Patient Selection

The key to high patient satisfaction and low postoperative complications is appropriate patient selection. Patients with mild to moderate facial rhytids and minimal pigmentary disturbances achieve the best outcomes with medium- depth peels [52]. The Glogau classification system for photoaged skin can be quite useful when deciding the appropriate peel type and depth for a particular patient (Table 4.3). Mild atrophic acne scarring and diffuse AK have been consistently improved with peels of this depth, as well. Traditionally avoided in darker skin types, medium-depth chemical peels are now being safely and successfully performed in these patients with some pre- and posttreatment precautions. Although these agents are applied safely to isolated lesions, full-face, medium- depth chemical peels are still, however, best avoided in very dark skin types (Fitzpatrick VI) because of the possibility of postpeel hyper- or hypopigmentation.