A case of facial hyperkeratosis induced by a cosmeceutical containing alpha-hydroxy acid and sunlight overexposure successfully treated using oral acitretin

Chemical peels cause destruction of the epidermis and subsequent repair. Postpeel care is important. An 18-year-old man presented with progressive erythematous keratotic papules with associated greasy debris bilaterally on the cheeks, postauricular, and submandibular areas, and to a lesser extent the bridge of the nose and forehead, that had been present for the past 4 months (Figure 1). He was otherwise in good health and denied any similar symptoms or hereditary keratotic dermatosis among his relatives. The patient washed his face twice daily with a mild cleanser and gently removed the hyperkeratotic debris using a gauze scrub; however, it would recur within a few days. Removing the debris revealed skin without bleeding or erosions but with mild itching. The patient had applied an acne cosmeceutical containing 15% alpha-hydroxyacid (AHA) tohis face, especially his cheeks, oncedaily