Chemical peels are fantastic in the right hands.
I have a CO2 and an erbium laser in my office but I love the results I can obtain with an appropriate chemical peel. It is important to recognize that doing a chemical peel is a flat out art form that is very difficult to teach to another doctor. No one learns how to do a chemical peel in their plastic surgery residency. It literally requires performing hundreds of chemical peels and this experience is best acquired in a cosmetic surgery fellowship.
There are many different choices in peeling agents. However several lighter peels do not equal the effects of one deeper peel. There is no free lunch in chemical peeling or laser resurfacing. The deeper the peel that is needed, the more downtime, recover, and increased risk of complications if healing is not closely monitored.
Regarding specific agents, 35% trichloroacetic acid is good for firming the face and improving sun damage without affecting natural pigmentation. Stronger agents like phenol and Baker's phenol are needed on deeper lines. However, these stronger agents are more often associated with loss of pigmentation. The key is to only use these agents when absolutely necessary and do proper blending to avoid demarcation lines. A peel should be like painting an oil painting. The agents need to be applied considering all of these factors including skin thickness, degree of damage, how much hypopigmentation is acceptable, etc.
What you need can only be determined by a personal consultation with a master chemical peeler. Look for someone who is conservative. If the doctors boasts that he or she only does a taped Baker Phenol peel, do yourself a favor and go elsewhere. Very few people need such an intense result. Less is more.
