A: I routinely do filler and Botox on the same day as light peels. If it is a salicylic acid peel, it even provides some anesthesia for the needle sticks. I would not do a peel that causes swelling on the same day, but a light peel would be fine. I always peel before I inject. If injected first, the chemical can go down the needle tract and possibly cause crusting.
Q: What Kind of Chemical Peel Can Help with Mosquito Bite Scars on my Legs from Child Hood? and if Chemicals Cant Work Than What?
A: Post-mosquito scars are really post-inflammatory hyperpigmentation in most cases. This is typically seen in darker skin and is worsened by any scratching from the itch. True scars from insect bites only occur if the patient scratches so much that they get a secondary infection.
My usual recommendation is an anti-inflammatory cream, and sometimes a bleaching cream. A series of light peels is also helpful as is SilkPeel dermal infusion. In severe cases, Fraxel might be considered. The best strategy is to use the anti-inflammatory cream BEFORE the discoloration occurs. And as always, avoid scratching and picking your skin.
Q: I have darker skin and I have had glycolic acid peels in the past that caused discoloration of my skin. Do you think peels are safe for darker skin?
A: Yes, but your doctor must be careful about the choice of peeling agent. I particularly like salicylic acid over glycolic acid in darker skin because it is really ideal for oiliness, acne and mild acne discoloration, which is what most of my darker patients ask to have improved (as opposed to wrinkles in Caucasian patients). Salicylic acid is also self-limiting and does not require the acid to be neutralized. This prevents "hot spots" where the acid can burn too deep and cause discoloration, which is a risk of glycolic peels.
Q: I had a 20% peel around my eyes, upper and lower lids and crow's feet. A full 3 days after the peel, the skin around my eyes have become slightly darker and it feels tight. The skin actually looks MORE wrinkled now. It almost feels like a very thin layer of Elmer's glue was applied to my skin and then allowed to dry. It is tight, dry, crinkly and weird looking. Makeup makes it look even worse. I am told it may take a while for the layer of dead skin to peel, but how long?
A: 20% TCA is a reasonable choice for periocular rejuvenation and it will help fine lines and discoloration. Your doctor should have warned you that you will look worse before you look better, for one week. Be sure to use sun protection and to keep the dry, dark skin moist to facilitate the peeling and relieve tightness. I still recommend Botox with the peel to help with the lines that are caused by the movement of the muscles around the eyes, as chemical peeling will show no improvement of this problem.
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