Meta-Analysis: Comparable Overall Outcomes With Lasers and Chemical Peels for Skin Rejuvenation
Key Takeaways
- A systematic review and meta-analysis of 38 comparative studies and almost 1,700 patients found laser resurfacing and chemical peels produced comparable overall improvements in skin rejuvenation outcomes.
- Laser treatments demonstrated greater efficacy for melasma and required fewer treatment sessions, while chemical peels performed better in psoriasis. No significant differences were observed for acne, acne scarring, or overall photoaging.
- Lasers were associated with higher rates of transient erythema and procedural pain.
A systematic review and meta-analysis published in Plastic and Reconstructive Surgery found that laser resurfacing and chemical peeling provide comparable overall efficacy for skin rejuvenation, although each modality demonstrated advantages in specific clinical settings.
Meta-Analysis Compares Outcomes Across Common Dermatologic Indications
George Karanasios, MBBS, and colleagues conducted the review in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, evaluating studies published through October 2024 that directly compared laser treatments with chemical peels. The analysis included 38 studies encompassing 1,695 patients and pooled outcomes using random-effects models.
Overall, both treatment modalities significantly improved clinical outcomes from baseline, with no statistically significant difference in overall efficacy between lasers and chemical peels (standardized mean difference [SMD], 1.53; 95% CI, 0.57-2.50).
Subgroup analyses identified differences by indication. Laser therapy was associated with greater efficacy in melasma (SMD, 1.53; 95% CI, 0.57-2.50), whereas chemical peels demonstrated superior outcomes in psoriasis (SMD, −4.30; 95% CI, −6.84 to −1.76). No significant differences were observed between the modalities for acne, acne scarring, or overall photoaging.
Laser procedures required approximately two fewer treatment sessions on average than chemical peels (P < .001). However, laser treatments were also associated with higher rates of transient erythema and procedural pain, while rates of postinflammatory hyperpigmentation were comparable between the two approaches.
The authors noted that treatment selection should be individualized based on the dermatologic condition being treated, patient skin type, and tolerance for treatment-related adverse effects.
"Both laser resurfacing and chemical peeling are effective for skin rejuvenation," the authors wrote. "Lasers may offer advantages in melasma and require fewer sessions, but with more short-term redness and discomfort. Chemical peels remain valuable, especially for certain conditions (eg, psoriasis) and in patients prioritizing minimal downtime. Treatment choice should be individualized on the basis of skin type, condition, and tolerance for side effects."
Source
Karanasios G, et al. Plast Reconstr Surg. 2026;158(2):263-272. Doi:10.1097/PRS.0000000000012719