Laser Resurfacing

Treatment Overview

Laser resurfacing uses brief pulses of light to improve the look of the skin. It can remove the surface layer of skin and heat up deeper tissue to stimulate the growth of collagen. This is also called ablative skin resurfacing. Or it may injure the surface layer of skin without removing it to tighten the skin. This is also called non-ablative skin resurfacing.

Carbon dioxide lasers and erbium lasers are often used for skin resurfacing.

The laser is passed over the skin several times. The pulses from the laser may sting or burn slightly. You may feel a snapping feeling against your skin. When the treatment is done, the area may be covered with a skin cream or a special dressing.

In most cases, laser resurfacing is very precise and causes little damage to the surrounding skin and tissue. It is done most often on the face. But it may be done on skin in other areas of the body, such as the hands, neck, and chest.

Types of laser resurfacing

Types of laser skin resurfacing include:

• Ablative laser skin resurfacing. This removes the top layer of skin. It tightens skin, treats acne scars, and reduces wrinkles.
• Non-ablative laser skin resurfacing. This injures but doesn't remove the top layer of skin. It reduces fine lines and wrinkles.
• Fractional laser skin resurfacing. This causes less injury on the surface but affects the deeper layers of your skin. It is used to treat fine lines, deeper wrinkles, acne scars, and sun damage.
• Hybrid fractional laser skin resurfacing. This treatment uses both fractionated non-ablative and ablative skin resurfacing at the same time. This reduces wrinkles and improves skin texture, color, and tone.

What To Expect

The time needed to heal and recover after laser resurfacing depends on how big and deep the treated area is. Someone who has their full face resurfaced, for example, will take longer to recover than someone who has only a small area of skin treated.

In most cases, the wounded area will be pink, tender, and swollen for at least several days. Cold packs and nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin or ibuprofen) may help reduce swelling and pain. After the skin grows back, the skin will stay red for several weeks.

If you are getting treatment around your mouth, you may get an antiviral drug called acyclovir to prevent infection. Tell your doctor if you've had cold sores in the past.

You may have follow-up visits with your doctor to watch for signs of infection or other problems.

What you can do

• Follow the instructions from your doctor. They often include:
  • Rinsing the treated skin several times a day.
  • Applying a skin cream or ointment on the treated area.
• Avoid sun exposure. After the peeling has stopped, protect your skin from the sun. New skin is more likely to be damaged by the sun.

Why It Is Done

Laser resurfacing may be used to remove or improve the look of:

• Wrinkles.
• Superficial scars from acne, surgery, or trauma.
• Color (pigment) changes or defects in the skin, such as liver spots, port-wine stains, or café-au-lait spots.

How Well It Works

There are many things that can affect the short-term and long-term results of laser resurfacing. These include your skin type, the health of your skin, how much experience your doctor has, the type of laser used, and your lifestyle after the treatment. Some types of skin problems or defects respond better to laser resurfacing than others. People with lighter skin who limit their time in the sun after treatment tend to have better results than those with darker skin and those who keep spending lots of time in the sun.

In general, laser resurfacing tends to have good results with fairly low risks.

• Wrinkles caused by aging and long-term sun exposure, such as those around the eyes and mouth, respond well to laser resurfacing. But the long-term results for these types of wrinkles aren't known. Keep in mind that new wrinkles will probably appear as your skin ages.
• Wrinkles caused by repeated movement and muscle use (such as those on the forehead or along the sides of the nose) may be improved. But they won't go away completely. They often come back months or years later because the muscles still perform the movements that caused the wrinkles.
• Mild or moderate acne scars may be somewhat improved. Laser treatment doesn't work as well on severe acne scars.

The long-term results of laser treatment may not be seen for several months.

Risks

Side effects and risks of laser resurfacing may include:

• Swelling, itching, crusting, and soreness. These are expected effects of laser resurfacing. They will go away over time.
• Redness. Normally this lasts 6 to 12 weeks, but it may last up to 6 months. Some people may turn red or flush during stress or exertion more easily than they used to. This can last for up to a year.
• Color (pigment) changes in the skin.
• Skin irritation, including acne flare-ups in people who are prone to acne.
• Bacterial, viral, or fungal infection of the skin. Infection may affect the rest of the body also.
• Scarring (rare).
• A condition in which the edge of the eyelid rolls outward and exposes the inside of the eyelid. (This is called ectropion.) It is a rare but serious complication of laser treatment in the eye area. Surgery is sometimes needed to correct it. It is more likely to occur in people who have a loose lower eyelid or who have had surgery (blepharoplasty) on their lower eyelids.