Aesthetic Dermatology MCQ - Post-peel care

A 37-year-old woman undergoes a 35% TCA medium-depth peel for treatment of melasma and photoaging. She returns the next day asking about proper aftercare to optimize results and minimize complications. Which of the following is the MOST appropriate advice for post-peel care?

A. Begin scrubbing and exfoliation after 24 hours to accelerate peeling
B. Avoid emollients and allow crust formation for better healing
C. Apply broad-spectrum sunscreen regularly and use bland emollients until re-epithelialization
D. Use topical retinoids immediately after the procedure to enhance results
E. Expose the treated area to mild sun to improve epidermal turnover

Correct Answer:
C. Apply broad-spectrum sunscreen regularly and use bland emollients until re-epithelialization

Explanation:
Post-peel care is crucial to prevent complications such as infection, post-inflammatory hyperpigmentation, and scarring.

Recommended steps after chemical peeling (especially medium/deep peels):

• Photoprotection: Strict use of broad-spectrum sunscreen (SPF ≥ 30) once re-epithelialization starts.

• Emollients: Use bland, non-comedogenic emollients (e.g., petrolatum, Aquaphor) to keep skin moist and support barrier recovery.

• Avoid trauma: No picking, scrubbing, or scratching during the peeling phase.

• Antiviral prophylaxis: For perioral peels in patients with history of herpes labialis.

• Delay active topicals: Retinoids, hydroquinone, and exfoliants should be restarted only after full epithelial recovery (7–14 days).

Other options explained:

• A: Scrubbing/exfoliation risks infection and scarring.

• B: Avoiding emollients delays healing and increases risk of PIH/scarring.

• D: Retinoids should be stopped before peels and resumed only after complete healing.

• E: Sun exposure worsens PIH risk and should be strictly avoided.

Key Point:
Post-peel care = strict photoprotection + barrier support with bland emollients + avoidance of trauma until full healing.