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Post-Operative Instructions:
Chemical Peel

Chemical peel post-operative instructions

Instructions for Care during Trichloroacetic Acid or Obagi® Blue Facials

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 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 your 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 feel major discomfort. We will coat your face with Vaseline, and you will continue to apply this until you see the doctor again.

Facial Peel Pain Management

Most patients do not experience significant pain after a 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 washcloths (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 perform 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.

Washing your Face After a Chemical 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 it 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 the mixture 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 (Some prefer 1% hydrocortisone ointment or Catrix®). Apply your ointment or moisturizer gently and do not rub them in hard. You should use the ointment or moisturizer as often as necessary to keep your skin from becoming dry and cracked. It’s better to 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. 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. Do not be alarmed since they will resolve over time. Also, be aware that some mild itching and burning is normal at this time.

The Healing Process

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. Also make sure that you 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. 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 your peel. Failure to do so can cause hyperpigmentation and will reduce the effects of your 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 skincare 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 sunscreen 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 your doctor will advise as to when you may wear 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 4 to 5 times per day. (Refrigerating your lotion will make it feel more soothing.)

Prescriptions

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. 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.

Summary


  • Continue to wash your face twice daily with cleanser and lukewarm water; do not wash off every bit of remaining ointment.
  • Use your daily lotion throughout the peeling, in the morning and evening.
  • Keep your face very moist with 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.

Give us a call with any questions or concerns at 805-648-5121.

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