Laser resurfacing uses a laser to send out brief pulses of high-energy light that are absorbed by water and 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. Some lasers only tighten the skin by heating it but do not destroy the skin.
The CO2 (carbon dioxide) laser is the most common type of laser used for resurfacing. Erbium lasers are also used frequently. The Q-switched laser is often used to take off tattoos because it can remove various colors from the skin.
Laser resurfacing is usually 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. The hands, neck, and chest may be avoided because skin in these areas does not heal as well as it does in other areas. It tends to thicken and scar as a result of the laser treatment. Some surgeons are willing to treat the neck using a lower-energy laser.
Newer methods of laser resurfacing cause fewer complications and have faster recovery times. These methods include:
How it is done
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 medicine 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 need to wear goggles 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.
Laser resurfacing is usually done in a doctor's office or an outpatient surgery center.
What To Expect After Surgery
The time needed for healing and recovery after laser resurfacing varies according to the size and depth of the treated area. Someone who has the full face resurfaced, for example, will require a longer recovery time than someone who has only a small area of skin treated.
In general, 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 skin regrowth occurs, the skin will remain red for several weeks.
Proper care of the treated area while the skin is healing is extremely important. This involves:
Several follow-up visits to your doctor will be needed to monitor the skin's healing and regrowth and to identify and treat early signs of infection or other complications.
Why It Is Done
Laser resurfacing may be used to remove or improve the appearance of:
People with lighter skin who do not get a lot of sun exposure after the procedure tend to have the best results. People with darker skin may benefit from laser resurfacing, but their skin may not heal as well.
You may not be a good candidate for laser resurfacing if you:
How Well It Works
Your skin type, the condition of your skin, your doctor's level of experience, the type of laser used, and your lifestyle following the procedure can all affect the short-term and long-term results of laser resurfacing. Some types of skin problems or defects respond better to laser resurfacing than others. People with lighter skin who limit their sun exposure after the procedure tend to have better results than those with darker skin and those who continue to spend lots of time in the sun.
In general, laser resurfacing tends to have good results with fairly low risks.
The long-term results of laser treatment may not be evident for several months.
Side effects and risks of laser resurfacing may include:
What To Think About
Laser resurfacing first injures or wounds the skin and then destroys the top layers. You need to prepare yourself for how your skin will look immediately after treatment and throughout the healing process. It is also extremely important for you to follow your doctor's instructions on caring for your skin after the treatment, so you can avoid infection and help your skin heal.
Be sure that your doctor understands what you hope to achieve and that you understand what results you can realistically expect. Even with realistic expectations, you may not see results for several weeks or months after laser resurfacing. You may need more than one treatment to achieve the results you want.
After laser resurfacing, you will need to wear sunscreen every day and avoid sun exposure as much as possible. New skin is more susceptible to damage and discoloration from sunlight.
Options for resurfacing
Laser resurfacing, chemical peel, and dermabrasion are the most commonly used techniques for improving the texture and appearance of the skin. Although these techniques use different methods, they have basically the same effect on the skin: they destroy and remove the upper layers of skin to allow for skin regrowth.
No one technique is necessarily better than the others. When performed by an experienced surgeon, laser resurfacing may be slightly more precise than chemical peels or dermabrasion. But the choice of technique is based on the site you want to treat, your skin type and condition, the doctor's experience, your preferences, and other factors. Some people may get the best results by using a combination of techniques.
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