Lasers, Facials and Peels, Oh My!

Updated: Nov 21, 2018


Spa facials, chemical peels and laser treatments - what are they and what are their differences? Let me break it down for you and help you figure out which treatment is right for your individual skin issues.

Young skin.  You do not appreciate young skin until you are older, and wistfully look back at old photographs.   I remember my mom gazing at me (years ago, ha) and saying “look at your skin, its so beautiful”.  I remember thinking, “it is skin; my skin looks like skin.” No, my skin looked like young skin but I did not even know what that meant.  If you are not 25 or under, you know what I am talking about.  Young skin is full, firm and hydrated, there are few lines and it reflects light, and literally looks luminescent.


As we age our skin does not “turn over” as quickly, and we lose collagen and therefore  elasticity and thickness which all results in dull and lifeless skin that may feel and look lackluster and wrinkled.

So, what to do?  There are many professional facial treatments that can actually turn back the clock. In this blog post, I'll briefly go over spa facials, professional peels, professional lasers and at home peel treatments.



SPA FACIALS

In general – spas are good for keeping skin healthy and exfoliated, and are especially  effective for teenage skin and acne to extricate black heads and pimples  in a safe and non scarring manner. Your skin will temporarily glow and look great, BUT they tend to have no lasting effect – or permanent change.  Spa facials are good for “maintenance” particularly if you have problematic skin, and if you do not exfoliate yourself.  You will feel good, and it may inspire you to take care of your skin.  A spa facial will also introduce you to products and skin care habits which may be beneficial for daily use.  For example, exfoliation is an important habit and certainly will help to make your skin look younger and more luscious.


BOTTOM LINE : Good for acne and for learning and employing good skincare habits - temporarily looks great. I am a big fan.



CHEMICAL PEELS

The idea behind a chemical peel is that it removes a top layer of skin to exfoliate and speed up cell turnover.  All face peels involve applying a chemical or natural solution to your face to expedite the exfoliation process. The main difference in the peels is how deep they go.

AHA, BHA, Glycolic, Lactic, Retinoic, and Salicylic acid face peels

AHA and BHA also  known as alpha hydroxy or beta hydroxy acids and the other acid peels listed are all quite light, and thus can be performed without any downtime.  They are often combined to combat a number of skin problems together.  Glycolic tends to be good for pigment issues.  Retinoic and Salicylic are especially good for acne, though all these peels are somewhat effective for acne.  They are particularly good for targeting acne or oily skin issues because they break down the bonds that hold dead skin cells together, allowing for easier exfoliation.  Many “new” peels use fruit enzymes and acids from natural sources such as pumpkins, as well as active ingredients to penetrate and deliver anti-oxidants and vitamins deep into the skin encouraging the new cells to grow stronger and healthier. (Look at my blog on winter skin, and anti-oxidants)

These peels are painless and well tolerated.  They can be done every other month, and tend to be inexpensive.  There are some in-home options for many of these chemicals. People typically have light peeling similar to after sunburn approximately  4-6 days post peel.  The skin will look brighter and  smoother, and be able to absorb moisture better, giving it that “glow”.  The skin will also feel softer and smoother.  There is essentially no downtime. I personally peel myself with a professional kit at least 3 times a year.



TCA face peels

Trichloroacetic acid (TCA) peels are a medium depth peel and help to treat pigmentation, sun damage and wrinkles. The downside of these peels is that they feel slightly more uncomfortable than lighter peels, and people tend to have side effects like swelling and redness. Your skin will noticeably peel and typically be red post treatment so it’s best to do these treatments over a period of time when you can have a few days of down time.

The good news is your new skin will look smoother in texture (it reduces fine lines and wrinkles) with improved tone and texture.

Carbolic acid face peels (PHENOL)

The Phenol peel is the strongest of the group and is usually done to help treat scarring, severe sun damage, deep lines and wrinkles. This peel is no joke.  The application can be  can be quite painful, so patients are often sedated. Expect to be very red following the procedure with a need for downtime of at least 1 week (your skin will get scabby, you will literally look like a burn victim) and a healing time of at least 2 months (meaning you will be red, and can’t be in the sun). It has to be done on the entire face, due to possible hyper-pigmentation.The results are dramatic….but there is real down time and recovery.



LASERS

Lasers are a different modality to perform the same task as peels. Other than the very light peels, which have no down time and are inexpensive, I prefer lasers. Lasers are specifically targeted to your skin problem and therefore the results are more predictable and controlled.


How do lasers work?  Lasers work by generating a single wavelength of light that’s absorbed only by a single pigment. Some wavelengths target the red color of acne scars, broken capillaries and blood vessels. Others hone in on melanin, the brown-ish pigment in hair and skin, so they can both zap dark marks and remove unwanted hair. To minimize wrinkles, some lasers are absorbed by water, which precisely wounds the skin, generates new collagen, and leaves fine lines much less visible. (This process is known generally as skin resurfacing, and is amazing.)  The changes produced by lasers are not temporary – in that the change is a permanent change, your skin will continue to age, but what has changed has changed until the aging process begins again.


What’s the difference between ablative and non-ablative lasers?  Ablation is the removal of material by vaporization, chipping, or other erosive processes. Non-ablative laser leave the outer layer of skin alone and target deeper tissue, so the skin does not become raw. Treatments from ablative lasers, therefore, take longer to heal (three to ten days), than non-ablative ones, which take hours to several days. Another way to think about it is “wounding” lasers versus “non-wounding”.


What’s a fractional laser?  In the same way that the pointillists painted with dots, and full swipes of paint, fractional lasers don’t treat the entire targeted zone. The result is a faster healing process with fewer chances of “complications”.


What makes one laser different from another?  Lasers are specifically designed for a particular wave length of light and therefore have very specific targets. I think of a peel as a shot gun, and a laser as, well, a laser. A laser focuses on your particular issue; pigment, acne scars, acne, fine lines, loose skin, veins, red spots, hair, tattoos and blood vessels.


Here are some common lasers:


Alexandrite: A greenish gemstone that generates a red spectrum wavelength used for blood vessels, excess hair or tattoos.


C02: A colorless, odorless gas that generates ablative infrared light for skin resurfacing. THIS IS GREAT FOR SKIN TIGHTENING AND LINES AND WRINKLES.  Real down time, but great for loos skin on the neck!  Some brand names you may have heard of – Fraxyl Repair.


Erbium: A silvery-white solid metal that generates infrared light for skin resurfacing and scars.  Also really good for pigment issues (age spots).  Very little down time. You may have heard of Fraxyl Restore.


Intense Pulsed Light (IPL): A spectrum of light absorbed by red blood vessels and brown pigment; ideal for treating both conditions at once.


Nd:YAG: A crystal that generates near infrared light used for blood vessels, brown pigment, excess hair, or tattoos.


Pulsed Dye: Generates a yellow beam of light for blood vessels, redness, and scars.


QSwitched: A process that allows a laser to produce very short pulses of a high intensity light beam for discoloration and tattoos.


Picosecond: A process that allows a laser to produce very short pulses of high intensity light beam for discoloration and tattoos.


NOW WHAT? 

I told you too much and you are confused.  Let's go through this to make it easier.

 You need to decide if you can afford down time or not – if you can’t then it eliminates deep and medium peels and ablative lasers. Now you are narrowing choices! You need to decide what your priorities are in terms of goals for your skin. Do you just want to start a maintenance routine or do you want to reset the clock back a few years? Go to a professional – see a cosmetic Board Certified Dermatologist or a Board Certified Plastic Surgeon. You don’t have to become an expert in all the options and choices, let them do the work!  Don’t worry about “brands” of lasers – the important thing is the TYPE of laser and what it targets. SCITON, LUMENIS, Fraxyl are all brands – and that is the least important aspect as a patient. Start an at home regimen this week – there are many over the counter peels that are great.


Here are some tips: 

You can do this monthly:

  1. FRUIT ACID peels smell great – especially PAPAYA. Papaya, Pumpkin and apple are all options.  They feel nice, do not burn at all and are easy to apply.

  2. RETINOIC Acid – is great to use for anti-aging, especially good if your skin cannot tolerate RETIN-A.

  3. Glycolic Acid 10% and above and combos with glycolic acid are great for age spots and can use on hands as well.

  4. Vitamin C peels are especially good at exfoliating and are often in combination with other products.

  5. Use CLAY and Charcoal for acne AHA and BHA are old school and work well.

  6. Post Treatment use Hylaronic acid serum to help your skin absorb moisture.

If you have any additional tips or questions, please comment below! Also, follow my Instagram and Facebook page for updates on new blog posts.


~Dr. Alexes Hazen



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