Laser skin resurfacing is a great way to improve lines and wrinkles, acne scars, dark spots, sagging skin, and textural irregularities on your face and overall to reduce the signs of aging. The laser emits light beams in a particular wavelength to precisely target the problem areas on your skin to reveal a more youthful-looking you.  

What is laser resurfacing?

There are two types of laser resurfacing: ablative and non-ablative. Ablative laser resurfacing is performed with either CO2 or Erbium laser. These lasers can remove just the epidermis (top outer layer of your skin) or the epidermis and dermis (middle layer of your skin), depending on what you are trying to improve on your face. They also simultaneously heat the dermis to trigger the new growth of collagen. Fractionated CO2 and Erbium lasers are types of ablative lasers that remove tiny zones or portions of skin (epidermis or epidermis and dermis) at a time resulting in minor damage to the skin. They deliver good results, but they are not identical to results from traditional non-fractionated ablative lasers. The benefit of fractionated lasers is shorter recovery times and fewer side effects. However, it takes multiple treatments to achieve these results.

Non-ablative lasers, such as IPL or Nd: YAG, do not physically remove layers of the skin but work by causing new collagen to grow by heating the dermis. These lasers will improve the tone and texture of your skin gradually. It takes longer to see results than with traditional ablative resurfacing lasers. The most significant benefit of these lasers is minimal downtime and fewer side effects. The downside is that the results are not as dramatic as seen with ablative lasers. There are also non-ablative fractionated lasers, such as Fraxel or Clear + Brilliant, which offer an even better side effect profile with less downtime. Like fractionated ablative lasers, fractionated non-ablative lasers target tiny areas of the dermis instead of the entire dermis to minimize downtime and side effects.

What are the side effects?

Every procedure has risks and side effects. Ablative laser resurfacing is no different. These side effects may be transient or permanent. Here are some of the possible side effects.

Many of these side effects are avoidable if you follow your doctor’s pre and post-op instructions. Avoiding sun exposure while healing is critical to prevent depigmentation of the skin. Tell your doctor if you have a history of cold sores or shingles. Your doctor will give you anti-viral medication to prevent an outbreak of herpes. If your doctor gives you an antibiotic to take to avoid infection or prevent an acne flare, make sure you take it. Proper cleansing is critical to prevent disease. It is also necessary to avoid smoking because it interferes with healing. Certain medications and over-the-counter supplements can increase your risk of bleeding, such as aspirin, Vitamin E, and fish oil. Discuss all prescription medications, over-the-counter medications, vitamins, and supplements with your doctor to see if you need to stop them before your procedure.

Non-ablative lasers carry similar side effects but with less frequency. Following your doctor’s instructions will mitigate most problems. Here are some of the risks.

• infection
• depigmentation
• redness
• swelling
• herpes reactivation
• pain
• burns
• acne flare

Laser resurfacing is not for everyone. Certain patients may not be good candidates for the procedure.

What are the benefits of laser resurfacing?

Ablative laser resurfacing can improve a multitude of problems with the skin.  

Non-ablative lasers do not remove the skin, so they do not deliver the same results or target problems. Here are some of the issues that they can improve.

• Fine lines and wrinkles
• Acne scars and scars of any kind
• Hyperpigmentation and “age spots.”
• sagging

How long until I see results?

You will see some improvement immediately, and your skin will continue to improve over several months as your collagen grows. Non-ablative and fractionated ablative laser resurfacing procedures may require multiple treatments, and it is essential to be patient.

How long will my results last?

Your results are not permanent, but they can last for years if you properly care for your skin. The normal aging process will continue, and you may need to have additional laser resurfacing procedures in the future to maintain your results.  

Proper sun protection, good skincare, a proper diet and exercise, and avoidance of smoking and excessive alcohol are critical to preserving your results. The sun emits UV radiation that breaks down your collagen to cause wrinkles and skin cancers. You can protect yourself from the harmful UV radiation of the sun by frequently reapplying the right amount of a broad-spectrum sunscreen. When combined with a wide-brimmed hat, you will get the best protection.  

A good skin care regimen will help prolong your results. Make sure you wash your face and apply moisturizer twice a day. Antioxidants, alpha hydroxy acids, and retinoids can help your skin too.

A proper lifestyle with a diet rich in antioxidants and lean proteins can help your skin. Carbohydrates and sugars will destroy your collagen leading to wrinkles and sagging, and smoking and alcohol also destroy your collagen.

Conclusion

Laser resurfacing is a great anti-aging tool to help you look younger. To achieve excellent results, carefully select your physician by doing your research. You may want to consult with 2 or 3 doctors before choosing one. Always have an in-depth consult with your physician before your procedure. Ask all your questions. Be honest when disclosing all your medical history, medications, and supplements. Follow all your doctor’s instructions. There is a reason for everything they ask you to do. The more engaged you are in your procedure and recovery, the better your results.

Author: Jennifer T. Trent MD, FAAD