Chemical Peel vs. Laser Treatment: What's Best For You?

Acne scars. Wrinkles. Dark spots. Any of these names ring a bell? Unfortunately, they happen, and when they do, we find ourselves in panic mode. From skincare products that claim to cure age spots to endless online searches, we have hunted everywhere hoping to eventually find that ‘magic’ treatment to erase the skin’s textural irregularities and beyond.

Luckily, there are solutions out there. Enter chemical peels and laser treatments, two skin resurfacing procedures that remove damaged regions to encourage skin regeneration. The end product? Smoother, revitalized skin. Combatting your problem areas has never been easier, but it can be overwhelming if you are new to the world of skin resurfacing.

We consulted with board certified dermatologist Sejal Shah, MD, of SmarterSkin Dermatology, to get the 411 on everything you need to know about chemical peels, laser resurfacing treatments, and how it affects the skin.

The Differences Between Chemical Peels and Laser Treatments

Chemical peels and laser treatments are skin resurfacing procedures that remove old skin to promote new skin growth. Both treatments are commonly used to minimize acne scars and hyperpigmentation, reduce fine lines and wrinkles, and correct sun damage issues such as age spots.

Foremost, what differentiates chemical peels and laser treatments is the procedure itself. As the name already implies, one utilizes chemical solutions to remove skin and the other uses lasers.

Chemical peels use acid solutions of varying strengths to treat the outer layer of skin. There are three types of peels: superficial, medium, and deep peels. Superficial chemical peels (e.g. VI Peel® and lactic acid peels) are gentle and utilize mild acids to lightly exfoliate the skin. Medium chemical peels (e.g. glycolic acid peels and TCA peels) are more intrusive and penetrate the middle and outer layer of skin. Deep chemical peels (e.g. phenol acid peels) are the strongest, using powerful acids to not only penetrate the skin, but remove damaged skin cells.

Laser resurfacing treatments use beams of light to penetrate the skin, removing one layer at a time. The laser method allows for a more precise removal process, but is generally more expensive than chemical peels, according to 2017 statistics from the American Society of Plastic Surgeons. There are two types of lasers: ablative and non-ablative. Ablative lasers (e.g. CO2 and erbium) are more intense but provide the best results by vaporizing the skin. Non-ablative lasers (e.g. Fraxel) are less intrusive to the skin and heat the skin instead without destroying it. Keep in mind that because non-ablative lasers are not as powerful as ablative lasers, multiple sessions may be required for best results.

However, Dr. Shah notes that although chemical peels and laser treatments are different, there is some overlap in the benefits they offer and the issues they correct. "For example, a strong TCA (trichloroacetic acid) chemical peel can provide a resurfacing similar to a resurfacing laser, or both peels and lasers can be used to improve acne and acne scars,” she explains.

The two procedures also differ depending on skin tone. According to the American Academy of Dermatology, people with a darker skin tone benefit the most from chemical peels, as peels are an effective treatment against hyperpigmentation. Dark skin tones are often prone to hyperpigmentation issues such as postinflammatory hyperpigmentation (PIH) because of an increased amount of melanin in their skin. Chemical peels use acid solutions to stimulate collagen production and contain antioxidants that better penetrate darker skin and treat pigmentation.

What Are the Most Popular Types of Chemical Peels?

• VI Peel®: The VI Peel® is a gentle, relatively painless peel that is effective on all skin types and skin tones. Made from a blend of trichloroacetic acid, Retin-A, salicylic acid, phenol, and vitamin C, it is often used to treat hyperpigmentation and reverse sun damage.
• Lactic Peel: A superficial lactic peel is derived from milk and works best on dry and sensitive skin. It helps balance skin pH and gently exfoliates by dissolving dead skin cells.
• Glycolic Peel: A superficial- to medium-depth glycolic peel is made out of glycolic acid that promotes the production of new collagen and elastin by targeting the skin’s outer layer. It is often used to treat acne/acne scars and tighten pores.
• TCA peel: A medium-depth TCA peel uses trichloroacetic acid and is more aggressive than the glycolic peel. It is often used to correct skin pigment issues and soften wrinkles.
• Phenol Peel: A deep phenol peel powerfully penetrates the skin to treat severe wrinkle and discoloration issues. It often requires a lengthy recovery time and may feel uncomfortable compared to milder peels.

What Are the Most Popular Types of Laser Treatments?

• Fraxel Laser Treatment: Non-ablative fraxel laser treatments uses FDA-approved fractional laser technology to rejuvenate skin. This type of laser works best on mild to moderate acne scars and fine wrinkles.
• Carbon Dioxide (CO2) Laser Treatment: Ablative CO2 laser treatments uses pixelated carbon dioxide lasers to treat more extreme skin issues such as deep wrinkles and severe acne scars. This type of laser is generally not good for treating skin redness.
• Erbium Laser Treatment: The ablative erbium laser is a milder and less intrusive laser treatment than the CO2 Laser. The laser penetrates the epidermis (the outer skin layer) and also stimulates the production of collagen. It is often used to reduce wrinkles, fine lines, and age spots.

Which Treatment Is Best for My Skin?

Long story short: It all depends on your skin type and concerns. “It can be difficult to determine the best course of action, so it is always important to consult with a board certified dermatologist to discuss your concerns and treatment options,” Dr. Shah advises.

If you have a darker skin tone, Dr. Shah warns that not all chemical peels and laser treatments are suitable for darker skin tones. Unsure of your situation? When in doubt, always consult a dermatologist.

For hyperpigmentation, Dr. Shah recommends a chemical peel. For textural changes, such as atrophic or indented scars, Dr. Shah finds laser skin treatments more beneficial. “However, a TCA chemical peel can also improve these acne scars,” she explains. “Often, combination approaches are needed, combining laser, peels, subcision, and/or fillers.”

What Should I Expect When Getting a Chemical Peel/Laser Treatment For the First Time?

“With chemical peels, expect redness and peeling afterward depending on the type of peel. Not all peels produce visible peeling,” Dr. Shah says. “The post-laser skin side effects depend on the laser, but include redness, peeling, swelling, and bruising.”

If you use topical treatments, Dr. Shah notes that your doctor may advise you to stop applying them a few days prior. Depending on the peel and laser, it may be recommended that you stop retinoids, hydroxy acids, benzoyl peroxide or other harsh, drying and potentially irritating ingredients. Patients with a history of cold sores may also be prescribed antiviral drugs for prophylaxis.

Am I a Good Candidate for a Chemical Peel or a Laser Treatment?

Dr. Shah advises against chemical peels and laser treatments if you:

• Have active infections in the areas you want treated
• Will be under sun exposure after the treatment
• Have a history of keloids or hypertrophic scars
• Do not allow an appropriate amount of recovery time post-treatment
• Have a darker skin tone (this applies to certain types of chemical peels and laser resurfacing treatments)

Whether you choose a chemical peel or laser treatment, there is a resurfacing skin solution for you out there!