Postprocedure Management

Postoperative management varies depending on the physician’s preference and experience. Most physicians follow a modified wet or semiocclusive technique. Patients are instructed to soak their face with plain water several times a day,which is best done by standing in the shower and letting the water fall on the crown and then run down the face for several minutes. This allows the debris and serous exudates to be gently removed from the treated area. Fingertips and gentle soap can also be used, but abrasives should be avoided.After cleansing the face, a bland emollient (petrolatum) or antibacterial ointment is then applied generously to the entire face. This regimen should be repeated three to five times during the day. It helps to avoid heavy crust formation and allows for rapid re-epithelialization, usually within 12 days [43].

Once epithelialization is complete, the patient is instructed to use green-tinted foundation makeup to minimized erythema. Daily sunscreen is resumed and continued indefinitely. Patients should be instructed that the residual erythema might take several months to subside. Also, hydroquinone and tretinoin therapy may be resumed after epithelialization is complete to reduce postinflammatory rebound hyperpigmentation.

Postoperative visits are scheduled 48–72 h after the peel to confirm that proper postoperative care is being strictly followed. The patient is then seen at the 12-day mark for instruction in makeup, sunscreen, retinoids, and hydroquinone usage. Then the patient is usually seen 4 weeks postoperatively. It is critical to ensure appropriate follow-up to confirm that healing is occurring at the expected rate and to evaluate for possible superinfection or irritation secondary to the ointments used. To avoid potential complications, any deviation from the norm should be address and treated promptly [43].