What is Laser Skin Resurfacing?
Sun exposure, acne and the aging process can result in wrinkles, excessive skin laxity, hyperpigmentation (“sun spots”), and a coarse texture of the skin. Laser skin resurfacing is designed to remove the damaged areas of skin, and to stimulate the growth of new and healthy skin from below.
Laser skin resurfacing comes in several different formats. One key distinction is whether the laser is ablative or non-ablative. Examples of ablative lasers are ablative CO2 lasers and ablative Erbium:YAG lasers. An ablative laser destroys, or vaporizes, the surface layer of skin (epidermis). This surface layer is subsequently replaced by the growth of new skin from below. At the same time, collagen production is stimulated and increased, resulting in increased volume and fullness. Historically, ablative lasers vaporized the entire surface layer of the skin. Although this was effective, it resulted in prolonged healing and an increased risk of complications including scarring and pigment changes. The newer ablative lasers are fractionated, meaning that instead of vaporizing 100% of the skin’s surface, they vaporize about 20% of the skin’s surface. The areas of intact skin that are left behind assist with the healing process and decrease the risk of complications. Fractionated ablative laser treatments are less effective than a fully ablative laser, and 2-3 sessions are required for maximal effect. The complication profile and healing times, however, are substantially improved.
A non-ablative laser leaves the surface layer of skin completely intact, and works by heating up the underlying layer of skin (dermis). This stimulates the growth and remodeling of collagen from below the surface. This technique does not create any open wounds in the skin, therefore recovery time is minimal. It does, however, require multiple sessions (4-8) to have a full effect.
An ablative laser is the best option for diminishing moderate to deep wrinkles, and for significantly improving skin texture and tone. A nonablative laser is effective for correcting more superficial concerns such as fine lines and hyperpigmentation, while also improving skin texture and tone.
Who is a candidate for Laser Skin Resurfacing?
- You may want to consider a laser skin resurfacing procedure if you have concerns about:
- Fine to moderate wrinkles of the face and neck
- Hyperpigmentation including areas of sun damage or melasma of the face and neck
- Broken capillaries or telangectasias of the face and neck
- Coarse or rough skin texture of the face and neck
- Acne scars or damage
How is Laser Skin Resurfacing Performed?
Dr. Rovelo uses the Alma Harmony Pro XL laser system. This system is compatible with a variety of laser therapies, including an ablative Erbium:YAG (2940-nm) laser. The procedure can be performed in the office, and takes about 30-45 minutes to perform. Prior to the procedure, a topical numbing medication will be applied. This is usually sufficient and most patients report minimal to no pain during the procedure.
Compared to other ablative lasers, the Erbium:YAG laser has a lower complication profile. Despite this, complications can occur and include changes in pigmentation, scarring, and prolonged healing. Prior to your procedure, you will have a consultation with Dr.Rovelo to discuss your unique skin type and to discuss how risks can be minimized to provide the best possible outcome.
Patients will go home the same day following their procedure. Patients can expect that their skin will initially be very red and then will start to develop a darker, brown shade. Peeling occurs around days 2-4 and will persist for up to about a week. During this time, ointments such as Aquaphore will provide a moist and occlusive wound healing environment. Once the skin has healed, usually after a week, regular moisturizers and sunscreens may be used. Sun protection during and after the healing process is extremely important to prevent permanent changes in pigmentation. Hydroquinones and Retin-A may also be resumed once skin healing has occurred. Most patients report that they can return to public life within one week. Repeat procedures may be performed after 6 weeks, and 3-5 sessions are usually required for optimal results. Maintenance treatments are then performed once every 6-12 months.