Early repeeling--a matter of time

Repeeling after a short interval in medium-depth or deep peeling is considered by most experts as hazardous, and is generally contraindicated. Most experts recommend an interval of 6 months or more before repeating the same level of peel. The results are presented of four patients who underwent repeeling after a short interval.

All four patients were dissatisfied with their first peel (medium-depth peel performed with trichoroacetic acid (TCA) 35%). Repeelings were performed using two methods: TCA 30-35% (Cases 1-3) and unoccluded Baker phenol peel (Case 4). On three occasions (Cases 1-3), the patients underwent three peelings at short intervals. All four cases gave excellent objective results.

The risk of a second peel shortly after the first is not as high as indicated in the literature, and should not be automatically ruled out. In a selected group of patients who, for various reasons, be persuaded to wait, repeeling after a short interval (2-3 weeks) may solve certain problems and may even make the difference between an unhappy patient and a satisfied one. In performing repeeling after a short interval, one should take into consideration that the skin, particularly the keratin layer, is thinner, so that the degree of penetration of the second peel solution and the peel depth will be greater. It is possible that the scarring reported after repeeling is a result of the disregard of this important factor and, consequently, the use of too high a concentration of peel solution in the second peel procedure.