Laser Resurfacing of the skin on the face is a technique whose purpose is to remove wrinkles, discolorations, and help tighten the skin. There are basically two variations: ablative and non-ablative resurfacing. Both methods involve the use of a laser. Ablative resurfacing involves rapid destruction of the surface skin It results in wounds that take 1-2 weeks to heal. During this time, the patient is required to nurse their wounds at home. They are quite unsightly. Non-ablative resurfacing is s slower process. While there is also wounding of the skin, the wounds heal quickly, essentially overnight. There is no significant down time. The trade off , is that as many as 5 treatments of non-ablative laser are needed to achieve the results of a single treatment with the ablative method. The results take 3-6 months to manifest.
The choice of which technique to use is based on how fast one desires results, and one’s tolerance for a week or two of down time.
Resurfacing has evolved significantly over the past 20-30 years. Previously, it was done with either dermabrasion or a deep chemical peel using phenol. Dermabrasion involves the use of a high-speed spinning wheel with either a coarse metal wheel, or a wire brush. It is, literally, sanding the skin. Phenol peels involve the application of a solution, which coagulates the surface of the skin. There is significant down time for both methods.
In the mid 90’s, CO2 laser became the gold standard of resurfacing. It is an aggressive ablative method. It not only smooths the skin remarkably, it results in significant tightening. However, some patients had long-lasting redness, scars, and, occasionally, turned white in the treated areas many months later. Down time is a minimum of two weeks.
A major breakthrough in resurfacing was made by Dr. Rox Anderson, a dermatologist at Harvard. The technique is known as “fractionated” resurfacing. If we think of standard resurfacing of the skin as equivalent to painting a wall with a roller brush, fractionated resurfacing would be like painting the wall with the tips of the bristles. The laser hits the skin with thousands of tiny bits of energy, causing tiny wounds, each surrounded by a wall of normal, intact skin. The tiny wounds heal quickly. There is significant remodeling of the skin. Depending of the type of laser used, fractionated resurfacing can be done with virtually no downtime, but requiring multiple treatments, or it can be done more rapidly, with 1-2 weeks of down time, getting the full treatment in one session.
It would be great if we could get all the benefits of full CO2 laser resurfacing with no risk and no down time. With fractionated resurfacing, we can approach those results with greater safety, and less down time.
For more information on Laser Resurfacing, please contact Dr. Brian Mekelburg at (310) 659-9075.