Pigmentary Changes

Delayed hypopigmentation is a reason why some doctors dislike the long-term results of deep peels. Hypopigmentation after phenol peels is proportional to the depth of the peel, amount of the solution used, inherent skin color, and post-peel sun-related behavior. Complete avoidance of any sun exposure years after the peel creates ivory skin color.

Reactive hyperpigmentation can occur after any depth of chemical peels. Usually lighter complexions have a lower risk for hyperpig-mentation, but genetic factors play an important role, and sometimes light patients with "dark genes" will hyperpigment unexpectedly. Therefore, we recommend introducing bleaching preparation 2-3 weeks after the peel in all patients and continuing until erythema fades. Demarcation lines can be avoided if the boundaries of the peeling area are hidden under the mandibular line and feathered gradually to the normal skin (Fig. 8.16). Medium-depth neck peel is required in patients with blotchy pigmentation of the neck and in those with no clear mandibular line. Accentuation of the pigment in previously existing intradermal nevi is common and should be recognized when it occurs to avoid any unnecessary alarm of a "changing mole".

Demarcation line due to wrong positioning of the lower margin of the treatment area

Demarcation line due to wrong positioning of the lower margin of the treatment area

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