Cardiac complications in deep chemical peels

Deep chemical peels have been used in dermatology for more than a century. The main indications for this procedure include photoaging, perioral wrinkling, acne scars, and precancerous skin lesions. The most important potential complication of deep peels is cardiotoxicity.

The objective was to estimate incidence of cardiac complications during full-face deep chemical peel and to suggest the methods to reduce the rate of this potential complication.

Clinical data on the patients being treated by full-face deep chemical peel between December 1, 2004, and November 30, 2005, were recorded. Full cardiomonitoring was performed during the peeling procedure. Any arrhythmia or medical intervention was recorded.

A total of 181 patients have been treated during the study period. All the patients were female; the mean age was 56 years (range, 30-77 years). In 12 patients (6.6%), cardiac arrhythmia has been recorded during the procedure. Cardiac arrhythmia was more common in patients with diabetes, hypertension, and depression. In 4 patients the arrhythmia was self-limited and did not require any intervention. In the other 8 patients, 100 mg of lidocaine was given intravenously to control the arrhythmia.

The incidence of cardiac complications in appropriately performed deep chemical peeling is lower than previously appreciated.