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Rejuvenation - Exfoliation to Resurfacing - Part 5 - Chemical Peel, Dermabrasion and Laser By Peter T. Pacik, M.D., F.A.C.S.  In
my previous e-mails, I discussed exfoliation, microdermabrasion, light chemical
peel and resurfacing. These e-mails are available in the newsletter
section of our website skincare-md.com.
Today, I will discuss how doctors chose between chemical peel, dermabrasion
and laser as resurfacing procedures.As I mentioned earlier, resurfacing is a deeper removal of the outer layers of skin than exfoliation, accomplished by chemical peel, dermabrasion or laser. New cells are made by the remaining dermis (under surface of the skin) resulting in a newly healed surface ("resurfacing"). This results in fresher, healthier, and more radiant skin and is suitable for wrinkles, sun damage, pre-cancerous actinic keratoses, and acne scarring. Some form of anesthesia is often necessary because of discomfort. Chemical Peel: A variety of caustic agents are available including TCA (trichloroacetic acid), phenol and croton oil. The chemicals actually burn the outer layers of skin. Different concentrations will cause varying depths of skin removal. Dermabrasion: A mechanical removal of the outer skin layers achieved by a rapidly rotating cylinder or dome covered with diamond chips or wires. Laser: Uses beams of concentrated high intensity light to accomplish the removal of skin layers. Doctors tend to use the modality that they are most comfortable with. In my own practice, I tend to use a variety of procedures. For sun-damaged skin, wrinkles and pre-cancerous conditions, such as actinic keratosis (scaling lesion), I tend to use chemical peels or laser. I find both methods to be helpful with skin rejuvenation. I follow this with the use of advanced skin care products. For acne scarring, I favor dermabrasion and excision of deep scars though good results can be achieved with laser. A recent scientific study compared dermabrasion with laser for vertical wrinkles of the upper lip. Half the lip was treated with dermabrasion, the other half of the lip (same patient) treated with laser. All results were considered to be good and the patients were satisfied with the outcome. They reported more pain and more redness with the laser treated side. In recent years, physicians experienced with resurfacing are treating areas more lightly and repeating the procedure as needed to avoid the complication of pigment loss (depigmentation) or hyperpigmentation when deeper treatments are done. After healing, resurfaced patients should follow the MD Forte 3-Step Advanced Skin Care Program. Advanced skin care with the use of glycolic compound exfoliates the outer layers of skin and allows better penetration of moisturizing agents. See below for links to individual products.  1.
Facial Cleanser I or II (start with I -12% glycolic compound, advance to
II -15% glycolic compound). Gentle, creamy cleanser removes daily residue,
makeup and oil without harshness or dehydration.2. Facial Cream I, II or Skin Rejuvenating Lotion I or II. Facial Cream I (15% glycolic compound) and II (20% glycolic compound) exfoliates, softens and refines dry skin. Skin Rejuvenation Lotion I (5% glycolic compound) improves dull, lifeless complexion or for sensitive skin. Skin Rejuvenation Lotion II (20% glycolic compound) is a higher strength for advanced correction. 3. Aftercare Environmental Protection Cream SPF 30 (glycolic free) for maximum protection against UVA/UVB exposure. LRS and Kinerase are added to enhance the skin care program. These products will re-establish moisture and maintain the healthy, glowing appearance of the new skin. Over-the-counter and esthetician products contain a smaller percentage of glycolic acid. These products are often neutralized to the degree that they are poorly effective. Forte has stronger concentrations of glycolic acid; and therefore, is both more effective and works quicker. Because of these stronger concentrations, they are available only through a doctor's office. In future e-mails, I will discuss the proper use of sunscreens and much more. If there are any topics that you would like covered in these educational e-mails, please let us know. We encourage you to share your experiences both positive and negative with us. Your comments are important to us. |
For more information, please visit our Web site skincare-md.com and our plastic surgery website plasticsurgerypa.com. All of our previous educational e-mails , as well as The MD Forte 4-Step Daily Regimen, Obagi Nu-Derm System Daily Regimen, and Obagi-C Rx Recommended Daily System Application are found on our website www.skincare-md.com. If you have any additional questions or would like to speak to or would like to speak to Dawn Mailhiot, our esthetician, please feel free to call us during office hours Monday thru Thursday 9-4, Friday 9-3 EST at 1-800-640-0290 or (603) 669-0290. If there are any topics that you would like covered in these educational e-mails, suggestions or concerns you may have, please let us know. We encourage you to share your experiences both positive and negative with us. Your comments are important to us.
Peter T. Pacik, M.D., FACS
Medical Director
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