Narrator: Who is and is not a candidate for a chemical or laser peel?
Robert Kotler, MD: The problems that occur with chemical skin peels, like as they would with the laser, have to do first with the patient selection. You can't do everybody.The ideal patient and the patient least likely to have problems is very fair skinned, with blue or green eyes, with natural red or blond hair.And they also tend to have thinner skin. Those are the best patients.
Robert Kotler, MD (cont.): At the other end of the spectrum are people with black skin, brown skin, yellow skin or olive skin that's very oily and thick. They are less predictable and more prone to problems.So you have to basically limit the procedure to only the best candidates.Once you try to encompass everyone, you're going to have a high percentage of failure and worse complications. So patient selection is everything.
Robert Kotler, MD (cont.): Some people shouldn't have it because they have an underlying medical condition.For example, if you have bad kidneys, you can't have a chemical peel, because the chemical that's put on the skin is absorbed just like any medicine that you put on your skin.It gets absorbed into your body, whether it's a liquid, a gel, a cream, and the kidneys have to remove it from the body. They have the burden of removing 85 percent of that chemical.Well if the kidneys aren't good, that chemical is going to build up and it will be a problem,so obviously, that physical exam which is so important that we've talked about would ferret out that patient.