Frequently Asked Questions About Laser Resurfacing

What is laser resurfacing?
How is the procedure performed?
Is there much scarring with laser resurfacing?
At what age is laser resurfacing performed?
Will laser resurfacing rid me of my wrinkles or acne scars?
What should I expect post-operatively?
When will I be able to go out into the sun?
When will I be able to see the results?
What are the risks of laser resurfacing?
What type of laser is usually used?
Will it be painful? What kind of anesthesia is used?

Laser resurfacing (also called a laser skin resurfacing or laser peel) is a cosmetic skin treatment that uses a laser to remove layers of sun damaged skin or wrinkled skin. A laser can either remove the top few layers of the skin or treat the skin in such a way as to make it create more collagen, making it firmer and younger looking. Lasers that remove skin layers are called ablative lasers. Those that do not are called nonablative lasers. Laser resurfacing is most commonly used to minimize the appearance of the superficial fine lines around the mouth (smoker's lines) and the eyes (crow's feet, smile lines). It is also used to treat scars and pigmentation problems. Laser resurfacing is sometimes done on the entire face or only in problem areas such as the cheeks for acne scarring or wrinkled areas like the eye and lip area.

After the skin is "treated" with the laser, it will react to the laser by creating more collagen as it heals. The treated skin tightens and will have a youthful appearance. However, depending on how deep the laser peel is, your skin may be very red or even become crusted for several days to two weeks as it heals.

2. How is the procedure performed?

Deeper laser resurfacing or is usually performed under sedation or even general anesthesia. Less deep peels may be done with local anesthesia. The procedure takes from 30 to 90 minutes. The laser is passed over the area of treatment in short controlled bursts that remove layers of damaged skin. After the procedure, your skin may be covered with an antibacterial ointment or bandaging.

3. Is there much scarring with laser resurfacing?

There may be redness, hyperpigmentation (dark spots or splotchiness), or hypopigmentation (pale spots), but there are usually no real scars if the resurfacing is done by an experienced surgeon. The surgeon should evaluate your skin first. There is also the possibility of an obvious line between where the laser was used and where it wasn't. People with tendencies to keloid formation or excessive scarring may not be good candidates for laser resurfacing. Also, if you are prone to herpes infections, such as cold sores or fever blisters, you must be pretreated with an antiviral drug to prevent an outbreak while you are healing. This infection can also cause scarring.

4. At what age is laser resurfacing performed?

Laser surgery is generally done people old enough to show damage from aging and sun exposure, but younger patients with acne scars, birthmarks, or other lesions are also treated.

5. Can laser resurfacing get rid of my wrinkles or acne scars?

Yes, it can. It may take more than one treatment to remove deeper acne scarring, but it can be a good solution for them. For wrinkles, lasers evaporate the top layers of skin and cause more collagen growth to create smoother, tighter, younger looking skin. Nonablative lasers leave the top layer, but promote collagen growth to fill in wrinkles and skin depressions from underneath.

6.What should I expect postoperatively?

Although this depends upon the depth of your laser peel, you can expect to be red, raw and looking as if you have a bad sunburn. Take care of the treated area as directed. You may be told to apply an antibacterial ointment to the treated area . You may be given an antibiotic and an antiviral drug to take before and after your laser resurfacing. Take them as directed.

7. When will I be able to go out in the sun?

You will have to protect the treated skin from the sun for 8 to 12 months after your laser treatment with a sunscreens with SPF 30 or greater. You should stay out of direct sun exposure during this time. The skin will be pink for about 3 to 5 months. Remember, excessive sun exposure will undo everything that the laser resurfacing has done.

8. When will I be able to see the results?

Laser resurfacing is a very effective tool in the improvement of aged skin, acne scars and other scars,but you may need more than one treatment. In aged skin, one treatment can have significant effects. In severely sun damaged skin sometimes a second treatment will be helpful. For severe acne scars, the procedure two treatments may be needed, but there is no way to completely eliminate acne scars.

9. What are the risks of laser resurfacing?

There are minor risks and complications involved with laser skin resurfacing that include prolonged hyperpigmentation. In 5% to 10% of patients, darkening or brown discoloration will occur that require treatment with bleaching creams. Prolonged redness occurs in 3% to 5% of patients.

Intense burns can occur with laser resurfacing. Make sure your surgeon is experienced with the technique and has a light "touch."

Patients with olive skin, brown skin or black skin (ethnic skin tones) may be at greater risk for pigmentation changes no matter what type of resurfacing method is used. Your surgeon should evaluate your skin characteristics and family history before making any diagnosis for treatment.

If you have used Accutane (isotretinoin) in the past 12 to 18 months, you may be prone to abnormal scarring or keloid formation. Consult with your doctor for more on this subject.

10. What type of laser is usually used?

Several types of laser are used in laser resurfacing. These include carbon dioxide (CO2), neodymium-YAG, erbium, pulsed dye. There are also nonablative lasers that do not disrupt the epidermis but actually heat the dermis to cause collagen formation underneath the scar, depression or wrinkle.

11. Will the laser treatment be painful? What kind of anesthesia is used?

You skin will feel hot and tight after the treatment. You may have regional anesthesia with sedation, intravenous sedation, or general anesthesia. Sometimes a topical anesthetic is used to ease discomfort after you wake up. You doctor may prescribe pain relievers for use once you are home.