Hello! I have done several 10% TCA peels in the past and all went well. A Client from two weeks ago, after a 10% TCA peel still appear a little red and some areas on cheeks appear tanned.  This hasn't happened in past. Any ideas?

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are you sure, she did not try to do something at home, on her own?

No,Ginger, I'm not sure. I did provide post care instructions and have asked her to bring in all products she uses at home tomorrow when she comes in.

Dont forget her diet...what has she changed there that could affect the external outcome. Foods, medication, hormones all play a role.

If the client didn't leave the flaking skin to fall off on its own; if they worked to remove the flaking skin - let's say with a washrag...it could leave the skin red and a little on the raw, stingy side and that would take longer to resolve.

Hyperpigmentation can result, scabbing can result...really important to keep the skin moist esp. during the flaking/peeling period. 

Until there is no more flaking (say 5-7 days to resolve) the client would continue with a gentle cleanser and moisturizer and take a break from any other products she/he may use as part of their daily skin care routine. It is imperitive to use sunscreen during the day.

Once the flaking has resolved (or any redness) then returning to products with corrective ingredients can be resumed.

You might check with your client about what products (ingredients) she/he is using in case that is adding to the problem. Ask if perhaps they assisted the skin in flaking off and then if that led to the skin stinging and reddness. If so have them use an occlusive product. Some occlusive ingredients that can be used on sensitive skin - silicones (dimethicone & cyclomenthicone), plant oils, squalane, shea butter, zinc oxide, niacinamide, petrolatum, lanolin. You might use a moisturizer that also includes a little hydrocortisone if there is inflammation with the reddness (use no more than approx. 7 days at a time, though).

If your client did not keep the skin cool for the first 24 hours or so and let's say worked out raising the body temperature and sweat or got in a hot shower or hot tub that can lead to reactions.

Aloe vera is good for decreasing redness and inflammation, too.

Do let us know how this goes and I hope it goes well!

 

Thanks, Ladies for the great input.  Will provide update after she's in on Saturday. 

Fabulous and informative reply from Sally!

Just one more thought... I am wondering if she has a history of melasma (just to explain the "tanned" parts).

But overall - I would guess that she did not follow instructions.

How many layers did you apply?

Cindy - only one layer was applied.  The client cancelled about 30 minutes before she was scheduled to come in on Saturday to see us. I encouraged her to try to come in, but she had another commitment.  She also stated she used her normal night cream which is Wexler Night Reversal & Repair and the treatment that goes with it as well as the SkinScript Hydrating Moisturizer I had given her. Thanks all for the support and input.

Ruby - did you check the ingredients on her normal night cream?

when I see the words reversal and repair the red flags of AHA's and retinol come to mind.

Your product is the one she should have used - which was appropriate.

I did check the ingredients and found that it contains Cyclopentasiloxane. Cyclopentasiloxane may cause mild skin and eye irritation, according to the ingredient's material safety data sheet, and a small percentage of it reaches systemic circulation through dermal absorption. It's the 7th ingredient. It also contains benzoic acid. She cancelled her reservation again.

...if she really thought it was YOUR fault and she was clompliant with homecare she would have kept her appt.

She probably thinks that you will be able to tell, just by looking at her skin, that SHE did something that she shouldn't have! (and by your amazing powers WHAT it was that she did!)  :D

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