Chemical Peel Post-Operative Instructions
Instructions for Care during Trichloroacetic Acid or Obagi Blue Facial Peels
The chemical face peel is a resurfacing procedure designed to rejuvenate the facial and/or neck skin. The face peel is a safe and effective procedure but patient compliance and the ability to follow directions are paramount for the success. Failure to obey your doctor’s orders can lead to serious complications such as herpes or bacterial infection or permanent scarring.
The day of you face peel, you will present to the office without any makeup. We will degrease your face before the peel and place the peeling solution on your face while you are asleep. When you awake, your face will feel sunburned but you will not be in extreme pain. We will coat your face with Vaseline and you will continue to apply this until you see the doctor again.
Most patients do not experience significant pain after face peel. If your face hurts, the best treatment is to apply cold compresses to the treated areas of the face. We recommend that you take a salad bowl and wash it well. Fill it with water and ice cubes and soak several wash cloths (or gauze) in the bowl and keep the bowl in the refrigerator. Apply the cold cloth to the face and this will ease the discomfort and assist the swelling. When the cloth becomes warm, replace it with a new cold soak cloth. You can do this as much as you wish, but doing this will wash off the Vaseline, so remember to place a good coat over the treated areas when needed. Remember, you can use as many cold soaks and as much healing cream as you wish.
Make sure you have your prescription for the Obagi Conditioning Kit, 3% hydrogen peroxide, and any bland moisturizer you may have. In addition, you will need five to seven days worth of antibiotics to take during your peel.
Use the Foaming Gel or a gentle cleanser (Neutrogena, Dove, Purpose) to wash your face gently for 20 to 30 seconds twice daily. Lather the cleanser in your hands and gently pat onto your face, then splash lukewarm water onto your face to rinse. Dry your face by patting gently and then cleaning with a towel. If you have been instructed to use 3% hydrogen peroxide (which reduces the chance of infection), use it diluted (mixed half/half with clean water) after washing your face twice per day. Gently dab onto your face with cotton balls or gauze. It will bubble and may often turn white. If hydrogen peroxide is too irritating and stings, you can dilute even more with clean water.
After washing and patting your face dry, apply the prescription conditioning ointments as directed, both morning and night. After this has soaked in, apply the mixture of Action (moisturizer) and Tolereen (0.05% hydrocortisone) or an equivalent moisturizing and anti-inflammatory ointment you may have (I prefer 1% hydrocortisone ointment or Catrix). Apply your ointment or moisturizer gently and do not rub this in hard, and you should use the ointment as all moisturizers as often as necessary to keep your skin from becoming dry and crackled. I would rather you be too greasy than not greasy enough. Do not let your skin dry out, it will pull on the new tissue underneath and may cause red, irritated areas. You can apply your ointment or moisturizer five times per day, if you so desire. This will reduce the tightness and make you more comfortable, and do not worry if all the ointment does not come off, when you wash your face; it will not harm you to leave some on. You may develop occasional whiteheads because of all the ointment on your skin, and this is normal, and do not be alarmed since they will resolve over time. Also, be aware that some mild itching and burning is normal at this time.
Be sure and minimize facial expressions during your peel. Excessive facial movements will cause the skin to crack prematurely and this is not a good time to see a funny movie, visit your dentist or eat a large burger or sandwich.
Do not pick or rub your skin at all! If you must wash your hair, wash it with your head tilted backward in the shower or in the sink. Do not wet your face in the shower, too much water will cause you to peel prematurely and it will leave you with red, sore areas that may lead to scarring or need to be treated again. If large pieces of skin are hanging from your face, they may be cut off carefully with a blunt-nose scissors. Do not sit in a sauna or Jacuzzi or do strenuous exercise at this time. Sweating will make your face sting and it will cause you to peel too soon.
Do not expose your face to sunlight at all during healing (for the first two weeks). If you have to do some exercise, you may go out for a walk in the early morning or late evening, when the sun is barely out and wear a hat.
During peeling, think of your dark old skin (which is peeling off) as a bandage protecting the fresh skin underneath. The longer you can keep this bandage in place, the better the results of your peel.
You may have some swelling during the first two to three days after your peel, particularly if it is a medium or deep peel. In extreme cases, your eyes may swell almost closed during the first two mornings. This is a normal response and will resolve on its own, but sleeping with an extra pillow to elevate your head may help decrease the swelling in the meantime.
Do not apply ice packs or cold compresses to your face to decrease the swelling. The moisture from these may cause the skin to peel prematurely.
It is important you try to sleep on your back so as to not rub your peeling against the pillow. This could create an area of prematurely peeled skin.
After the peel, sunscreen must be used to protect your skin from the rays of the sun. Sunscreen – Keeping sun off the face is very important and important for proper healing. All patients should avoid direct sunlight for 4-6 weeks after surgery. It is also very important to avoid sunlight or sun exposure for the first month after peel. Failure to do so can cause hyperpigmentation and will reduce the effects of you peel. In addition, sunlight will prompt a quicker return of brown spots. After the tenth day, you should be wearing daily sunscreen (you should be anyhow!). In addition our office can provide you with medically based skin care products that will protect the longevity of your facial improvement.
Using sunscreen and sunglasses, and a wide brimmed hat are necessary. It is also important to protect your healing skin from sunlight that comes through car or office windows. Using a high quality sun screen with at least SPF 30 is recommended. This should be applied several times per day during the healing period. You need to use sunscreen even if wearing a hat, since the reflected rays may also cause damage, and you do have a prescription for sunscreen in your Obagi Kit.
Makeup may be used after one to two days after peeling is complete (usually after a week), and I will advise as to when you may where it.
If you have unexpected irritation or possible infection, call the office immediately! Do not wait until your next appointment. This is especially important, if you think you may be developing a cold sore on your lip.
If you are experiencing a lot of itching, be sure to use plenty of 1% hydrocortisone ointment. You may also try using a daily lotion four to five times per day. (Refrigerating your lotion will make it feel more soothing).
Your chemical skin resurfacing is a safe and predictable procedure, but is reliant on multiple medications to prevent viral and bacterial infection, reduce swelling, control discomfort and assist in sleeping. You will be given prescriptions for some of the following medications. The prescriptions that you have been given should be taken as prescribed. It is imperative that you understand the prescription regimen and take the medicines as directed by Your doctor.
- Continue to wash your face twice daily with cleanser and lukewarm water; do not wash off every bit of remaining ointment.
- Use may your daily lotion throughout the peeling, in the morning and evening.
- Keep your face very moist with the Action and Tolereen or 1% hydrocortisone ointment as recommended.
- Do not pick or rub your skin.
- Do not go into the sun at all while peeling, even for five minutes!
- Do not use the cleaning or moisturizing routines as an excuse to speed up the peeling of your skin through excessive rubbing; it will only increase your risk of complications.
- Do not be alarmed, if you feel flush or warm, when you bend over, as this is a temporary condition that resolves after the peel has completely healed.
- Avoid exercise and sweating.
- Minimize facial expressions.
- Sleep on your back.
If you have any problems or questions your doctor is available 24/7 at Oral & Maxillofacial Surgery of San Buenaventura Phone Number 805-648-5121