Definition & Overview

Laser skin resurfacing is a cosmetic procedure used to get rid of acne, wrinkles, fine lines, scars, and other blemishes to help the patient achieve younger and healthier looking skin. The procedure works by removing the damaged layers of the skin using laser energy to expose new skin cells. It is most commonly done on the face. The procedure can be performed on its own or in combination with other cosmetic facial procedures.

Who Should Undergo and Expected Results

Laser skin resurfacing can be taken advantage of individuals who suffer from or are bothered by:

  • Acne
  • Wrinkles
  • Fine lines
  • Crow’s feet
  • Scars
  • Aged skin
  • Skin laxity
  • Sunspots
  • Liver spots
  • Yellowish or grayish skin tone
  • Warts
  • Unsightly birthmarks
  • Precancerous skin growths


The skin is made up of the epidermis, which is the outermost layer, and the dermis, the layer underneath it that is made up of two layers that consist of collagen, which are long fibres. When these fibres loosen and stretch, the skin weakens and wrinkles as well as fine lines occur. If the damage reaches the deepest layer, which is called the reticular layer, this results in scarring.

Skin damage is caused by:

  • Aging
  • Exposure to the sun’s UV rays
  • Lifestyle habits, such as smoking


Laser skin resurfacing works by:

  • Removing the damaged outer layer of skin or the epidermis
  • Heating up the dermis to stimulate its collagen fibres to grow and renew


This is done with no bleeding and minimal pain and trauma to the skin.

How is the Procedure Performed?

Laser skin resurfacing is a quick, outpatient procedure that can be completed in about 30 to 45 minutes for small treatment areas and up to 2 hours for larger treatment areas.

Although the procedure is not generally painful, patients are usually given either a sedative or a local anaesthetic to keep them comfortable all throughout. However, if the treatment area is large, such as the full face, the patient may also be given general anaesthesia.

Laser skin resurfacing can be either ablative or non-ablative. Ablative laser resurfacing uses rapid pulses of high-intensity laser light and is most effective for removing the damaged outer skin layers. Non-ablative laser resurfacing, on the other hand, is less invasive and uses low-intensity light beams. It is more effective in stimulating the growth of new collagen.

The process through which both types of procedures are performed is the same. The practitioner presses a probe against the treatment area and emits laser energy that penetrates through the different layers of the skin.

After the procedure, the treatment area is covered with bandages for protection. The doctor will then teach the patient how to clean the area, which has to be done about four to five times per day to prevent infection, scarring, and scabs. Following the procedure, the treatment area is usually:

  • Swollen, especially the area around the eyes
  • Has itching and stinging sensation
  • Looks red or flushed


It is important to note that these are normal and resolve without treatment after a couple of days or weeks.

Since the skin is particularly vulnerable as it heals, patients are strongly advised to use a broad-spectrum sunscreen that protects against ultraviolet A and B rays, preferably one with an SPF of 30 or higher. They should also limit their exposure to sunlight.

After around five to seven days following the procedure, the patient’s skin will begin to dry up and peel off. The skin will continue to heal over the next 10 to 21 days. During this recovery period, patients are advised to refrain from wearing makeup, but should keep the skin moisturised. After 21 days, they can begin using oil-free makeup.

Possible Risks and Complications

Although laser skin resurfacing can produce great-looking skin, it comes with certain risks, such as:

  • Burns resulting from the heat of the laser
  • Scarring
  • Bacterial infection


Skin pigment changes, such as lighter or darker patches of skin Reactivation of herpes cold sores in patients who have been previously diagnosed with the condition

Also, the procedure may not be safe for all patients as some have an increased risk of developing adverse reactions to the procedure. For example, patients with oily and sensitive skin may be prone to scarring. The procedure is also best for major skin problems, as there are gentler alternatives that are more suitable for those with only minor skin issues.

References:

  • Loesch MM., Somani AK., Kingsley MM. et al. “Skin resurfacing procedures: new and emerging options.” Clin Cosmet Investig Dermatol. 2014; 7:231-241. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155739/

  • Preissig J., Hamilton K., Markus R. “Current laser resurfacing technologies: A review that delves beneath the surface.” Semin Plast Surg. 2012 Aug; 26(3): 109-116. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580982/

  • Armenakas MR., Dover JS., Arndt KA. “The spectrum of laser skin resurfacing: Nonablative, fractional, and ablative laser resurfacing.” Journal of the American Academy of Dermatology. http://www.jaad.org/article/S0190-9622(08)00083-2/abstract

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