Combined Carbon Dioxide Laser Resurfacing and TCA Chemical Peel

Abstract

Currently, various modalities such as phenol and TCA peels and dermabrasion are available for regeneration of the aged skin. A prior study by our group has demonstrated the clinical effectiveness of CO₂ laser resurfacing in treating actinically damaged skin of the entire face with concomitant histologic improvement characterized by elimination of the solar elastosis and replacement by new collagen bundles. In the present study, we have taken this approach one step further and are presenting results of a series of 130 patients treated with combined CO₂ laser resurfacing and trichloracetic acid (TCA) chemical peeling. The laser is used primarily for wrinkles, keratotic lesions, and pigmentary changes; and TCA is used to blend affected and unaffected skin. Fewer complications were noted with CO₂ laser resurfacing/TCA peels than with phenol peels or dermabrasion. This combined technique can be a useful modality in the cosmetic as well as therapeutic treatment of the aged skin, as marked clinical and histologic improvement has been demonstrated.