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Chemical peel, also known as chemexfoliation or chemical exfoliation, is a procedure where a chemical substance applied to the skin causes controlled destruction of the epidermis with or without part of the dermis, leading to skin regeneration and remodeling.

Chemical peels can be used to treat various skin conditions, such as acne vulgaris, photodamage, pigmentary disorders, and scars.(1)

Chemical Peel consists in the application of one or more chemical substances, in immediate or delayed sequence, able to induce the destruction of epidermal areas and/or layers of the dermis and the subsequent tissue regeneration process, to treat some skin conditions and/or resolve or improve the clinical-aesthetic aspects.(2)

The effects of the chemicals range from simple detachment of the corneum layer to considerable inflammatory reactions of the dermis; they depend on various factors and on some variables, able to determine the uniformity of the penetration effect, the levels of attainable depths and a more or less marked exfoliative reaction.(3)

Chemical peels are commonly classified based on their depth of skin penetration into superficial, medium, and deep peels. The factors affecting the depth of peeling, and thus the degree of its therapeutic effects, include the properties of the chemical agent used (e.g., concentration and pH), the physician's application technique, and the patient's skin condition and sensitivity.(4)

When performing a chemical peel, proper patient evaluation, and execution of a comprehensive treatment plan can produce safe, reliable, and satisfactory outcomes.

Various indications for using chemical peeling as a technique for skin resurfacing exist, including (5),(6),(7),(8):

  • Facial rejuvenation of the aging skin to address issues such as enlarged pores and rhytides
  • Inflammatory disorders including acne vulgaris, pseudofolliculitis barbae, rosacea, and post-acne scarring
  • Pigmentary disorders such as melasma, ephelides or freckles, lentigines, and post-inflammatory pigmentation
  • Epidermal proliferation and pre-cancerous lesions including sebaceous and actinic keratosis



Microdermabrasion is a minimally invasive cosmetic procedure consisting of two components: an abrasive component and a vacuum component.

An inert crystal like aluminum oxide or sodium chloride is accelerated from the handpiece toward the skin. The interaction between the skin and crystals creates a gentle mechanical abrasion that removes the superficial layers of the skin.

The spent crystals and skin debris are then collected by the vacuum and deposited in a waste receptacle.(1)

This dual action will resurface the skin and stimulate the blood flow, encouraging the skin to rejuvenate itself.

Microdermabrasion is used to remove the stratum corneum and the epidermis. After several treatments there is thickening of the epidermis and increase in collagen and elastic fibers.(2) 

Microdermabrasion therapy has been advocated for treatment of photoaging (i.e., wrinkles, dyspigmentation), acne, acne scars, and striae distensae.(3)


(1)Spencer J M. Microdermabrasion. Am J Clin Dermatol. 2005;6(2):89–92.

(2)Zaidi, Zohra, Hussain, Khalid, Sudhakaran, Simi Treatment of Skin Diseases: A Practical Guide 2019/01/01 doi:10.1007/978-3-319-89581-9

(3)Karimipour D J, Karimipour G, Orringer J S. Microdermabrasion: an evidence-based review. Plast Reconstr Surg. 2010;125(1):372–377.



The laser, an acronym for light amplification by stimulated emission of radiation, is employed for a variety of medical indications.(1)

The use of high-power lasers and skin peeling by heat generation is one of the methods for skin rejuvenation.(2)

Lasers resurfacing of skin as peeling could remove fine wrinkles of skin although, however potentially have the advantages to treat deep wrinkles by collagen making stimulation.(1) Skin healing in deep peeling and laser resurfacing is known as like wound healing mechanism and depends on the depth of the lesion.(3)

Different types of lasers for skin rejuvenation are ablative lasers, non-ablative lasers, and fractional lasers:(2)

  • Ablative lasers have been used to treat scars, pigmentations, and rhytides by removing the epidermis and heating dermis. Ablative lasers are generally used for skin resurfacing and rejuvenation. For severe facial wrinkles, pigmentation, and skin challenges, ablative lasers are often the preferred treatment.(5)
  • Non-ablative lasers have become the treatment of selection for a broad range of aesthetic indications. This type of laser is less aggressive than the optical laser and due to the stimulation of collagen in the dermis, it makes the skin firm. They have been used for patients with moderate photoaging.
  • Fractional lasers, by virtue of rapid healing, provide a means to reduce the complications and downtime associated with ablation lasers, while maintaining a laser thermal effect superior to that of non-ablative rejuvenation (NAR) lasers. Therapeutic effects of non-ablative fractional lasers (NAFL) are achieved by irradiation of multiple micro-treatment zones on the skin. Fractional lasers are effective for both aging facial skin rejuvenation and scar improvement.(5)




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