Edward D. Buckingham, M.D.
Facial Plastic & Reconstructive Surgery
Facial Peel Preoperative Instructions
PLEASE READ THE FOLLOWING LIST OF INSTRUCTIONS VERY CAREFULLY TO MINIMIZE ANY ADVERSE SURGICAL OUTCOMES. IF YOU SHOULD HAVE ANY QUESTIONS, PLEASE DO NOT HESITATE TO ASK US. |
IF YOU HAVE BEEN ON ACCUTANE ISOTRETINOIN) DURING THE PAST YEAR, YOU MUST INFORM DR. BUCKINGHAM BEFORE YOUR PROCEDURE. IT IS NOT ADVISED TO UNDERGO RESURFACING OF ANY KIND IF YOU HAVE BEEN RECENTLY TREATED WITH ACCUTANE.
Two to Six Weeks Prior:
(Please note that all the following directions apply equally to Renova. If you have been prescribed Renova instead of Retin-A, simply substitute Renova for Retin-A in the following text.)
Stop using Retin-A 2 to 4 weeks prior to procedure
Retin-A: Initially, this cream/medication should be applied every other evening before going to bed for the first 2 to 3 weeks, slowly increasing to every evening. This cream helps prepare your skin for the chemical peel and is believed to aid with the healing process after the peel. It is not unusual to experience some mild tingling and irritation during the first few weeks. If you are experiencing a burning sensation, or the skin appears to be cracking, discontinue Retin-A for 2 evenings and apply moisturizer to the irritated areas. You may resume using Retin-A when your skin is feeling and looking better. It is important to moisturize your skin in the morning as well as using a good SPF sunscreen. Please feel free to call us if irritation persists.
Directions for applying Retin-A:

1. Wash your face thoroughly with a mild soap or gentle alcohol-free cleanser and pat dry (do not rub).
2. After washing, wait at least 10 minutes before applying Retin-A to be certain that the skin is totally dry. Skin that is wet, damp, or even moist tends to absorb cream quickly, which may cause unnecessary irritation.

3. After your face is totally dry, squeeze a pearl-sized amount (about a ¼” diameter) of Retin-A onto your fingertip. Using more than a pearl-sized amount will not increase your results and may cause irritation.

4. Dab it on your forehead, chin, and both cheeks but not immediately under your eyes.

5. Pat your skin so the small dabs begin to spread into a thin layer that covers your entire face. Smooth into skin until all white streaks have disappeared.
6. After applying Retin-A, you may apply a moisturizer. However, for best results, wait one hour in between if possible.
Stop using Hydroquinone 2 days prior to procedure
Hydroquinone 4%: This cream/medication should be applied twice daily after cleansing. Apply Hydroquinone in the evening after Retin-A and in the morning for 2 to 6 weeks prior to the procedure. It helps to stop the production of pigment in the skin and will help prevent the skin from hyperpigmentation (darkening of your skin) after the chemical peel. This product is not to be used if you are on the Obagi program. You must stop all pretreatment creams 3 days prior to the procedure.
Directions for applying Hydroquinone: | |
A.M. 1. Cleanse 2. Apply Hydroquinone 3. Apply Moisturizer and eye cream 4. Apply SPF 5. Make-up may be applied | P.M. 1. Cleanse – let dry at least 10 minutes 2. Apply Retin-A 3. Apply Hydroquinone 4. Apply eye cream only |
Two Days Prior:
Valtrex (antiviral medication): Only use this prescribed medication if the area around the mouth will be treated. This tablet should be started two days prior to the chemical peel and continued for a total of 7 days as instructed. This helps prevent a break out of cold sores. If you experience breakouts that burn or tingle, or a cold sore, please notify Dr. Buckingham and his staff.
Items Needed Prior to Your Procedure:
Q-tips, ice pack, or small bag of frozen peas or corn, Aquaphor ointment, Toleraine cleanser, Toleraine facial cream (the ointment, cleanser, and cream will be provided by The Buckingham Center).
On the Day of Your Procedure:
Thoroughly cleanse your face and neck with an antibacterial soap. We recommend you wear a shirt, blouse or sweater that unbuttons in the front for easy removal postoperatively. Please bring a hair band for your hair if it is long.