I want to provide my experience for people that are considering the treatment since there is a lack of acccurate information out there.
I've had my share of peels, microderm, etc. so not a virgin to this type of thing. I'm 39 with pretty good skin to begin with. My main goals were: 1) to remove sun damage around my eyes and mouth and 2) improve texture. My experience was very similar to the post from "on the fence" so I won't repeat the things she mentioned. FIRST, I would say that the actual "downtime" is 5-6 days, verses the 3-4 that the literature states. However, if you don't mind looking like a lobster then 3 days should be fine :)
Day 1: I had the proceedure at 10am and the pain during is moderate (had numbing for 45 min. plus a zanax that the dr. gave along with a vicodin). My Dr. said that in his experience one pass at the highest level achieved the best results so that is what we did. You are VERY RED, (the color of a dark red apple) and your face is on FIRE for several hours. The one inch of crisco type cream is the worst part as it sticks to everything (your hair, pillow cases, etc.). Around the jaw is extremely painful and the reddest of all there are also several quite large patches of totally brown skin.
Day 2: I begin the vinegar/water solution and notice that the burned skin stinks, It is just as red as the first day and mildly painful. The cream is still the worst part and then it also itches. Benadryl stops a majority of the itching.
Day 3: Continuing the vinegar solution (3-4 x's a day) but just as red and seems to smell more and very tight. I started to peel around my mouth that evening. It itches the worst today.
Day 4: In the shower the entire surface peels and the smell goes with the skin (thankfully). The skin below is just as red (read:lobster). SO, I call the doctor's office because it doesn't seem consistant with what I was told to expect and what my research said. They say that I have prematurely peeled (my skin's reaction to it) and it's fine but that I will peel again (great). However, I'm so glad that 1) it doesn't still stink 2) the cream can be decreased 3) that the dark brown patches are gone, so at this point I am thrilled. BUT still looking like a lobster.
Day 5: Better today but only a small decrease in the redness, Still very tight so I continue using a thin layer of the tissue repair cream or else my face feels like the saraha. That evening, I put on foundation and still had quite a bit of staring and four people asked about my really bad sunburn.
Day 6: Still RED (geez!) and using cream but beginning to peel again but this time thinner and flaky. I believe this will probably continue for another 4-5 days. By the evening, I put on foundation and look closer to normal. Hardly anyone noticed.
Day 7: Progressing to a lighter red but not yet pink color. Can be mostly covered by foundation although the cream is still needed and preferred to anything else.
I can tell you that the sun damage has been knocked off about 50% , not totally gone as I had hoped and the texture is slightly improved but not the DRAMATIC results predicted. Keep in mind that I am still flaking/peeling and probably won't see a true texture result until that stops. Having a lot of experience with chemical peels light, strong and everything in between, right now I can not say that the huge cost difference in the pearl is worth it. I would guess that it is about 25% stronger (deeper, etc.) than a good self neutralizing chemical peel. Not really enough to justify it in my mind and with longer recovery. Good luck!