Can I get skin peels or laser treatments while I'm using Retin-A?

I find your suggestions to discontinue RetinA for weeks prior to a peel confusing, especially since my derm, whose extremely well known in the "peel world" and has written chapters in two medical text books on peels--Harold Brody, has told me to keep using the RetinA up until the night before my peel. I'm surely confused. DDCNGA

Retin-A is a great medication to help with acne, fine wrinkling, mottled hyperpigmentation, and roughness.  It works best in conjunction with other preventive measures, such as a comprehensive skin care plan, emollient creams, and sun avoidance.  One side effect of the medication, unfortunately, is thinning of the horny layer of the skin, which is why Retin-A should be discontinued sometimes up to 6 months prior to deep exfoliating treatments, such as deep chemical peels or laser peels.  The variable depth of the skin after using Retin-A can sometimes lead to unpredictable results with the peels, and sometimes even complications such as hyper- or hypopigmentation (darkening or lightening of the skin), or scarring. Depending on the constituents of the chemical peels, and whether they self-neutralize (stop themselves after they get to a certain layer or pH of the skin), or if they require the clinician to neutralize it after a certain period of time, you could expect some differences in penetration of the chemicals if you use Retin-A.  Lasers are usually set to a certain depth, so it's a little safer, but there is still a risk it will go deeper than expected and could affect your melanocytes (cells that produce pigment) or other structures under the surface of your skin.  You may want to ask your clinician to do a test spot to see how your skin does.  It would need to be in an area that you have been applying the Retin-A to get an accurate result; not behind your ear, where most testing occurs, unless you've been using the Retin-A there.  Your best bet is to just discontinue the Retin-A, continue the other preventive measures to prevent future skin damage (SPF, skin care, etc), and get the chemical or laser peel a few months down the line.  It is usually a good idea to wait for when you don't plan to be in the sun so much (being summertime now) regardless of the use of Retin-A, since your skin is more reactive to sun exposure after the top layer has been removed. The minocycline also predisposes you to increased sensitivity to the sun, so be sure to wear your SPF religiously.  The windows in your car will not protect your skin.