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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.
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
Newer methods of laser resurfacing cause fewer complications
and have faster recovery times. These methods include:
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.
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.
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
have a longer recovery time than someone who has only a small area of skin
Typically, 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.
You may be given an antiviral drug called acyclovir to
prevent infection if you are receiving treatment around your mouth. Tell your doctor if you have had
cold sores in the past.
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
Laser resurfacing may be used to
improve the appearance of or remove:
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
You may not be a good candidate for laser resurfacing if
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
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.
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 done 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 things. Some people may get the best results by
using a combination of techniques.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
CitationsTanzi EL, Alster TS (2008). Skin resurfacing: Ablative
lasers, chemical peels, and dermabrasion. In K Wolff et al., eds.,
Fitzpatrick's Dermatology in General Medicine, 7th ed.,
vol. 2, pp. 2364–2371. New York: McGraw-Hill Medical.
July 31, 2012
Anne C. Poinier, MD - Internal Medicine & Keith A. Denkler, MD - Plastic Surgery
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