorice extracts, etc.) is especially recommended to curb the enthusiasm that certain melanocytes have for converting tyrosine into melanin. Preventive measures should begin 3-4 weeks before a medium or deep peel. 

If the melanin responsible for the melasma is too deep, TCA will only be effective after many repeated sessions. In any event, the TCA peel must be combined with effective sun protection and appropriate post-peel care in the long term. Simple aqueous solutions of TCA also require the skin to be prepared, in order to even out penetration and prevent common pigmentary changes. 

Prevention of pigmentary changes Blending Bleaching cream and Melablock HSP 50 or 25 should be applied until the following treatment or for at least 6 weeks. 

A few areas of mild erythema, which changes color with the cold, alcohol or emotion, can very occasionally last for several weeks. Erythema after a resorcinol peel is usually reversible without treatment, but requires preventive treatment against pigmentary changes, especially in high-risk patients (see the preceding paragraph and Chapter 37). 

Not counting the importance of skin preparation, the adjuvants used, technical errors and preventive postpeel care and treatment, the risk of pigmentary changes can be quantified diagrammatically as follows ... 

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