Reviewed by Varnada Karriem-Norwood on May 17, 2012

Sources

Robert Kotler, MD, FACS Cosmetic and Plastic Surgeon of the Face and Neck Clinical instructor, Division of Head & Neck Surgery, UCLA Medical School.

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Video Transcript

Narrator: Why are you a fan of chemical instead of laser peels?

Robert Kotler, MD: I think the chemical skin peel is one of the greatest gifts of cosmetic surgery to patients because it takes old skin and makes it new. It fulfills ambition that human beings have had for thousands of years, to not have wrinkles. It's been around for 50 years in the United States, but there's basically only a limited number of practitioners have been interested enough to master it and perform it regularly. But when you pick the right patient, meaning the patient with the right color skin, the right thickness skin, all the ingredients of safety, you have a very happy patient. A happy patient for many years.

Robert Kotler, MD (cont.): Now, about 10 or 15 years ago was delivered a new technology to hopefully erase wrinkles instead of this chemical process which is essentially just the application of an acid to the skin, a laser. An invisible beam of high powered light, which would basically destroy the outer layer of skin with heating the cells and making them burst. The water would boil. Literally, on a cellular level, that's what happens. It makes the skin the little individual cells pop and die, as opposed to the chemical or acid that makes them die from the acid treatment.

Robert Kotler, MD (cont.): In principle, the same thing happens. The outer layer of skin is deliberately destroyed to a certain thickness forcing nature to send up brand new smooth tight fresh pink skin. Great.

Robert Kotler, MD (cont.): The problems came with the laser when we realized that it took a very long time for doctors to master it. And that led to some people being disappointed because of under treatment and some people having complications because of over treatment, because it was a very powerful tool and the mastery took a little bit longer, and there were too many difficulties in getting it just even, not too superficial, not too deep. And so, it kind of fell out of favor. There's some other, less strong, you know, lower powered lasers, that again, are less prone to complications and problems. On the other hand, don't quite deliver the exotic results people want.

Robert Kotler, MD (cont.): People do want to have after having a significant procedure with the time and money outlay, they would like to have quite a good result. The chemical delivers it. So personally, for me, it's been the gold standard, and I think other experienced practitioners feel the same way. Sometimes, there is one process that just beats the others, and I believe this is.