Comparative Efficacy and Safety of Laser versus Chemical Skin Peeling in Skin Rejuvenation: A Systematic Review and Meta-Analysis.

BACKGROUND

Laser resurfacing and chemical peeling represent 2 widely practiced skin rejuvenation techniques, each with distinct mechanisms and risk profiles. Despite their widespread use, comparative efficacy and safety across various dermatologic conditions remains incompletely synthesized. This systematic review and meta-analysis compares these modalities to guide evidence-based decision-making.

METHODS

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors searched major databases through October of 2024 for studies directly comparing laser treatments and chemical peels. Data on clinical improvement, adverse effects, and treatment sessions were pooled using random-effects models.

RESULTS

Thirty-eight studies involving 1695 patients were included. Both modalities achieved significant improvement over baseline. Overall efficacy was comparable between lasers and peels (standardized mean difference [SMD], 1.53 [95% CI, 0.57 to 2.50]). Laser treatment was more effective for melasma (SMD, 1.53 [95% CI, 0.57, 2.50]); chemical peeling was superior in psoriasis (SMD, -4.30 [95% CI, -6.84, -1.76]). No significant efficacy difference was observed in acne or acne scarring or overall photoaging. Lasers required fewer treatment sessions on average (mean difference, 2 sessions; P < 0.001). Transient erythema and procedure pain were more common with lasers (risk ratio, 6.63 [95% CI, 0.39 to 113.14]; risk ratio, 4.42 [95% CI, 1.72, 11.37], respectively); postinflammatory hyperpigmentation rates were similar.

CONCLUSIONS

Both laser resurfacing and chemical peeling are effective for skin rejuvenation. 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.