One of the most important advancements in skin rejuvenation within the past decade has been the introduction of laser resurfacing, designed to diminish the signs of aging and treat damaged skin.

More specifically, lasers have been perfected to smooth fine lines and wrinkles of the face, tighten eyelid skin, improve crow’s feet, soften pucker marks and frown lines, remove brown spots and splotchy skin color and lighten and flatten scars and repair smoker’s lines.

Non-Surgical Approach, Precise Benefits
In laser resurfacing, undesired skin cells and wrinkles are softened or removed in a non-surgical manner using a wand-like laser hand piece. The procedure is relatively bloodless and offers the physician more control in the depth of penetration of the skin’s surface, allowing increased precision and safety in treating delicate areas, such as around the lips and eyes.

LASER stands for Light Amplification by the Stimulated Emission of Radiation. Lasers work by producing an intense beam of bright light that travels in one direction. A laser has the unique ability to produce one specific color (wavelength) of light, which can be varied in its intensity and pulse duration and which corresponds to the specific type of problem that needs to be addressed.

There are two categories of lasers used for skin resurfacing: ablative and non-ablative. The performing surgeon selects the most appropriate mode of treatment, considering the patient’s preferences and desires.

Ablative Lasers
Ablative lasers remove the top layers of the skin and heat the layer under the epidermis, or outer layer of the skin, which causes collagen regeneration. Collagen is the substance that gives skin its structure; lack of collagen results in loose skin, called skin laxity. As the wound created by the laser heals, smoother and more even-toned skin is revealed.

Following ablative resurfacing, the treated areas should be kept moist with ointment or surgical bandages for the first few days. The skin is typically red or pink and may be covered with a fine crust. The treated sites must be protected from sunlight after the procedure. Depending on the type of laser used and the individual’s ability to heal, a pink surface color may remain for several days to several months.

Ablative lasers are more aggressive than non-ablative lasers which do not remove any layers of skin. However, ablative lasers produce significantly better results after just one treatment.

There are two types of ablative lasers used for skin resurfacing: Carbon Dioxide (CO2) and the Erbium:YAG (Er:YAG).

CO2 Laser
The carbon dioxide (CO2) laser delivers short bursts of extremely high-energy laser light which actually vaporize the undesired skin tissue one layer at a time, revealing fresh skin underneath. Often referred to as a Pulsed CO2, Laser, the laser’s highly focused beam enables the surgeon to gently remove the skin’s surface with a very low risk of scarring and other complications. CO2 laser energy best treats deeper lines, wrinkles, skin laxity, discoloration and other effects of aging and sun damage.

Erbium:YAG Laser
The high-powered Erbium:YAG laser produces energy in a wavelength that gently penetrates the skin, is absorbed by water (a major component of tissue cells) and scatters the heat effects of the laser light.

These unique properties allow surgeons to remove thin layers of skin tissue with exquisite precision while minimizing damage to surrounding areas of skin. The Er:YAG laser is commonly used for skin resurfacing in patients who have superficial to moderate facial wrinkles, mild surface scars or skin discoloration.

The gentle properties of the Er:YAG laser means it is uniquely effective in rejuvenating sun-damaged skin in areas such as the delicate skin around the eyes and mouth, where other lasers may cause scarring. Other body areas, such as the neck and hands, also may be considered for treatment with the Er:YAG laser.

Non-Ablative Lasers
Non-ablative lasers have gained immense popularity in recent years because they require little or no healing time. They work by bypassing the surface of the skin and treating the layers underneath. This allows the skin to respond as if it was repairing a wound by regenerating skin.

With this technique, the top layer of skin is generally not removed. Non-ablative treatments require multiple sessions and may take several weeks after the last session for the optimal results of treatment to be seen.

Fraxel® Laser
One of the most unique and revolutionary non-ablative lasers is the Fraxel®. This laser works by producing microscopic areas of thermal wounds in a dot-like grid, leaving areas of untouched healthy skin between them. The healthy, untouched areas promote rapid healing of the entire treated area.

Since fractional resurfacing with the Fraxel® laser does not destroy all of the treated skin, there is minimal swelling and redness and patients may apply make-up and return to normal activities right after the procedure. The Fraxel® also is effective for treatment of the chest, hands and neck.

Healing of potentially frail, thin skinned areas is much easier with the Fraxel® laser. Clinical studies suggest that four to six treatments spaced about five to seven days apart produce renewed and refreshed skin that contains collagen and elastin, replacing old skin tissue. Improvement in sun damage may be seen in one to three months. Additionally, in this past year alone, the Fraxel® laser has been cleared by the Food and Drug Administration to treat melasma (hormonally-induced facial pigment patches), stretch marks and acne scars.

Laser resurfacing is not a substitute for a facelift. However, beneficial tightening of loose skin can occur, resulting in an improvement of certain folds and creases. In many cases, laser resurfacing offers an alternative to traditional methods for skin rejuvenation, such as dermabrasion and deep chemical peels. It can also work well in conjunction with, or as an additional treatment to, other aesthetic procedures such as eyelid surgery, facelift, liposuction of the neck, dermal fillers, radiofrequency tissue tightening and Botox®.

Roger Bassin, MD, is a board certified Ophthalmologist and Oculoplastic surgeon whose Melbourne practice is limited to eyelid and facial plastic surgery and reconstructive surgery. For more information, call (321) 723-9558 or visit www.bassinplasticsurgery.com.