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Laser Resurfacing - Benefits and Side Effects

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Laser resurfacing is a facial rejuvenation procedure to reduce facial wrinkles and skin irregularities and improve the skin's appearance.

Medically reviewed by

Dr. Dhepe Snehal Madhav

Published At September 13, 2022
Reviewed AtFebruary 8, 2023

What Is Laser Resurfacing?

Laser resurfacing is a popular facial rejuvenation procedure that uses a laser to enhance the skin's appearance or treat minor facial flaws. It is often conducted with:

  • Ablative Laser: This laser typically removes the skin's outer layer (epidermis) and heats the underlying layer (dermis). This process induces the growth of a collagen protein that improves skin firmness and texture. After the epidermis gets healed, the newly formed skin appears smoother and firmer. Various ablative therapies, such as carbon dioxide (CO2) laser, an erbium laser, and combination systems, are used.

  • Non Ablative Laser: This is a less aggressive approach that also promotes collagen growth. Although the recovery time is shorter, the results are less visible. Nonablative therapy includes pulsed-dye laser, erbium, and intense pulsed light (IPL) therapy.

Why Is Laser Resurfacing Done?

Laser resurfacing can be used to treat various conditions such as:

  • Age spots.

  • Fine lines or wrinkles.

  • Uneven skin tone or pigmentation.

  • Sun-damaged skin.

  • Mild to moderate acne scars.

  • Birthmarks.

  • Non-responsive skin after a facelift.

  • Benign and malignant lesions.

  • Scars from chickenpox.

  • Enlarged oil glands on the nose.

Laser resurfacing cannot be used for the following conditions:

  • Active acne.

  • Very dark skin.

  • Deep wrinkles.

  • Loose or sagging skin.

How Does Laser Skin Resurfacing Work?

The most commonly used lasers in laser resurfacing are carbon dioxide (CO2) and erbium.

  • CO2 Laser Resurfacing: This method was used to treat wrinkles, scars, and other benign skin growths like warts, birthmarks, enlarged oil glands on the nose, and other skin conditions. The new generation CO2 laser resurfacing, fractionated CO2 directs very short pulsed light energy (ultra pulse) or continuous light beams that are directed in a scanning pattern to remove thin layers of skin, causing minimal heat damage. Recovery may take up to two weeks.

  • Erbium Laser Resurfacing: Erbium laser resurfacing removes surface-level and moderately deep lines and wrinkles on the face, hands, neck, or chest. One of the benefits of this type of laser resurfacing is that it causes minimal burning of surrounding tissue. However, this approach can cause side effects such as swelling, bruising, and redness. The recovery time is usually faster than with CO2 laser resurfacing. Recovery time is usually one to two weeks. Erbium laser resurfacing may work better for people with darker skin tones.

  • Pulse-Dye Lasers: Also called vascular lasers, pulse-dye lasers are designed to treat skin problems related to the blood vessels. This method is a good option for reducing redness, hyperpigmentation, broken capillaries, and rosacea. These non-ablative lasers use concentrated yellow light to heat the skin and absorb pigments.

  • Fractional Lasers: Fractional lasers often target a fraction of the skin simultaneously. They can be used to treat several age-related blemishes and get rid of hyperpigmentation, acne scars, and wrinkles. Fractional lasers can either be ablative or non-ablative.

  • Intense pulsed light (IPL): Ideally, intense pulsed light treatments (IPL) are not lasers but are used to treat several similar skin issues as lasers. IPL utilizes light energy to target a specific color in the skin. It may be used for various reasons, such as to repair scarring, sun damage, stretch marks, acne, rosacea, birthmarks, and hyperpigmentation, and to get rid of unwanted hair.

What Are Possible Complications of Laser Resurfacing?

Laser resurfacing can cause some side effects. However, these side effects are milder and more likely with ablative laser resurfacing than with nonablative approaches.

These may include:

  • Milia, which are small, white bumps, can appear in the treated areas during healing. These bumps may be removed by gentle cleansing with a washcloth.

  • Hyperpigmentation and sometimes hypopigmentation may result in the laser-treated areas. The hyperpigmented areas are treated with bleaching creams. In addition, broad-spectrum sunscreens can be used for weeks before and after the treatment to prevent skin changes.

  • Reactivating a herpes simplex cold sore may happen after laser skin resurfacing around the mouth. This can be avoided by taking an antiviral medication, which a person can begin taking before the surgery and continue taking for seven to 10 days after laser resurfacing.

  • Bacterial infections may happen that can be prevented by taking an antibiotic before surgery and continuing to take it for seven to 10 days after the surgery.

  • There is a risk of swelling around the eyes after laser skin resurfacing. Oral steroids can be recommended to manage the swelling.

  • Laser-treated skin areas may become red, itchy, or have a burning sensation that may be intense and last for several months.

  • Rarely, scarring after ablative laser skin resurfacing may occur in laser-treated areas.

How to Prepare for Laser Resurfacing?

Consult a plastic surgeon or dermatologist to know who is a good candidate for laser resurfacing. The doctor determines the best laser treatment for a person after considering the medical history, current health, and desired results.

Before the surgery, the doctor may ask the following things to do:

  • Avoid tanning or unprotected sun exposure. Always use broad-spectrum sunscreen daily for four weeks before treatment.

  • Avoid deep facial peel procedures such as strong chemical peels, laser resurfacing, and dermabrasion for four weeks before treatment.

  • Take medication to prevent complications if you have a history of herpes infections around the mouth. The doctor may prescribe antiviral medications (Valacyclovir, Acyclovir) before and after treatment to prevent a viral infection.

  • Avoid using medications that cause photosensitivity, such as Doxycycline and Minocycline, for at least 72 hours before treatment.

  • Stop smoking to stop at least two weeks before and after the treatment. Quitting smoking also improves the chance of avoiding complications and helps the body heal.

  • Apply a topical retinoid on the skin for about four weeks before the procedure.

How to Take Care of Skin After Laser Resurfacing?

Immediately after treatment, the skin may appear red, inflamed, sensitive, and sunburned, lasting for a few days. Depending on the type of treatment, the skin may also appear raw, ooze a yellow fluid, and even blisters.

The following steps may help in minimizing the risk of post-treatment complications, including:

  • Avoid scratching or picking at skin that crusts, as this can cause scarring or may lead to an infection.

  • A few days after laser resurfacing, the skin may become dry. The new skin may appear pink and gradually lightens over the next two to three months.

  • Cleanse the laser-treated area two to five times a day or as instructed by the doctor.

  • Apply a cool compress for 15 minutes every one to two hours during the first 24 to 48 hours post-treatment.

  • Apply a thin layer of petroleum jelly or antibiotic ointment to the treated area twice a day until the skin heals completely.

  • Avoid using any topical products that may irritate for six weeks following treatment.

  • Avoid doing activities that can cause flushing for two weeks after laser treatment.

  • Quit smoking as it slows the healing process.

  • Apply a daily broad-spectrum sunscreen with an SPF of at least 30 after healing to protect the newly laser-resurfaced skin.

  • Apply moisturizer as recommended by the doctor.

What to Expect After Laser Skin Resurfacing?

Usually, people who undergo laser resurfacing see an immediate difference in their treated skin. Depending on the type of laser treatment, the skin may remain inflamed for a few months. But once the treated area starts healing, marked improvements are seen in the skin quality and appearance. This effect mostly lasts for years. Although, normal aging eventually leads to new wrinkles, which can be treated with laser resurfacing. After laser resurfacing, always use sun protection as sun damage also can reverse the results. Downtime and recovery are important to ensure the skin heals completely to reduce the risk of side effects and achieve the desired results.

Conclusion

Laser skin resurfacing is a popular skincare procedure performed using lasers to provide a youthful appearance to the skin. Depending on an individual’s needs, the doctor may recommend either ablative or non-ablative lasers. Many people who undergo laser-resurfacing notice an immediate change in their laser-treated skin that may last for years. However, laser resurfacing may pose a risk of complications. Following the doctor’s pre-care and post-care instructions can reduce the risk of these complications.

Dr. Dhepe Snehal Madhav
Dr. Dhepe Snehal Madhav

Venereology

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