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Skin Injuries Following Layperson Application of Chemical Peel Products
Allison Lardieri1, Melissa Reyes1, Karen E Konkel1
1All authors are with the Division of Pharmacovigilance, Office of Surveillance and Epidemiology at the FDA Center for Drug Evaluation and Research in Silver Spring, Maryland.
Objective:
We sought to characterize skin injuries following layperson application of chemical peel products (CPPs).
Methods:
Cases of skin injuries following layperson application of CPPs from August 31, 2018 through August 31, 2023 were retrieved from the United States Food and Drug Administration (FDA) Adverse Event Reporting System, the Human Foods Complaint System, the literature, and Amazon.com consumer product reviews with images.
Results:
We identified 18 skin injuries following layperson application of CPPs, including several cases using products labeled with concentrations typically used by healthcare professionals. Injuries involved burns with associated wounds, pain, swelling, and scars. Consequences included disfiguring scarring, reduced mobility, and need for emergency department, dermatologic, or surgical care. Analysis of Amazon.com demonstrated that CPPs are sold under many names with numerous therapeutic claims, list a variety of concentrated agents, and have thousands of reviews.
Limitations:
Limitations include underreporting of adverse events to the FDA and incomplete clinical information. With consumer product reviews, there was potential bias and poor replicability due to the dynamic nature of the Amazon website.
Conclusion:
Laypersons who apply CPPs of any strength without guidance from licensed and trained healthcare professionals may experience skin injury and long-term sequelae. Dermatologists are positioned to advise against application of CPPs without professional supervision.
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