The sullivan centre for plastic and reconstructive surgery
FACIAL AND NECK CHEMICAL PEEL
TRICHLOROACETIC ACID (TCA)
You will need to purchase:
Purpose soap or Cetaphil soap, 1% hydrocortisone cream, if indicated
(over-the-counter preparation), Aquaphor, and prescriptions.
You will be given a prescription for a resurfacing facial cream (Renova, Retin-A, Avage,
Retinol Complex or Kinerase). You will be instructed when to begin using this cream. You will also be given a prescription for a bleaching cream (Eldopaque, EpiQuin or Bleacheze) to be applied in the same time regimen as the above-mentioned cream. Using these creams both before and/or after your procedure help condition the skin, minimize demarcation lines with untreated areas and promote ultimate results and success of the surgery. Stop all resurfacing and bleaching creams two (2) days before procedure.
Evening before surgery:
to eat, drink, or smoke after midnight if having general anesthesia.
2. Take medications as prescribed.
Morning of surgery:
1. Shower/bathe and wash hair (if you have not done so the night before). Wash face thoroughly and
2. Take two (2) aspirin tablets or other anti-inflammatory (Motrin, Ibuprofen) one hour before the
peel. DO NOT
take these products if you are restricted from them due to having the peel in conjunction with another procedure, or if your medical history contraindicates.
3. If procedure is being done under local anesthesia, you will need to apply numbing cream
(ELAMAX) beginning two (2) hours before procedure. See separate instruction sheet.
1. You may experience a feeling similar to a sunburn during application of the TCA and for several
hours or more after the procedure. You may also experience some swelling within the first 24 hours. These side effects may be diminished by gently splashing the skin with cool water five to six (5-6) times a day. Or you may use cool compresses, intermittently.
2. Take two (2) additional aspirin tablets four (4) hours after the TCA peel and again eight (8) hours
after peel, if allowed
3. Wash your face twice daily by using the recommended soap (Purpose or Cetaphil); lather in your
hand and use fingertips to GENTLY cleanse the face. Rinse with lukewarm water and GENLTY pat dry.
TCA Peel Instructions
4. Apply Aquaphor four to five (4-5) times a day It is important to prevent the face from becoming
dried our following your procedure. NO
picking, rubbing, or unnecessary touching of the face; this
can cause scarring. You will continue to use the Aquaphor until instructed by our office to
5. Exercise may be resumed 7-10 days after the TCA peel. Exercise may exacerbate any remaining
redness but this can be lessened with cold packs after exercising.
Other Instructions/General Information:
1. There will be redness to the skin for the first 48-72 hours. The skin will then begin to darken and
wrinkle. Small blisters may also occur. During this time your skin will begin to flake and shed itself. This process may take 48-72 hours. At completion of the healing, the skin may be faintly pink and blotchy, which will usually fade over a three to five (3-5) day period.
2. If the area to be peeled includes around the mouth, you will be started on Zovirax (anti-viral
medication) three (3) days before the peel and will continue Zovirax for at least a week following the peel. This minimizes the risk of developing cold sores/fever blisters. It is important to contact the office immediately both before and after your procedure if you develop unusual tingling of your lip or the early stages of a cold sore.
3. Prescribed facial creams (resurfacing/bleaching creams) will be resumed ONLY
by Dr. Hobgood. This will not usually be for two to three (2-3) weeks following your peel. Introduce one product at a time, waiting one to two (1-2) weeks before adding another product to your skin care regimen
4. It is best to avoid make-up for the first 7-10 days. If necessary, a water-based make-up may be
applied, the day after the peel, but use Aquaphor continuously
while at home. Please contact the office before applying any make-up.
excess sun exposure. Use a sunscreen with an SPF of at least 20 with both UVA and UVB
Please do not hesitate to call Dr. Hobgood if you have any questions or concerns.
COUNTY COURT, COUNTY OF EL PASO, COLORADO Court Address: 20 East Vermijo Ave. Room 105 PO Box 2980 Colorado Springs, CO 80901-2980Plaintiff: PEOPLE OF THE STATE OF COLORADO -v- Defendant(s): • COURT USE ONLY • Case No: ___ T _______ CERTIFICATE OF COMPLETION STATE OF 9 COLORADO 9 __________________________COUNTY OF 9 EL PASO 9 TELLER 9 __________________Court order regardin
Diagnostiek 1. Audiogram (gehoortest): Doel is vaststellen van gehoorverlies in decibel. U krijgt een koptelefoon op waaruit afwisselend uit de linkerkant en de rechterkant piepjes van verschillende toonhoogte te horen zijn. Wanneer u een piepje hoort geeft u dat aan. De assistente kan zo in kaart brengen welke toonhoogte u op welke sterkte hoort. Het resultaat wordt besproken met de h