Avoiding and Addressing Complications

Avoid complications

Complications from PCA SKIN® professional treatments are unlikely, but they are possible. There are many variables that contribute to the outcome of a chemical peel. The clinician’s level of training and experience, full disclosure on a patient profile, pre-treatment and post-procedure care with PCA SKIN® daily care products all play a role. Regardless of the reason, PCA SKIN® wants you to know the best ways to avoid them and how to respond to complications should they happen. Our highly trained staff is on hand to assist you with questions or concerns. Please call 877.PCA.SKIN [722.7546] for assistance.

Performing a consultation two weeks prior to treatment is your best tool to avoid complications. Recommending PCA SKIN® daily care products prior to treatment also lowers your chance of negative reactions and enhances your results. PCA SKIN® professional treatments and daily care products are formulated with the same philosophy and many similar ingredients, so before the patient would have a chance to react to a peel, they likely would have already presented the allergy or sensitivity to a daily care product. Allergies or sensitivities to PCA SKIN® products are rare, but it is always safer to identify them with the use of a daily care product rather than a peel. This is especially important for more reactive ingredients such as hydroquinone (HQ). We recommend performing a patch test in front of or behind the ear at least one week prior to treatment with hydroquinone as it is a common irritant for patients with more sensitive skin.

Antidote for extreme heat

Use the following protocol for extreme redness and heat.

Ask patient their number on the sensitivity scale of 1 to 10:

  • If less than five, you may proceed with the treatment protocol.
  • If higher than five, conclude the treatment with ReBalance mixed with the appropriate PCA SKIN® broad spectrum SPF product.
  • The decision to proceed with the treatment depends on each situation and patient’s sensitivity level.
  • If it is determined that all traces of peel need to be removed, a copious amount of water should be flooded on the skin to increase pH of the skin. This is only typically necessary in extreme situations, but is often employed to adjust pH as quickly as possible for patients undergoing dramatic discomfort.

Addressing complications

Allergic reactions

Although allergic reactions are rare with PCA SKIN® products, asking the proper questions will help the clinician avoid the application of an ingredient to which someone is allergic. If an extreme reaction to a peel solution does occur, wash the solution off with copious amounts of water and call 911 if the reaction is dramatic, or the patient seems to be having trouble breathing. Adding water is recommended in these types of situations as it will help dilute the solution and restore skin to its natural pH faster. A good treatment product to address histamine responses during a treatment is CliniCalm® 1%. This should be applied liberally. Many physicians also suggest taking an over-the-counter antihistamine, such as Claritin® or Benadryl®, as well, to help calm the response.

Unintentional blanching

Protein coagulation or blanching, usually occurs only from deeper peeling. Physicians will sometimes perform a medium-depth or deeper peel during which a full-face blanch is desired and anticipated. Skincare clinicians who are not physicians or working under the advisement of a physician should not perform treatments of this nature. If a patient is peeled too deeply, blanching and open oozing areas may result. Keep in mind that if a patient’s peel penetrates deeper in specific areas, those areas will have a pH closer to blood (7.3-7.4) than intact skin (5.5). Products must be chosen carefully to accommodate for this change in pH. Apply an occlusive barrier product to keep the area protected and moist. Advise the patient that they will peel more and will probably have some temporary darkening at the blanch site until it peels. With proper care the skin discoloration should dissipate. Once the area is re-epithelialized (approximately 48 hours), the patient may introduce Hyaluronic Acid Boosting Serum and Silkcoat® Balm to create an environment that can effectively produce natural moisturizing factor (NMF). Once the skin has normalized, have the patient use Dual Action Redness Relief and ReBalance to help promote healthy skin and reduce redness. This is not a common occurrence when following PCA SKIN® treatment protocols. Patients who experience minor surface blanching may continue using the PCA SKIN® The Post-Procedure Solution.

Periorbital edema (puffy eyes)

Mild to moderate edema can occur in some patients following chemical peel treatments. This is actually not considered a complication, but rather a side effect. Patients experiencing swelling around the eyes should not apply ice packs, as superficial freezing will only serve to traumatize the area more. The best course of action is to apply a cool cloth to the eye area and sleep with the head slightly elevated to aid in the reduction of the swelling.


Each PCA SKIN(R)’s professional treatment has unique contraindications that should be reviewed prior to selecting a treatment for your patient.

To determine if a professional treatment is contraindicated for your patient we have created a comprehensive set of consultation forms that help you gather the necessary information to select the most effective and safe daily care regimen and treatment plan for your patient. For more information go to the Peel Consultation and Initial Treatment section.

If your patient is lactating, pregnant, or may be pregnant, consult the OB/GYN before performing a treatment.

To review specific contraindications and guidelines see individual treatment protocols.