Laser resurfacing is a relatively new treatment for reducing facial wrinkles and skin irregularities, such as blemishes or acne scars.
The technique directs short, concentrated pulsating beams of light at irregular skin. Laser skin resurfacing removes skin very precisely, layer by layer. This popular procedure is known by several other names, including lasabrasion, laser peel or micro peel.
Who Is a Good Candidate For Laser Resurfacing?
If you have fine lines or wrinkles around the eyes, mouth or on the forehead, scars from acne, or non-responsive skin after a facelift, then you may be a good candidate for laser skin resurfacing.
If you have active acne or if you have very dark skin, you may not be a candidate. This technique is also not recommended for stretch marks.
How Does Laser Skin Resurfacing Work?
The two types of lasers most commonly used in laser resurfacing are carbon dioxide (CO2) and erbium. Each laser vaporizes superficial, damaged skin cells and both reduce the risk for the patient because they limit the amount of heat absorbed by the skin.
CO2 Laser Resurfacing
This method has been used for years to treat different skin conditions including wrinkles, scars, warts, birthmarks, enlarged oil glands on the nose (rhinophyma), skin cancer and other conditions.
The newest version of the CO2 laser resurfacing uses very short pulsed light energy (ultrapulsed) or continuous light beams that are delivered in a scanning pattern to very precisely remove thin layers of skin with minimal heat damage to the surrounding structures. Recovery time from the procedure is up to two weeks.
Erbium Laser Resurfacing
Erbium laser resurfacing is designed to remove superficial and moderately deep lines and wrinkles on the face hands, neck, or chest. One of the benefits of erbium laser resurfacing is minimal burning of surrounding tissue. This laser causes minimal side effects, such as swelling, bruising and redness, so your recovery time should be more rapid than with CO2 laser resurfacing - one week in most cases.
If you have a darker skin tone, erbium laser resurfacing may work better for you. Your doctor will determine which laser is best for you after he or she fully evaluates your medical history, current physical condition, and desired results.
What Can Be Expected During Laser Resurfacing?
Both erbium and CO2 laser resurfacing are performed on an outpatient basis, using local anesthesia (pain relief at the site of the procedure) in combination with an oral sedative medication.
Wrinkles around the eyes, mouth or forehead may be treated individually, or a full-face laserabrasion may be performed.
A partial-face lasabrasion takes 30-45 minutes and the full-face treatment takes 1-1/2 to 2 hours.
What Happens After Laser Resurfacing?
Following laser resurfacing, a sterile dressing is applied to the treatment sites. When the dressings are removed (usually after 1 to 3 days). The patient then cleans the treated areas two to five times a day with cool tap water saline or a dilute vinegar solution. An ointment such as Vaseline, Eucerin or Aquaphor is then applied. This wound care is intended to prevent any scab formation. In general, the areas heal in 10-21 days, depending on the nature of the condition that was treated.
Once the areas have healed, makeup may be worn to camouflage the pink to red color that is generally seen after laser skin resurfacing. Green-based make-ups are particularly suitable for this camouflage since they neutralize the red color. Oil-free make-ups are recommended after laser resurfacing. The redness in the laser-treated sites generally fades in two to three months but may take as long as six months to completely disappear. The redness generally persists longer in blondes and redheads.
Patients with darker skin tones have a greater risk of healing with darker pigmentation. This may be minimized by use of a bleaching agent before laser skin resurfacing as well as continued use of this agent after healing.
What Are the Possible Complications of Laser Resurfacing?
Milia, which are small white bumps, may appear in the laser-treated areas during healing. These may be removed by gentle cleansing with a washcloth.
Hyperpigmentation (increased pigmentation), and hypopigmentation (decreased skin pigmentation), may result in the laser-treated areas. In general, the hyperpigmented areas may be treated with bleaching cream to speed fading of the pigment.
Reappearance of a cold sore may occur, especially after laser skin resurfacing around the mouth. To prevent this, we can prescribe an antiviral medication, which you can begin taking before your surgery and continue taking seven to 10 days after laser resurfacing.
You can also prevent bacterial infections by taking an antibiotic prior to the surgery and continuing for seven to 10 days afterwards.
You should expect swelling after laser skin resurfacing. Ask your doctor about what you can do to lessen this effect.
Patients are encouraged to sleep on an extra pillow at night to help reduce the swelling after laser resurfacing. Ice pack application is also helpful in the first 24-48 hours.
Scarring after laser skin resurfacing, although unusual, may occur in laser-treated areas.
Cessation of smoking is highly recommended because smoking is known to have harmful effects on the healing process.
How Should I Take Care of My Skin After Laser Resurfacing?
It's important to remember that skin treated with laser resurfacing may react in different ways.
Most commonly, you may feel like you have moderate sunburn. There will be swelling and redness of the skin. You may experience itching or stinging for 12 to 72 hours after the procedure. Five to seven days after laser resurfacing, your skin will become dry and peel.
New skin will form after the treated area has been peeled. This skin will at first appear pink. It should begin to gradually lighten for up to a year after treatment.
Daily sunscreen application is necessary after healing to protect the newly laser-resurfaced skin. A "broad-spectrum" sunscreen, which screens both ultraviolet B and ultraviolet A rays, is recommended. A sunscreen specifically formulated for use on the face should be chosen, with at least a sun protection factor (SPF) of 15.
Liberal moisturizer application is also recommended after healing. Patients may resume application of Retin-A and/or glycolic acid products around six weeks after laser resurfacing or as directed by their physician.
Will My Insurance Cover Laser Skin Resurfacing?
Insurance does not usually cover laser resurfacing because it is an elective cosmetic surgery.
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