The Lowdown on Laser Skin Resurfacing

Varicose laser treatment on female legs in clinic

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The CO2 laser is used as a resurfacing instrument, as well as for laser peels. The doctor can adjust the amount of energy in the laser beam, thus controlling the depth of penetration. Resurfacing is the most common application of the CO2 laser. It will reduce wrinkles by a considerable amount. reduce acne scarring, tighten the skin, stimulate new collagen formation in the dermis, tighten the existing collagen fibers, and remove 70% to 80% of sun damage. The

Other types of lasers have been developed to address more specific skin concerns, including the Erbium YAG and fractional lasers, among others.

Who Is a Good Candidate

Fractional CO2 laser resurfacing can successfully treat all skin types, though other types of laser may have some limitations. In general, you should be free of any active skin infections, including acne. People who take or have taken certain medications (including but not limited to Accutane and some steroids) within the previous 18 months and those who tend to have unusual scarring, such as keloids, may not considered good candidates for laser resurfacing. It's important to talk with your doctor about your specific needs to make sure you receive the most suitable treatment with the most suitable type of laser.

Who Can Benefit

Those who can benefit from a skin resurfacing procedure include patients with skin imperfections like wrinkles, loose skin, scars (including acne scars), vascular lesions (like broken capillaries or spider veins), enlarged pores, rough skin texture, dark spots (hyperpigmentation) on the skin, or unwanted tattoos, hair, or birthmarks. Even pre-cancerous lesions on the skin can be effectively removed with laser resurfacing.

Post-Operative Care

Skin resurfacing is usually performed on an outpatient basis. With the CO2 laser, a balm is used to help skin healing. Your surgeon will provide instructions for washing the skin. You can expect some swelling, discomfort, and possible crusting and weeping of the skin. Do not pick at the skin, as this can lead to infection and scarring. Over-the-counter medications are often sufficient to manage pain, or you may be given prescriptions for pain medication and/or antibiotics.

Recovery and Downtime

It is generally recommended that the patient rest indoors for at least 7 to 10 days, except in the case of a very light peel. However, some people prefer to remain unseen by others until the worst of the redness, crusting, and/or peeling subsides. This time period can be from 2 weeks to 2 months, depending on the depth of your peel. Even if you do decide to return to work before healing is complete, you must absolutely continue to follow the recommendations of your surgeon in regards to sun exposure and the use of protective skin barriers.

Risks and Complications

Risks and complications associated with the procedure are extremely rare.

Possible short-term risks and complications include prolonged redness of the skin, tenderness or a burning sensation, itching, increased sensitivity to light, and easy flushing. In rare cases, the procedure can trigger the re-appearance of an existing dormant virus or infection. You may also experience skin irritation caused by sensitivity to the post-procedure healing cream. This usually resolves on its own.

More long-term problems can include changes in skin color, like hyperpigmentation or hypopigmentation. It is also possible for a surgeon to go too deep during the procedure, resulting in scarring.

Costs

The average total cost for a laser skin resurfacing procedure varies between $800 to $8,000, depending on the geographical area, the depth of the procedure, the number of treatment sessions required, and the size of the area(s) being treated. The U.S. average is around $2,500, which includes not only the surgeon’s fee but also pre- and post-operative care and medications.

Skin resurfacing is usually not covered by insurance unless it is being performed to treat precancerous skin conditions or improve scars from a previous reconstructive procedure or trauma.

Complementary Procedures

Laser skin resurfacing is often done in conjunction with other procedures, such as a facelift, eyelid surgery, or other anti-aging procedures, to enhance the patient’s results.

Other Cosmetic Uses for Lasers

In the past several years, lasers have become a staple in the world of aesthetic improvement and anti-aging procedures. In addition to skin resurfacing, they have been shown to be effective for non-surgical skin tightening, improvement of stretch marks, hair removal, and even teeth whitening.

Procedure

  1. Anesthesia is given. Depending on the type and depth of the procedure, skin resurfacing may be performed using only a topical anesthetic (a cream which is placed on the skin’s surface to numb it). In this case, a waiting period is usually required before beginning the actual procedure, to allow time for the anesthetic to work. For deeper peels, the area may be injected with a local anesthetic. An oral sedative may be given to help you relax. In rare cases, or when other procedures are being performed in conjunction with resurfacing, IV sedation, or even general anesthesia may be used.
  2. The skin and surrounding areas are prepared. The skin is thoroughly cleansed, and any areas that will not be treated may be marked or draped to protect them. Usually, the patient will have some sort of barrier put in place to protect the eyes during the procedure. The procedure is performed on dry skin.
  3. Laser procedure is performed. The CO2 laser can be used as an ablative laser, which means that it literally removes upper layers of damaged skin, but it is most commonly used as a fractional laser. It can also be used as a cutting instrument.
  4. Cooling preparation is applied. Many surgeons will apply some sort of cooling preparation to the skin for a brief period post-operatively. The purpose is to reduce swelling and discomfort.
  5. Protective skin barriers are applied. Your surgeon will apply some sort of protective barrier to the skin. Sometimes, this consists only of a healing ointment and sunscreen.
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Article Sources

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  • Skin Resurfacing, Consumer Information Sheet. American Society for Aesthetic Plastic Surgery.

  • Facial Peels And Laser Surgery, Consumer Information Sheet. American Academy of Facial Plastic and Reconstructive Surgery.

  • Goldberg DJ. Lasers for Facial Rejuvenation. American Journal of Clinical Dermatology. 2003;4(4):225-234.

  • Skin Rejuvenation and Resurfacing, Consumer Information Sheet. American Society of Plastic Surgeons.