Preparation for a skin peel depends mainly on the type of skin you have and will ultimately be decided by your doctor. Fair-skinned people may not need to be treated before peeling. If you have skin of color, however, then you're at increased risk of developing dark spots following your peel. In this case, a pretreatment regimen including glycolic acid, hydroquinone, and Retin-A (retinoic acid) is frequently suggested to help minimize the possibility of postoperative hyperpigmentation, make your peel more uniform, and decrease your downtime. As a general rule, you should follow the pretreatment regimen for three to four weeks.
After your treatment, most surgeons will give you prescriptions for antiviral medications and antibiotics. Physicians vary from practice to practice on what topical creams and ointments they prescribe to reduce pain and inflammation. Your physician will determine your specific postpeel regimen.
Here's what you should know about your recovery from a peel:
- You need to be prepared for your appearance more than anything else. You'll look worse than you feel, but your appearance will improve very rapidly in the first week after your procedure.
- You'll swell to some degree, but swelling will diminish fairly rapidly in the first few days. Having someone around to help with activities such as dressing changes and meal preparations is a good idea.
- Any discomfort you experience will be short-lived but can be significant for the first few days.
- You'll see your physician either daily or every other day for the first week to have your wound assessed.
- You'll probably want transportation to the office for the first few visits. You may be very swollen, and discomfort may interfere with driving ability.
- Peels can be uncomfortable for a few days, and the peeled area may look unsightly. Some patients want to hide the peeled area.
Getting through the pain
In general, anyone who undergoes a trichloracetic acid (TCA) peel will have a relatively painless post-treatment course. The injured skin stays on the wound and acts as a dressing. This skin doesn't peel off until the underlying skin is healed. Your skin will feel tight and you will feel like you can't apply enough moisturizer. Pain, however, isn't the major symptom.
Laser peels and croton oil peels are deeper than most other peels, and for a few days, you'll experience discomfort from the open wound created by the peel. You'll receive pain medication and detailed dressing instructions to follow until you're healed. You'll also start taking an anti-inflammatory medication before the peel and continue it until you've healed. If pain becomes intolerable, call your doctor's office.
Taking it easy
After a skin peel, you need to stop all vigorous physical activity. If you're taking any pain medication, you won't be able to drive because the medication may slow your reaction time or make you drowsy. You'll be swollen as well, so if you have trouble opening your eyes, you shouldn't drive. In addition, you should avoid any activity or environment that causes you to sweat because sweating will make your ointment or cream runny and more likely to get into your eyes, causing irritation and blurriness.
Laying low or hiding out
Moderate and deep skin peels do have associated downtimes. You'll want to hide out for seven to ten days, depending on the depth of the peel, because you'll have excessive peeling during this time or the need to apply heavy coats of petroleum jelly to keep the wound moist. After your wound has completely epithelialized (grown new skin), you can apply coverup makeup and resume normal life activities.
Knowing what's normal
Deep skin peels, either with the laser or chemicals, require more labor-intensive care than other peels in the first few days. You'll experience irregular healing based upon skin thickness, and the wound won't look good to you. You'll need reassurance from your surgeon that your appearance is normal. Somewhere between two and seven days, you'll probably wonder if it was all worth it. Be reassured, however, that you're experiencing normal healing.
Judging the result
Deep skin peels, either laser or chemical, take several months to heal. Redness means that your skin is still inflamed and still generating collagen. The final result won't be evident until the redness is gone. The timing of a second peel, if you need one, is up to your doctor. At a minimum, you have to wait until you're completely healed from the previous procedure, which in most cases takes several months. Many doctors wouldn't even consider doing a second peel for six to nine months.
