TREATMENT OF DELAYED SECOND-DEGREE CHEMICAL BURN

Clinic director Mei Abadiano assesses the effectiveness, safety, and outcomes of professional-grade medical low level light therapy in treating residual symptoms of a second-degree chemical burn

Chemical burns can result in long-term complications such as prolonged erythema, post-inflammatory hyperpigmentation (PIH), sensitivity, and scarring particularly when managed inappropriately. Evidence-based first-aid burns intervention is essential; however, treatment delays are common due to mismanagement or limited access to specialist care.

This case study presents a non-surgical and non-invasive medical aesthetic treatment with professional-grade medical low-level light therapy for a second-degree chemical burn sustained from a Trichloroacetic acid (TCA) peel performed by a doctor abroad.

Despite a month of delayed intervention after the incident, the protocol conducted by RESET Medical Aesthetic Clinic showed significant improvement in skin pigmentation and scarring.

CASE

The patient, a 32-year-old woman, sought treatment while on holiday in an Asian country due to hypopigmented scarring from a microneedling treatment performed by an aesthetic clinic in London.

Enticed by a promotional offer of a 100% TCA peel for under £100, she consented, and the treatment was performed by a doctor. During the procedure, the patient experienced an unbearable burning sensation.

Immediately after the incident, she was only prescribed Clindamycin oral antibiotics with no other first-aid burns treatment. She was also unable to attend any follow-up appointments, due to returning to the UK shortly after.

One month after the procedure, she presented herself to RESET Medical Aesthetic Clinic. Initial examination revealed clear signs of a second-degree chemical burn: dyschromia, sharp demarcation lines, persistent erythema, and early scar formation. The area was non-tender, with no active peeling, but the patient reported occasional itchiness.

TCA PEELS AND RISKS

TCA peels are widely used to improve pigmentation, texture, and collagen stimulation. TCA, a potent acid with a pKa of 0.52, works by inducing coagulative necrosis in the epidermis and papillary dermis, followed by reepithelialisation from follicular germinative centres.1

The depth of injury determines the risk of complications. Improper application or excessive concentration, such as 100% TCA, can lead to second-degree burns, especially when applied without adequate skin assessment or post-care.

Second-degree burns are the most frequent type seen in aesthetic injury cases and can be difficult to treat effectively when intervention is delayed. Globally, burns are the fourth leading cause of trauma-related injury.2

METHOD:

The non-surgical and non-invasive protocol using professional-grade medical low-level light therapy, also known as photobiomodulation, refers to the use of absorbed photons (light energy) that results in increased production of adenosine triphosphate (ATP), which is then used to power metabolic processes, which include synthesising DNA, RNA, and the proteins and enzymes needed to repair or regenerate cells.

Treatment protocol:

• Red (640nm), blue (465nm), and near-infrared (880nm) wavelengths

• Administered once a week for 30 minutes per session

• Total of 10 sessions over 10 weeks

• Adjunct care: Topical polynucleotides with hyaluronic acid gel and SPF 50+ broad-spectrum sunscreen.

Although recommended treatment frequency for this protocol is every other day, only weekly session is possible due to the patient’s travel distance and availability.

RESULTS

Despite the one-month delay in clinical intervention, LED light therapy produced progressive and visible improvement:

• After one session: The patient reported an immediate soothing and reduced skin sensitivity. Mild reduction in erythema was observed.

• After five sessions: Erythema and irritation had significantly subsided. PIH began to fade and skin texture appeared more even. The patient noted a visible difference and increased comfort.

• After 10 sessions: Marked improvement in overall skin tone, reduced hyperpigmentation, and softening of scar tissue were achieved. There were no adverse effects reported.

After 5 sessions

After 10 sessions

The anti-inflammatory, regenerative, and reparative benefits of multi-wavelength LED light therapy were evident, particularly in modulating pigmentation and promoting scar resolution. This reinforces photobiomodulation’s role as a non-invasive adjunct for subacute skin injury management.

Furthermore, the 30-minute weekly protocol was both time-efficient and well-tolerated – offering a realistic option for patients with busy schedules or with treatment delays.

CONCLUSION

This case study demonstrates the efficacy and effectiveness of professional-grade medical low level light therapy as a nonsurgical and non-invasive modality for managing delayed second-degree chemical burns.

Despite a four-week lapse before treatment initiation, RESET Medical Aesthetic Clinic’s protocol improved erythema, pigmentation, and scarring while restoring patient comfort and confidence.

Given the rise in complications from overseas aesthetic procedures, clinics must be equipped with versatile, evidence-based treatments to manage late presentations.

Clinics must consider professional- and medical-grade low-level light therapy not only as an anti-ageing medical device but as a clinically valuable intervention in post-injury skin management.

MEI ABADIANO

Mei Abadiano is the founder and director of RESET Medical Aesthetic Clinic, a multi-award-winning clinic in Bromley, Kent known for its exceptional patient care, innovative treatments, and outstanding reviews. As the regional leader for South East England for the British Association of Medical Aesthetic Nurses (BAMAN), Abadiano plays a critical role in shaping national standards, mentoring peers, and advancing evidence-based practice