IMCAS - Congresses on Dermatology and Aesthetic & Plastic Surgery

Complications post PhenTCA peel

Peelings

Mots-clés:

Lésions cutanées, Cicatrices, Peelings

Anonyme

5 décembre 2025 09:24

Description du patient

Women 74 yo, Phototype 3b,
Hypothyroidie / Levothyrox
no allergy

Description du cas

Dear collegues,

I performed a phenTCA ( 10%/35% Mesoesthetic) peel on 24th of novembrer after 5 weeks of skin preparation with Skinretin 0,3% and without sun exposure.

I saw the patient 7 days after the peel and she explained me that she was continuing to apply the night the skin retin 0,3%... She had to wash her face 5 times per day with water and i am afraid that she may have tore off her skin.

I am asking for your help to minimize the risk of complications as scars or HPPI. What would you do? Just wait? Currently, she is using Antistress Mask from Mesoesthetic as much as needed and LED therapy 3 times per week.

Thank you all for your precious advice

Veuillez vous connecter pour voir le contenu

Dr Fadi HAMADANI

Coordinateur IMCAS Alert

Chirurgien Plasticien, Territoire palestinien

5 décembre 2025 09:46

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I would actually stop all active products immediately — including the Mesoestetic Antistress Mask. At this stage, adding more cosmeceuticals often worsens the barrier disruption. This looks much more like an irritant contact dermatitis superimposed on a deep phenol/TCA peel rather than anything infectious or necrotic.

For the next 7 days, I would keep the regimen extremely simple:

— High-potency topical steroid (class I–II) twice a day for 7 days. This is the most reliable way to shut down the inflammatory cascade before it evolves into prolonged erythema or even early scarring.

— LED therapy is acceptable. Low-level LED can continue since it’s non-irritating, but I would avoid any heat-based modalities for now.

— Moisturizer: Vaseline only. If she needs hydration or barrier support, stick to plain petrolatum. Nothing else. Even “soothing” masks often contain botanicals or acids that will worsen the irritant reaction.

— Stop all retinoids, acids, and washout practices. The overwashing five times a day and continuing 0.3% retinoid post-peel almost certainly contributed to this presentation.

— Close follow-up. She should recover without sequelae, but I would keep a close eye on her over the next 10–14 days.

— Monitor for PIH. Given her phototype, any persistent erythema can easily drift into PIH. If that happens, it can be managed later once the barrier is fully restored.

Overall, she should heal well. This is far more consistent with irritant dermatitis on top of an otherwise normal peel course, not a true peel-related complication. The priority now is simply to calm the inflammation and restore the barrier.

Dr Dianne QUIBELL

Coordinateur IMCAS Alert

Interniste, États-Unis

Modifié le 6 décembre 2025 01:57

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Dr Hector Ricardo GALVAN GARCIA

Dermatologue, Mexique

8 décembre 2025 18:57

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Complications post PhenTCA peel

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