Use Caution when Combining some Supplements, Foods, and Medications with Chemical Peels

Those of us plagued with acne, even mild, have great results with chemical peels. Others choose oral prescription medications to control acne, and one common medication is Accutane, roaccutane, or isotretinoin.  Even doses as low as 10mg per day show incredible results for many people, but do NOT combine isotretinoin and chemical peels! Also, females taking isotretinoin are required in the United States to take two forms of birth control since this medication causes birth defects.

Even a low dose of only 10mg per day does not mix well with any type of chemical peel. The recommendations are to wait a minimum of 90 days after the final dose of isotretinoin before performing a light chemical peel, although six months is probably safer.

These photos show the results of combining 10mg per day of isotretinoin with a 70% glycolic acid peel:

 

10mg/day isotretinoin + 70% glycolic acid peel

The hyperpigmentation will require other treatments, such as corrective laser or chemical peels, although some fading can be achieved with a mild glycolic acid peel used 2-3 times per week in conjunction with a good physical sunscreen.

Typically, if a medication or supplement will cause increased sensitivity to UV rays, that's a red flag that it shouldn't be mixed with a chemical peel; however, I would ask my prescribing healthcare provider about doing a peel while taking medication. I never like to leave these details to anyone else, so I'd verify anything someone tells me--or thoroughly investigate it myself. 

Even some sunscreens increase UV sensitivity, so I would investigate other items I consumed and/or applied before a chemical peel. I would investigate medications, supplements, product ingredients, or even certain foods. 

Here's a list of items known to increase UV sensitivity, so I'd investigate further if I were considering a chemical peel:

• Acne treatments: Creams and astringents with benzoyl peroxide. Prescription drugs including Accutane, doxycycline (an antibiotic), and Soriatane.
• Antihistamines: Benadryl and other products with diphenhydramine.
• Antibiotics: Tetracyclines, including Sumycin, Tetracyn, and Vibramycin (doxycycline). Sulfa drugs including Bactrim and Septra. Quinolones, including Cipro and Levaquin.
• Antifungals: Griseofulvin, including Grifulvin V, Fulvicin P/G, and Gris-PEG.
• Anti-inflammatories: Prescription and over-the-counter nonsteroidal anti-inflammatory pain relievers, including Celebrex, naproxen (Aleve), and ibuprofen (Motrin, Advil).
• Chemotherapy drugs: Imatinib and dasatinib.
• Cosmetic treatments: Microdermabrasion, chemical peels, laser treatments, exfoliating facial scrubs.
• Diabetes: Sulfonylureas including Diabinese (chlorpropamide) and glyburide (Micronase, DiaBeta, Glynase).
• Diuretics: Hydrochlorothiazide (HCTZ), used to treat high blood pressure. Lasix (furosemide). Combination drugs with HCTZ include Dyazide, Hyzaar, Maxide and Zestoretic.
• Foods: Celery, citrus fruits (such as lime peel), dill, fennel, parsley, parsnips, and artificial sweeteners.
• Heart medicines: Amiodarone (Cordarone), nifedipine (Procardia), quinidine (Quinaglute and Quinidex), and diltiazem (Cardize, Dilacor, and Tiazac).
• Herbal remedies: Dong quai, St. John’s wort.
• Perfumes: Lavendar, cedar, bergamot oil, sandalwood, rose bengal, musk, 6-methylcoumarine.
• Psychiatric: Tricyclic antidepressants such as Norpramin and Tofranil; the antipsychotic medication chlorpromazine (Thorazine).
• Skin care products: Check ingredients for alpha-hydroxy acids (AHAs), beta-hydroxy acids (BHAs), salicyclic acid, glycolic acids, Retin-A, and hydrocortisone.
• Sunscreen: Benzophenones, dibenzoylmethane, oxybenzone, cyclohexanol, salicylates, cinnamate, and PABA (para-aminobenzoic acid).

List provided by WebMD. Photo from

"Severe hyperpigmentation and scarring following glycolic acid peel treatment in combination with low-dose isotretinoin" by Peter Arne Gerber,corresponding author Gabriela Kukova, Edwin Bölke, Bernhard Homey, and Evelyn Diedrichson.