What are risks of laser peels for the face?

Arthur W. Perry, MD
Plastic Surgery
Many complications can occur with lasers. In the early days of the laser, corneal injuries and eyeball perforations were frequent. Even today, scarring and pigment changes are common. Brown pigment streaking and lines demarcating where the laser stopped can occur. This hyperpigmentation can be extremely troublesome and may require skin creams such as tretinoin (Retin-A) and hydroquinone, peels, microdermabrasion, and even repeat lasering. It may even be permanent. The skin can scar over the years, stiffening and lightening. The cells that make pigment are destroyed by the heat of the laser, making it dangerous to be in the sun without complete sunblock.

Infections from laser peels can cause scarring. If a herpes infection occurs, it can create chicken pox-type scars. Antiviral drugs can prevent this complication and should be used in all patients undergoing a laser peel.

Thick red scars or even keloids are possible after lasering. Accutane or steroid use prior to lasering will delay healing for up to a year, which can cause intense scarring.

Since lasering really does work and really does shrink the skin, it can cause the eyelids to shrink to the point that they do not close. An experienced surgeon will know how deeply to laser and whether the lids require a tightening procedure such as a canthopexy to prevent this complication.

The laser is safe only on the face, since the skin of the neck and the rest of the body heals differently. Scars are more common in other areas.

The laser will permanently damage teeth. They are protected with a gauze pad or mouth guard during the procedures. After the skin has regrown, it is bright red for months, even up to a year. A skin reaction called milia, or "whiteheads," often occurs a few months after the peel; it is helped by tretinoin and exfoliants.

The deep laser peel is declining in popularity, mostly because of the high chance of skin lightening and the uncomfortable, lengthy recovery. In 1996, there were 46,000 deep laser peels performed in the United States. After a peak in popularity around the year 2000, by 2005 there were 58,000 deep lasers performed. Because it so effectively lessens wrinkles, the laser peel is still selectively used despite its problems. On the other hand, 418,000 so-called nonablative laser peels were performed the same year. In these, the upper layers of skin are not removed.
Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.