Chemical Peels and Microdermabrasion

Summary

Superficial Chemical Peels and microdermabrasion don't make a dramatic difference to the skin by themselves. However, they do greatly enhance the penetration of prescription skin care creams and so are a useful adjunct to the treatment of acne and melasma.
Mid-Depth Chemical Peels remove brown marks and very fine lines. They have largely been replaced by Fraxel laser treatment because it is safer and works better.
Deep Chemical Peels and carbon dioxide laser peels were the gold standard method of removing wrinkles and tightening skin in the 1980s and 1990s. Again these procedures have been replaced by Fraxel laser treatment because it is safer.

Superficial Chemical Peels and Microdermabrasion

Superficial chemical peels and microdermabrasion only affect the outer layer of the skin, the epidermis. The epidermis produces skin cells that last for about 30 days before shedding. Therefore, the effects of superficial chemical peels and microdermabrasion can only be temporary, when used alone. The side-effects are also very temporary and are confined to mild redness and peeling that settles after a few hours or days.

However, the main function of the epidermis is to act as a barrier between our skin and the outside world. Therefore, these procedures can greatly increase the penetration of the active molecules of prescription creams into the skin and so boost the cream's beneficial effects.

Mid-Depth Chemical Peels

Mid-Depth Chemical Peels disrupt the whole of the epidermis and the upper part of the dermis. They can therefore reduce the number of flat brown marks that are sited between at the base of the epidermis. However, acne scars involve the deeper layers of the dermis and so are not improved by mid-depth peels. Acne scars are better treated with the Fraxel laser.

After a mid-depth peel, the skin is swollen and weeps for about 48 hours and then becomes dry and strips of dead skin cells peel off. The skin heals after seven to ten days. Mid-depth chemical peels are still used to freshen up the skin during a face-lift because the stinging from the acid can't be felt and because people won't be going out in public to a week after this surgery and that gives time for the skin to heal. However, as a stand-alone procedure, Fraxel laser therapy produces a much bigger improvement.

Mid-depth peels are still used to treat people with darker skin colours who might not respond as well to the Fraxel laser.

Deep Chemical Peels and Carbon Dioxide Chemical Peels

Deep Chemical Peels and Carbon Dioxide Chemical Peels destroy the epidermis and the upper and mid dermis. They can therefore treat brown marks, wrinkles and scars. However, the treatment produces severe swelling, weeping and peeling. The skin takes two weeks to heal; six months to stop being red and one fifth of people have permanently white skin after treatment.

These peels are usually carried out in a general anaesthetic. Permanent scarring remains the most feared complication of this procedure. The newer Fraxel SR1500 penetrates more deeply into the skin than the original model and, if used on its most powerful settings, can, after several treatments, produce improvement comparable with that seen after a deep chemical peel but without the risks.

Further reading: http://www.asds-net.org/Patients/FactSheets/patients-Fact_Sheet-chem_peel.html