85% lactic acid or 70% glycolic acid peel: which would be best for acne and scarring?

Question

I am Caucasian 29 looking for a semi gentle approach to help clear my acne, acne scarring and melasma. I am nervous about the side effects of lasers and other more invasive treatments but have always had pretty good result with light peels. However, i would like to make progress faster in healing and improving my skin and am looking for deeper peels. I am looking at LA and GA because they are more naturally derived which appeals to my more natural overall approach to skin care. Thank you!

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Simon Liubinas, MBBS · Answer

I understand the appeal of having a natural approach to your treatment, however many doctors and dermal clinicians are going to have a scientific approach to treating acne and scarring and may suggest alternative peels such as Jessner, Salicylic or Vitamin A peels. Although the acid percentages that you have mentioned are high, in reality it is not just the concentration, but a combination of the concentration, pH and pKa value of the acid that dictates the depth of skin penetration. Not knowing these variables is dangerous and can result in adverse reactions.
I would advise you to have a skin consultation with a dermal clinician and have them formulate a personalised treatment plan, including appropriate home skin-care and skin preparation, before administering any form of peel. I can also understand your concerns regarding the potential side-effects of laser treatments, however a qualified dermal clinician is an expert in laser treatments and in the right hands the appropriate treatment, with the appropriate laser, can be a very safe and effective means of treating certain forms of acne. Best of luck!

Morris Westfried, MD · Answer

Both these peels are equivalent. The response and variability is dependent on how strong the last peel you had. You should not be fearful of a laser such as q switched which can lighten dark color and stimulate new collagen without downtime.

85% lactic acid or 70% glycolic acid peel: which would be best for acne and scarring?

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85% lactic acid or 70% glycolic acid peel: which would be best for acne and scarring?

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