Nov 26, 2019

Which is Best for Acne Scars and Facial Aging, Chemical Peels or Lasers?

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We asked Dr. Peter Rullan, a board-certified dermatologist in Chula Vista, California, “Which do you prefer for acne scarring and wrinkles, chemical peels or lasers?”  

Dr. Rullan’s areas of special interests and training include the treatment of Acne and Psoriasis, Chemical Peels for Acne Scars, Skin Rejuvenation and Pigmentation. He is an author in chapters on Chemical Peels in 5 medical textbooks and has lectured nationally and internationally over 100 times. 

“I love both and I use them together”, says Rullan. In the video below Rullan explains which treatments work best for acne scarring and facial aging.


MILD SCARRING WITH ICE PICK, BOX SCARS

*Minimal down time

i. CROSS (chemical reconstruction of skin scars) with TCA or phenol

ii. Subcision with either 20 gage or 18 gage Nokor

iii. Above plus chemical peel with 3-Step Z.O. Peel or VI Precision

iv. Above plus Fractionated Erbium laser

v. Microneedling with/without CROSS

MODERATE SCARRING WITH ICE PICK, BOX SCARS, ROLLING SCARS AND ATROPHIC OR HYPERTROPHIC SCARS

*3-7 Days Down Time

  • Options i- ii above plus Fractional CO2, or

  • Options i-ii above plus Blue Peel with TCA 20-26%

  • Add Fillers ranging from Hyaluronic acids, to Bellafil, to Silikon 1000 for rolling or atrophic scars (shadow-enhanced scars)

*9-14 Days downtime

Full-face 2-day modified Phenol peel when skin laxity is worsening appearance of acne scars

SEVERE SCARRING WHERE > 50% OF THE FACE AND UPPER NECK HAS ALL SCAR TYPES LISTED ABOVE

(touch-ups will be needed in areas with deepest scars)

*7-10 days downtime

  • 26% TCA Blue Peel plus CO2 laser peel to selected areas

*14 days downtime

  • CROSS, Subcision and Full-face 2-day modified Phenol peel

  • Always consider addition of Fillers afterward

  • Hypertrophic scars need intra-lesional Kenalog and 5-FU and possibly V-Beam perfecta



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