Laser resurfacing

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Laser resurfacing uses a laser to send out brief pulses of high-energy light that are absorbed by water and certain substances in the skin called chromophores. The light is changed into heat energy, and the heat then destroys (vaporizes) thin sections of skin, layer by layer. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment. With advances in laser technology it is now possible to reduce, and in some cases remove, facial wrinkles, acne scars and other facial scars, and a variety of skin growths and blemishes. When used for skin rejuvenation, the carbon dioxide or Erbium-YAG resurfacing laser removes the sun-damaged skin layer-by-layer in a controlled manner. The old, damaged skin is replaced by new, smoother, more evenly toned skin.

Lasers are widely available to treat many conditions. Laser resurfacing can minimize fine wrinkles on the face, particularly those that form around the mouth and eyes. In laser resurfacing, a carbon dioxide (CO2) or erbium laser is used to remove fine wrinkles and treat facial scars or areas of uneven pigmentation. The procedure can be done on the whole face or only specific regions. Often, resurfacing is combined with another cosmetic procedures, such as a face-lift or eyelid surgery (blepharoplasty). Laser resurfacing rejuvenates the skin through a beam of light energy that removes the upper layers of damaged skin. During the healing process, new cells form, producing a smoother, tighter appearance. Alternative skin resurfacing treatments include dermabrasion and chemical peels.

In general, ideal candidates for laser resurfacing are patients with facial wrinkles or fine wrinkles localized to the region of the eyes or mouth. Individuals with olive skin or those who have taken Accutane within the past 12 to 18 months are at risk for scarring. At your consultation, the surgeon will evaluate your skin and make recommendations, accordingly.

The areas to be treated are cleaned and marked with a pen. A nerve block with a local anesthetic is usually used to numb the area before treatment. You may also be given a sedative or antianxiety medication to help you relax. If your entire face is going to be treated, you may need stronger anesthesia (in some cases, general anesthesia), pain relievers, or sedation. You may be given goggles to wear to prevent eye damage by the laser, and wet towels will be placed around the area to absorb excess laser pulses.

The laser is passed over the skin, sending out pulses. Each pulse lasts less than a millisecond. Between passes with the laser, the skin will be wiped with water or a saline solution to cool the skin and remove tissue that the laser has destroyed. The number of passes required depends on how large the area is and what type of skin is being treated. Thin skin around the eyes, for instance, requires very few passes with the laser. Thicker skin or skin with more severe lesions requires a greater number of passes. The pulses from the laser may sting or burn slightly, or you may feel a snapping sensation against your skin. Little or no bleeding occurs in most cases, although severely damaged skin may bleed. When the treatment is finished, the area is covered with a clean dressing or ointment.

Following surgery, the resurfaced skin is treated with applications of protective creams or ointments until healing is complete. Some surgeons prefer to apply a dressing over the treated regions for five to ten days.

During the recovery period, swelling and mild discomfort may occur. The period of recovery depends on the depth of the resurfacing and the individual's capacity to heal. The resurfaced skin will remain red and gradually lighten to pink in the weeks following the procedure. Strong sunscreens (SPF 30 or higher) and avoiding sun exposure are mandatory during this time. Patients with darker skin are often also treated with bleaching creams for one or several months following treatment.

Fine lines and wrinkles are caused by the deterioration of the connective fibers (collagen and elastin) in the skin. Like dermabrasion, laser resurfacing forces the growth of new tissue in which fibers are more plentiful and better organized. Although it may take several months for skin to recover from laser resurfacing, the end result is skin that is smooth, soft, and silky.