Contraindications for chemical peels

Relative contraindications	Absolute contraindications
History of hypertrophic scars or keloids off the face*	History of keloids or hypertrophic scars on the face
Daily smoker (tobacco, marijuana, or electronic cigarettes [e-cigarettes])*	Active skin infection anywhere on the body
Active psychiatric disorders that are likely to inhibit tolerance of the procedure, adherence to postpeel care instructions, or satisfaction with results of the peel^¶	Pregnancy^Δ
Medical diseases that alter wound healing*	Inability to follow pre- or post-peel care instructions
Medications that impair wound healing*
Active inflammatory skin conditions that may be exacerbated by chemical peels, such as rosacea, atopic dermatitis, acne vulgaris, and koebnerizing skin diseases*	Malnutrition and severe protein deficiency (eg, postbariatric surgery)*
Lactation^◊	On or recently completed oral isotretinoin therapy^§
Hepatic or renal disease^¥

* For medium to deep peels.
¶ Examples of psychiatric conditions that may be problematic include depression, skin picking disorder, and body dysmorphic disorder.
Δ Insufficient data to confirm safety.
◊ Insufficient data to confirm safety. Light chemical peels are generally considered safe. Trichloroacetic acid and phenol peels are typically avoided during lactation.
§ For medium-depth and deep chemical peels, waiting 3 to 6 months after completion of isotretinoin is advised due to concern for poor wound healing or scarring. Performance of light chemical peels during isotretinoin therapy does not appear to be associated with increased risk for these adverse effects. However, some clinicians delay light chemical peels until after completion of isotretinoin because of concern that skin dryness and peeling may contribute to uneven penetration of the peel solution.
¥ Associated with increased risk for phenol toxicity.

Graphic 121455 Version 1.0

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Contraindications for chemical peels