Before getting a chemical peel, some patients need to follow a pre-peel skin care plan for 2 to 4 weeks. This plan can improve results and reduce potential side effects. Your dermatologist will tell you whether this is necessary.

On the day of your peel, you will first be prepped for the treatment. This includes cleansing your skin thoroughly. If you will have a deep peel, you will receive general anesthesia, which will put you to sleep. A deep peel must be performed in a surgical setting. 

After you are prepped, your dermatologist will apply the peel quickly and evenly. Your dermatologist will watch your skin carefully to remove the peel at just the right time. With a deep peel, the skin is treated one small section at a time. This limits the effects on the heart and lungs. 

After the peel comes off, your skin will be treated as needed. Patients who get a medium peel may need cool compresses followed by a lotion or cream to soothe their skin. If you have a deep peel, you will have a wound that requires a surgical dressing. 

All peels that a dermatologist performs require some at-home care. The following table shows you what you can expect.

Once your skin heals, you will see the results. Healing time ranges from 1 day for a refreshing or lunchtime peel to 14 days or longer for a deep peel. To get the results you seek from a refreshing peel or lunchtime peel, you may need to have 3 to 5 peels. 

Most results are not permanent because our skin continues to age. If you have lots of sun-damaged skin or precancerous skin growths called AKs, you will likely continue to see new spots and growths on your skin. 

The erbium:YAG laser is a 2940-nm ablative laser that targets intracellular water like the CO2 laser does; however, its affinity for intracellular water is 10 times greater than that of carbon dioxide laser. This greater affinity allows for a cleaner target cell ablation with less thermal collateral cell damage. Collagen shrinking is reduced with the erbium, resulting in decreased effect on rhytids. Yet the erythema and complications are greatly diminished compared with the CO2 laser due to the decreased collateral thermal necrosis.

The zone of thermal necrosis can be modified from 20-micron to 200-micron ablation based on the pulse width chosen. Even with variable pulse widths the side-effect profile and recovery period are still more favorable than with CO2 resurfacing.

The following skin disorders can be treated with Er:YAG laser beams.

– Atrophic acne scars

– Herpes simplex scars, smallpox scars

– Sun damaged skin

– Mild to moderate facial wrinkles

– Uneven pigment (brown age spots, freckles, melasma)

– Seborrhoeic keratosis and other benign skin growth

– Some superficial non-melanoma skin cancers

– Some vascular birthmarks (capillary vascular malformations)