Laser Skin Treatment Options


Valerie DeBenedette, Senior Medical Editor

Valerie DeBenedette is a science writer who specializes in keeping people informed about medicine and their health. She has more than 20 years of experience writing for newspapers, magazines, and websites and has written about most areas of medicine. For many years, she was a contributing writer to Cosmetic Dermatology and to Drug Topics, the leading pharmacy trade magazine. She also was a contributing editor to The Physician and Sportsmedicine for many years. She has written about most fields of medicine, including dermatology, sportsmedicine, ophthalmology, general surgery, orthopedics, and women's health; as well as public health policy and the pharmaceutical industry. In addition, she is the author of Caffeine, a book for young people. She is a member of the National Association of Science Writers.

March 25 2008

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Laser Skin Resurfacing: Taking Off Old Skin and Letting New Skin Show

Skin damage is cumulative. You may have some scars from acne, some wrinkles from aging or sun damage, a bit of blotchiness or pigmentation problems (some due to hormonal changes, if you are a woman), and uneven skin tone. It all adds up, and your skin can end up looking older than it needs to look.

If this is you, and you are in good health, you may be a candidate for laser skin resurfacing. In laser skin resurfacing, a dermatologist or plastic surgeon uses a laser to resurface the skin. Generally, the treatment is on the skin of the face, but lasers can be used to rejuvenate the skin of the hands as well.

A laser is a device that creates an intense coherent beam of visible, infrared, or ultraviolet light. Unlike ordinary light, laser light is made of light waves that are all parallel to each other, all in the same wavelength or color, and all going in the same direction. This means that a beam of laser light carries large amounts of energy and can be focused onto a very small spot. Types of lasers used to treat skin include CO2, Neodymium-YAG, Erbium-YAG, and pulsed dye.

Laser skin resurfacing is just one type of skin resurfacing treatment. These treatments also include chemical peels, dermabrasion, microdermabrasion, and intense pulsed light (which uses very strong light that is not a laser). The idea is to either remove the top layer of skin (usually the layer of dead skin cells called the stratum corneum) and cause the skin to create new skin cells that contain more collagen, or simply treat the skin in such a way as to cause it to create more collagen.

There are many different types of lasers used in medicine, but in cosmetic medicine there are two general categories of laser: ablative and nonablative. An ablative laser—to put it bluntly—burns off the very top layers of skin to reveal younger, healthier skin underneath and causes faster formation of collagen, a protein building block of skin, to occur. Both processes cause the skin to look younger. A nonablative laser does not remove any skin. Instead, it heats up a lower level of the skin, which causes faster collagen formation. For both types, as your skin heals after the lasering, new skin cells will develop and give the face a smoother, firmer appearance.

Ablative laser skin treatments can do more than nonablative lasers: remove more scarring and treat deeper wrinkles. However, there is a longer recovery time and a period of time during which your skin will crust over and weep clear fluid. Nonablative lasers can treat hyperpigmentation problems better, and also have a shorter recovery time. Frequently, you may need more than one nonablative laser treatment.

Read that sentence about the recovery time after laser skin resurfacing again. Laser skin resurfacing is nowhere near being an instant cure for whatever ails your skin. A deep ablative laser resurfacing—one done to help eliminate bad acne scarring, for instance—may mean that you will be bandaged for a few days and probably want to stay out of the public eye for at least a week and maybe 10 days. And after that, your skin will be very pink or red for many weeks. Even nonablative laser skin resurfacing will leave your skin pink or red for a few weeks. As the skin heals, you absolutely must protect it from sunlight. It is brand new skin and very easy to burn and damage.

Not everyone is a good candidate for laser skin resurfacing. If you have dark skin or problems such as allergies, a history of poor scarring, or radiation exposure, you may need special evaluation by a qualified dermatologist or plastic surgeon before having laser skin treatments. If you have a history of cold sores and fever blisters (herpes infections), inform your surgeon. You will need to be pretreated with antiviral medications because if a herpes outbreak occurs before your skin is fully healed, the infection can spread to the whole treated area and possibly cause bad scarring.

Laser skin resurfacing is a cosmetic treatment where there is continuing advancement. The first laser skin treatments were ablative, and then nonablative laser treatments were developed, and then treatments that were useful on people with darker skin. Now, cosmetic plastic surgeons and dermatologists are working with more minimally invasive skin resurfacing technologies, including fractional laser resurfacing, a nonablative laser resurfacing done in three to six treatments. Another type of resurfacing uses plasma energy rather than a laser to resurface the skin. In most cases, the research is leaning towards several treatments using less energy to resurface the skin and with shorter recovery times, rather than one treatment that requires a long recovery time.