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| When to Consider a Chemical Peel vs. Microdermabrasion vs. Laser Resurfacing |
| By Scott M. Ross, MD Eden Prairie, MN |
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Dermatologists have numerous ways of removing skin imperfections, including facial wrinkling, pigmentary changes, fine scarring and bumpy skin irregularities that appear on the surface of the skin. In general, laser resurfacing is used for deeper scars and wrinkles. Microdermabrasion is used for more superficial skin irregularities and chemical peels can be used to treat even finer irregularities on the skin’s surface.
Chemical Peel
Typically, an individual will undergo a chemical peel to remove sun spots or age spots that appear most often on the face and hands. A chemical such as glycolic acid, trichloracetic acid or phenol is applied directly to the skin. These chemicals change the composition of the skin, delivering a very controlled type of superficial tissue destruction that removes the outer layers of the skin. Deeper peels can also reconstitute the lower, collagen and elastin layers of the skin to remove deeper wrinkles. There is minimal scabbing associated with the peel procedure which clears within three to seven days. As the scabbing clears, the pigmentation of the skin is removed. Some mild, glycolic peels may be repeated while the deeper peels such as phenol usually do not require repeat treatment.
Microdermabrasion
Since it is slightly more aggressive, microdermabrasion can be used to treat irregularities in the texture of the skin, fine wrinkles and superficial scarring. Microdermabrasion involves "sanding" the skin with small microscopic crystals made of aluminum oxide, similar to grains of sand on a beach. A special high-powered instrument passes the crystals over the surface of the skin and then removes them quickly to "buff" superficial skin irregularities. Changes are cumulative and most microdermabrasion procedures are repeated at one to two week intervals. Six to eight sessions are usually suggested for optimal results. There is minimal redness of the skin after each treatment which usually subsides within about 30 to 60 minutes so there is little down time associated with this procedure
Laser Resurfacing
More significant skin problems such as deeper wrinkles, crow’s feet around the eyes, smoker’s lines (vertical lines above the lip) and scarring from moderate to severe acne need to be treated more aggressively with carbon dioxide, ultrapulse lasers. These lasers effectively cut away at the skin, layer by layer, but, because they deliver an intense amount of heat, seal the blood vessels as they cut. This vaporization process removes skin in layers. As new skin replaces the old, wrinkles and scarring are improved considerably. Laser resurfacing involves a recuperation time of approximately one week during which the skin is quite red and often results in one week of down-time from work and social situations. Another 6 to 12 weeks of camouflage make-up can often be expected while the pinkness of the skin gradually fades.
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