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What's the Difference Between Laser Treatments and Chemical Peels?

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In the world of in-office skin-care procedures, there are few that offer a larger variety of options—or can treat more skin concerns—than lasers and peels. They're also often lumped into the same general category, and yes, there are some similarities. "Both procedures are used to treat photodamage—sun spots and wrinkles—and to improve the texture and tone of the skin," says dermatologist Jennifer Chwalek, M.D., of Union Square Dermatology in New York City.

Still, the two are ultimately very different, each with their own set of pros and cons. Here, a head-to-head comparison to help you determine which is right for you.

How Laser Treatments Work

"A laser is a device that emits a particular wavelength of light that targets either pigment, hemoglobin, or water in the skin," says Dr. Chwalek. Targeting pigment helps eliminate spots (or hair or tattoos, for that matter), targeting hemoglobin reduces redness (scars, stretch marks), and targeting water is used to treat wrinkles, she adds. There's no shortage of types of lasers, each of which is best for addressing these different issues. Common ones you may have seen or heard of include Clear & Brilliant, Fraxel, Pico, nd:YAG, and IPL. (Related: Why Lasers and Light Treatments Are Really Good for Your Skin

Pros and Cons of Laser Treatments

Pros: The depth, energy, and percent of skin treated can be easily controlled with a laser, allowing for a more targeted treatment that can be individualized for each person. Ultimately, that means you may require fewer treatments with a lower risk of scarring, notes Dr. Chwalek. Plus, there are certain lasers that can address more than one issue at a time; for example, Fraxel and IPL can treat both redness and brown spots in one fell swoop.

Cons: Lasers are more expensive (ranging from about $300 to over $2,000 for a single session), depending on the type, according to the 2017 American Society of Plastic Surgeons Report) than chemical peels, and in many cases require more than one treatment to see results. And who is doing the lasering definitely matters: "The efficacy of the procedure depends on the knowledge and skill of the laser surgeon in manipulating the parameters of the laser to best target the problem," says Dr. Chwalek. Step one: See your dermatologist for a thorough skin check and to make sure the cosmetic issue you're trying to treat (say, brown spots) isn't something more serious (say, possible skin cancer). Seek out board-certified plastic surgeons who specialize in cosmetic treatments; most physicians who specialize in lasers have multiple lasers in their practice (so they aren't going to sell you on "one laser that does all") and often belong to professional organizations such as the ASDS (American Society for Dermatologic Surgery) or ASLMS (American Society for Laser Medicine and Surgery), adds Dr. Chwalek. (Related: How Often Should You Really Have a Skin Exam?)

How Chemical Peels Work

Chemical peels work less specifically than lasers, using a combination of chemicals (usually acids) to remove the top layers of the skin. While super-deep chemical peels were once an option, those have largely been replaced by lasers; nowadays most peels work superficially or at a medium depth, addressing issues such as spots, pigmentation, and maybe a few fine lines, points out Dr. Chwalek. Common ones include alpha hydroxy acid (glycolic, lactic, or citric acid) peels, which are fairly mild. There are also beta hydroxy acid (salicylic acid) peels, good for helping treat acne and for minimizing oil production, as well as to unclog pores. There are also peels (Jessner's, Vitalize) that combine both AHAs and BHAs, as well as TCA peels (trichloroacetic acid) that are medium depth and are used to help improve fine lines and wrinkles. (Related: The 11 Best Anti-Aging Serums, According to Dermatologists)

Pros and Cons of Chemical Peels

Pros: "Since peels work by exfoliating, they're often useful in treating acne, and overall can do more to improve the texture of your skin, increase radiance, and minimize the look of pores," says Dr. Chwalek. Again, they're also cheaper than lasers, with a national average cost of about $700.

Cons: Depending on what you're trying to treat, you may need a series of chemical peels to see the best results. They're also unlikely to significantly improve deeper scars or wrinkles, says Dr. Chwalek, and peels can't improve redness in the skin.

How to Decide Between Laser Treatments and Skin Peels

First and foremost, consider the exact skin issue you're trying to address. If it's one of the conditions that can only be helped by one of the treatments exclusively (e.g., acne, which only a peel will help, or redness, when only a laser will do), then you have your decision. If it's something like spots, which both can help with, take into account your budget and how much downtime you can afford. How much downtime depends on the particular laser and peel you go with. But generally speaking, lasers may involve a few more days of post-procedure redness. In theory, if you're younger and just have some mild, superficial issues you want to treat (uneven tone, dullness), it may be a good idea to start with peels and ultimately work your way up to lasers once you have more visible signs of aging. (Related: 4 Signs You're Using Too Many Beauty Products)

Another option: Alternating between the two, since they do target different things. Of course, at the end of the day, a chat with your dermatologist is the best way to help plot your course of action. Oh, and if you have a history of sensitive skin, be sure to bring that up; it doesn't necessarily mean you can't opt for one of these treatments, but it should be discussed so your doctor can help figure out which one is best for you. The one time both lasers and peels are a no-go is if you have any kind of active skin infection, such as a cold sore.

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