- Best Results2-3 sessions
- Treatment Recovery3-8+ days
- Procedure Time40 minutes
- Skin Specialist Nurse, dermal therapist
- Duration of Results6-12 months
- AnaestheticNumbing
- Back to WorkNext day (peeling usually delayed)
- Cost$$
Laser Assisted Retinoic Peels
VitA consists of specialist strength retinoic acid. This powerful molecule is the most potent collagen stimulant & forms the basis of anti-aging treatments. The concentration of retinol is approximately 100 times that of over-the-counter creams. Lasers allow delivery of this agent into the dermal layers, providing next-level collagen remodelling.
FactsMore Facts on Laser Assisted Peels A Peels
- This peel uses VITAmin A, hence the term VitA peels
- This peel is classed as a superficial intraepidermal chemical peel
- The active ingredient in this peel is retinoic acid
- VITA peels can treat acne, sun damage, wrinkles, congested skin & enlarged pores
- Retinoic acid peels can also be used to treat pigmentation & melasma
- Lasers aid in the delivery of retinoic acid into the dermal layers of skin
What conditions can chemical peels treat?
Specialist strength retinoic acid chemical peels can address the following skin conditions-
- Acne – oily skin. Retinoids form the cornerstone of acne management as they reduce blackheads, oil production & bacteria.
- Enlarged pores. Vitamin A promotes collagen production & decreases sebum (oil).
- Skin pigmentation, as retinoids suppress pigment cells.
- Wrinkles, sun damage & premature aging. Peels increase collagen & elastin, promoting a healthy dermal layer. Retinoids have a pivotal role in antiaging.
How is this laser peel performed?
We select one of two lasers, depending on the clinical features & downtime. Thulium lasers are gentle non-ablative lasers, CO2 lasers are ablative & suitable for more mature skin.
The steps are as follows-
- Skin is cleansed, makeup & sunscreen are removed.
- Local anaesthetic is applied for 40 to 60 minutes.
- Laser resurfacing takes 10 to 12 minutes to complete.
- We then apply retinoic acid in a predetermined make up base.
- This peel mask is left on for 4 to 8 hours (time dependent penetration).
- The retinoic acid peel mask is washed off in the convenience of your home
- A moisturiser is applied before bedtime
- Your skin will peel after 24 to 48 hours for 1-8+ days
What is the recovery following laser assisted retinoic acid peels?
1-8+ days depending on your skin sensitivities, laser settings & the strength of the peel. As a guide, delayed peeling may occur 36-48 hours after application of the peel. Peeling can occur for up to 8 or more days after application.
For first time users my advice is to start at 1% retinoic acid. This is still 20 times more powerful than prescription retinoids, and at least 100 times stronger than over the counter retinols. Once you have an idea on the duration of peeling, you may step up to a higher concentration. We can guide you as to the expected duration of peeling based upon laser settings (wavelength, density, depth) as well as concentration & time of the retinoic acid peel.
Why is retinoic acid peeling different compared to beautician peels?
Retinoic acid is the strongest form of vitamin A. These are physician prescription peels. Retinol requires conversion to retinoic acid, hence with 1% retinol formulations, less than 1% gets converted to the active ‘acid’ form. In theory, this gives an ‘active concentration’ of 0.01%. In comparison our retinoic acid peels start at 1 to 4%.
This is delivered directly into the deep epidermal & dermal layers of skin. It takes out the variability of skin absorption.

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How often should I get laser assisted retinoic acid peels?
Laser assisted retinoic acid peels are next level peeling & differs from standard VitA peels. My recommended frequency ranges from 6 – 20 weeks, depending on the clinical indications. As a guideline-
- Acne prone skin, enlarged pores: Every 6-10 weeks
- Fine lines, anti-aging concerns: Every 10-20 weeks
- Skin pigmentation: Every 10 weeks
- General skin care: Every 20 to 52 weeks.
*Guideline only, peels should be tailored according to your skin as well as your goals.
Are there any side effects with laser retinoic acid peels?
Side effects are extremely uncommon following this type of peel. Firstly, we need to define what are the expected effects (these are predictable).
Predicted effects include- redness, mild stinging & peeling for 2-8+days.
Exaggerated side effects include- prolonged redness & peeling (greater than 10 d). Other rare side effects include post-peel skin darkening (especially if you receive lots of UV), viral infections such as cold sores are uncommon. If you have a history of cold sores, you must take antivirals.
Experimenting with laser assisted delivery of retinoids AKA: LARI or laser assisted retinoid infusion 2.0
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🔬Skin science: approximately 1-2% of topical retinol is absorbed by the skin. It requires conversion to retinoic acid for activity. Stuff that, too many variables, too many steps before it is biochemically active
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👍🏻The Concept: increase absorption by a factor of 20-50. I have been using small spot super dense, low energy CO2 fractional lasers. They work infinitely better than NA lasers. Last week I nearly tripled the spot size to 300 microns. This week it’s 500 microns, super dense with adjusted joules (due to bigger spot size)
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🧪The molecule: I have been playing around with retinoic acid 1-5%, trifarotene, & today #tazarotene (third gen retinoid). I would have continued with #trifarotene, but it is patented, so I can’t increase my concentration. Solution? Tazarotene at 5 mg/ml (5-10x stronger than prescription, when it was available)
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🧬Hopeful outcome: retinoid bomb topically, MOAR - monther of all retinoids, it’s probably 1000X more acitve than topical retinol. Hopefully peel for 4-8 days
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🔎Aiming to improve: skin quality- wrinkles, pores, pigment, etc…
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💯Stay tuned
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#retinol #retinoids #retinoicacid #retinoltips #retinolskincare #differin #acnetips #co2laser #skincaretips #skincarescience #skinscience
Table based upon intended use, comparisons with other agents and clinical effects
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👌🏻Chemical peels: are great. They are underutilized in the day and age of lasers & devices. Peels, like everything else, are merely tools to get the job done. Clinical scenarios where peels have advantages over lasers include-
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1️⃣Treatment of comedonal acne. Salicylic acid 20-30% is a marvelous agent for blackheads & congestion, as is retinoic acid 1-7%
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2️⃣Freckles & superficial pigmentation: A medium depth peel can beat fractional lasers & BBL or IPL. One session of Jessner TCA or TCA will do the trick
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3️⃣Ice Pick scars, enlarged pores (like pathologically enlarged, not psychologically), TCA or phenol will beat fractional and even ablative devices
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4️⃣Deep rhytids; severe sun damage/elastosis: Phenol croton oil will out gun ablative lasers, albeit long downtime
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5️⃣Accelerated melasma treatment: in superficial > dermal pigment, where time is an issue. Remember, high gain, high risk, higher cost, but in some, but not all cases, faster results
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🔫🍌Combination lasers & peels: LARI or laser assisted retinoid infusion, combines laser & potent retinoids. The former aids in delivery of the latter. It works. Downtime can be tailored from 48 to 96 hours
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🎬Action: Book an appointment with my nursing team @clinic cutis to see whether peels are right for you
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
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Disclaimer: My clinical work deals with medium to deep peels only. For superficial peels including lactic, glycolic, retinoic, mandelic, #cosmelan #dermamelan & salicylic acid peels, please consult our nurses @cliniccutis
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#peels #chemicalpeels #tcapeels #jesserpeels #jessnertca #AHApeels #retinol #BHA #glycolicacid #lacticacidpeels #skincare #mandelicacid #melasmapeels #cosmelan
This table is based on probability and not possibility, as exceptions do occur👉
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Facts💯
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1️⃣Concentrations, formulations (pH, stability) make a difference in tolerability, and efficacy
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2️⃣Rosacea & sensitive skin can tolerate low strength BHAs as it is an anti-inflammatory, esp if combined with sodium sulfacetamide, the rule is not absolute. Same applies to #retinoids & sensitive skin, as careful titration can improve tolerability
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3️⃣Anti-aging: Azelaic acid has some anti-aging properties (example is reduction of pigment and hence dyschromia), but other acids are better
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4️⃣Safety in pregnancy is debated. Most derms won’t rx OTC topical retinol based upon principle, BHAs fine,
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😎Dr Davin Lim
Dermatologist
Brisbane🇦🇺
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#skincare #skincaretips #skincareroutine #skinacids #ahapeels #glycolicacid #BHApeels #chemicalpeels #retinoids #retinol #skincarehacks #skincarescience
A Lot of these chemicals have primary and secondary effects. These comments are based upon the intended use / efficacy of the molecule rather than in-vitro properties
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👉Molecules within families: Example of alpha hydroxy acids- there are many examples including glycolic, mandelic, lactic, citric, malic and tartaric acids. Glycolic and lactic acids are favourites for their exfoliative effects, whilst the large molecule size of mandelic can reduce skin penetration and hence be useful for skin rejuvenation in sensitive/rosacea skin (but why would you want to risk putting chemicals on rosacea-like skin when lasers & lights are inherently safer?)
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🎬Powerful science: I think most dermatologists stick to the main three for their own personal skin care, namely retinoic acid, ascorbic acid (as an antioxidant) and alpha hydroxy acids (as an exfoliant, usually in high concentration, low pH in a pulse manner). For those with uber sensitive skin, azelaic acid can be useful. As for hyaluronic acid? ...it works far better under your skin (dermal filler), not sitting on the skin 💉👍🏻
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#skinscience #hyaluronicacid #kojicacid #skincareacids #skinscientist #lacticacid #ahas #glycolicacidpeels #drdavinlim #dermatologist #dermatologistbrisbane
Can IPL be used on darker skin types?Who CAN NOT get this type of laser assisted chemical peel?
If you suffer from sensitive skin, including rosacea, chemical peels may not be the best solution for your skin type. Enzyme peels may decrease any potential post peel side effect, but these peels do not give a meaningful change. Lasers including pulse dye laser, dermal toning & laser genesis are better options to improve skin quality & generate collagen.
Should you have chemical peels if you have rosacea & sensitive skin?
In general, I do not recommend chemical peels if you have sensitive skin. This includes rosacea patients. As a guide, most rosacea patients do not tolerate prescription retinoids (0.05%), the concentration we use is up to 80 times STRONGER than prescriptions, and approximately 1000 X stronger than over the counter retinols. Not a good choice if you have sensitive skin.
Ideally for patients with rosacea, the use of low powered vascular, Q Switch, Pico & LLED (Low Level Laser Emission Devices) are advisable. Lasers can reduce BOTH redness & stimulate collagen production. For more information on skin rejuvenation in sensitive skin patients / rosacea patients, book an appointment with my clinical team @cliniccutis
How can I incorporate laser assisted clinical peels with my skin care routine?
Be guided by the clinical team @cliniccutis. Our approach to skin rejuvenation & skin care is simple- make every application count. This philosophy entails finding skin care that suits your skin concerns & end goals. By incorporating specialist strength peels, your anti-aging routine can be boosted.
How would I know if this peel is the correct peel for my skin?
Discuss skin issues with my clinical team @cliniccutis. My nurses & dermal therapists will guide you through our chemical peels, lasers & EBD (energy-based devices) to find the correct treatment to address your skin concerns & goals.
Davin’s viewpoint on laser assisted retinoic acid peels
Super strength retinoic acid peels (VITA peels, stands for Vitamin A) are my favourite chemical peels. Why? Because they can address a myriad of skin concerns ranging from wrinkles, pigmentation, acne, congested skin, through to anti-aging concerns.
Laser assisted peels are next level sh*t. Only for the hardcore. Thulium *& CO2 lasers increase absorption of topicals. In the context of thulium, it is non-ablative, whilst CO2 laser provides controlled epidermal ablation. Both these lasers allow retinoic acid to be delivered into the dermal layer of skin. This is where fibroblasts live, hence it is the most efficient way of delivering retinoids. I particularly like retinoic acid as a peeling agent because of the versatility of retinoids. They can treat both dermal & epidermal conditions including fine lines, pigment, skin aging, enlarged pores, acne & acne scars.
