When people are seeking to improve the quality and appearance of their skin they turn to a number of options. Some believe that creams, lotions, and serums can provide a more youthful looking, smoother face with less appearance of wrinkles and a nice glow. Exfoliation is also high on the list. Others turn to procedures. As dermatologists, aesthetic practitioners, and medical spa owners and employees, we see a lot of patients seeking skin rejuvenation. While most of us are used to using lasers and performing chemical peels as alternative therapies, this post is intended to showcase the pros and the cons of each and to hint at what is on the horizon of light therapy.

Of course, this topic will be covered in depth at SCALE 2019 Music City, so make sure you register today and sign up for these sessions.

What is a Skin Peel

A skin peel is essentially the rejuvenation of the skin through a resurfacing process. The basic mechanics of it are that the top layers of skin are taken off. This exposes the layers beneath in all of their freshness, with a youthful glow. According to the American Society of Plastic Surgeons, “Sun, skin disorders, aging and even heredity can all contribute to skin irregularities on the face and elsewhere on the body. These include textural irregularities like wrinkles and acne scars, pigmentation changes like freckles, sunspots or visible blood vessels. In addition, skin may lose tone, feel less firm and lose the healthy glow that is evident in younger skin…Laser resurfacing, mechanical resurfacing, chemical peels and injectable products can improve the appearance of fine lines and wrinkles of the entire face or those that develop in specific regions of the face, such as the upper lip and around the eyes. These treatments can also be used to address pigmentation disorders, such as sun and age spots, and they can be used to improve the appearance of acne scars or other skin conditions.”

Chemical Peels are Tried and True

It is true that chemical peels can enhance the look of the skin. In fact, they are quite effective at this. They work by blistering the top layer, or layers, of skin so that it eventually peels off which reveals fresh new skin underneath.

The American Society for Dermatologic Surgery describes the treatments and results as follows:

The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also temporarily more sensitive to the sun. There are three basic types of chemical peels:

• Superficial or lunchtime peel: Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest or hands.
• Medium peel: Glycolic or trichloroacetic acid is applied to penetrate the outer and middle layers of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration. It also can be used to smooth rough skin and treat some precancerous skin growths (i.e. actinic keratosis).
• Deep peel: Tricholoracetic acid or phenol is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles and shallow scars. Patients will see a dramatic improvement in skin appearance. The procedure is used on the face and only can be performed once.

As pointed out by The Dermstore, however, while chemical peels may “lessen fine lines and rough skin, it won’t do much good with deep wrinkles or sagging skin.” These are issues that can be treated more effectively with laser therapy.

Light and Energy Therapies are the New Wave of Youth

Lasers are made up of light; a concentrated single wavelength, high energy light, directed in an extremely precise way to trigger the impact desired. The word laser is actually an acronym for Light Amplification by Stimulated Emission of Radiation. Very Well Health has a helpful description, in layman’s terms of how this works on the skin:

Lasers are monochromatic (mono means one and chromo refers to color), which means that a given laser emits light of only one wavelength (or color) of light. Lasers work in cosmetic applications through a process called “selective photothermolysis.” When broken down, this very fancy word means that it modulates the frequency of light (photo) to produce heat (thermo) in the specific area of the corresponding thing you wish to destroy (lysis). To do this, the wavelength of the light beam must be in sync with the color of the target which is to be addressed, whether that be brown spots, unsightly red broken capillaries or some other undesirable skin condition.

Laser treatment tends to be more precise and effective than chemical peels, targeting more deeply into the skin’s layers with the energy produced. This makes it possible to provide treatment with more control, individualizing the treatments to each client. It also means that there is less risk for scarring and that fewer treatments are required to get the sought after result. The American Society of Plastic Surgeons recommends the following two laser treatments:

 

• Laser And Intense Pulse Light (IPL) Treatments – used to remove discoloration and/or tighten sagging skin.
• Ablative Laser Treatments (Fractional, CO2 Lasers) – remove outer layers of skin to smooth lines and wrinkles.