Answer:
Skin depigmentation - The reduction of melanin-producing cells causes a bleaching effect, which is almost unavoidable and is most noticeable at the line of demarcation below the jawline after a facial peel.
Persistent erythema - Also, a normal after-effect but may persist for several months before subsiding.
Sensitivity to sunlight - Patients are instructed to use daily sunscreen for 4-6 months.
Hyperpigmentation - Seen in patients who have not adequately protected themselves from sun exposure. Usually subsides with treatment by topical creams containing tretinoin, hydroquinone, and glycolic acids. In laser resurfacing, often seen 2-4 weeks.
Infection - Occasional superficial contamination of a peeled area may be encountered which is usually treated with antibiotics. Patients with a history of herpes may experience a postpeel outbreak (See also Question 11.)
Acne and milia - Small superficial inclusion cysts may appear during the first few weeks and usually last only a few days. If they continue to persist after the peel has completely healed, frequent vigorous scrubbing and washing will remove them. Rarely, puncture under magnification in the office may be necessary.
Scarring - One of rarest but most upsetting complications, hypertrophic scarring usually subsides over a period of months with intralesional injection and topical use of steroids. Neck skin is particular prone to scarring after chemical peel.
Ectropion of the lower eyelid - Seen in some patients who have also had blepharoplasty. Usually resolves spontaneously, but may require surgical treatment.
Alteration of existing skin condition - Nevi often appear darker postpeel because of the lightening in color of the surrounding skin. Spider telangiectasias may appear more visible and skin pores may appear larger.