Management of the Patient

Before performing any peeling procedure, an accurate evaluation of the patient is very important. In order to assure a satisfactory outcome and to minimize the risk of scarring and delayed reepithelialization, the appropriate peeling agent for a patient needs to be determined and a period of pretreatment is required [1, 2]. Considerations for the individual choice of peeling agent include: lifestyle, including avoidance of sun exposure and appropriate use of sunscreen, history of perioral herpes simplex virus (HSV) infection, previous or concomitant treatments (oral isotretinoin, contraceptives and other photosensitizing medications such as radiation and laser skin resurfacing), and positive history for abnormal or keloid scarring. For example, patients susceptible to facial herpes simplex virus infection may be treated with antiviral drugs from the pre-peel period until reepithelialization is complete, especially when medium-depth or deep peeling is performed [3–8].