Laser Resurfacing

The surface layers of the skin are removed in order to erase or soften wrinkles, sun damage, and scarring or pigmentation problems.

Resurfacing has been performed by chemical peels and dermabrasion but these techniques have largely given way to lasers.

How does laser resurfacing work?

Resurfacing lasers create a controlled burn to 'peel' back the skin to a level less affected by scarring or sun damage. C02 and Erbium lasers can be used to resurface a range of skin conditions but have individual advantages in certain circumstances.

The C02 laser removes a deeper layer of skin in one pass than the Erbium, and also provides more thermal damage to the underlying structures. This is of benefit to patients who have scarring or severely sun-damaged skin, as a degree of 'tightening-up' in the skin is also achieved. C02 laser resurfacing is almost always performed under general anaesthetic in a hospital setting.

The Erbium laser removes a very fine layer of skin at a time and produces minimal thermal damage to the surrounding tissues. This translates to less post-operative redness, and a shorter healing time. It is very suitable for moderate degrees of sun-damage and more suitable for darker-skinned patients than the C02. Erbium is often performed in our rooms, and may only require a local anaesthetic cream, although if broad areas are to be resurfaced, a hospital setting may be advised.

For what conditions is laser resurfacing ideal?

• General signs of sun-damage such as thicker, leathery skin, age spots and blotchy pigmentation.
• Rhinophyma (strawberry nose) can be de-bulked and reshaped with the C02 laser.
• Laser resurfacing constitutes a great advance in the treatment of acne scarring. Resurfacing with the laser softens the scarring, but is often combined with other treatments such as dermal grafting or fat transplants for the best overall result. Erbium laser (but not C02 laser) may be employed on areas other than the face, such as the neck chest, hands, etc.

Areas treated

The full face may be resurfaced or smaller areas such as the upper lip, or under eye region.  Resurfacing removes fine wrinkling and will soften, but not completely erase stronger lines such as deep smile lines, crow's feet and forehead lines. (If these expression lines are the only concern, an injectable filler or muscle relaxant may be a better treatment option.)

The procedure

Local anaesthetic or an anaesthetic cream will be applied to the area prior to the procedure. (C02 laser is normally performed under general anaesthetic.) Protective eyewear is worn during the laser use. The area is resurfaced and icepacks are applied. It is normal to feel a burning sensation (like sunburn) for 10-90 minutes following the procedure. Dressings or bandages may be used to cover the area.

The healing process

The procedure produces a burn that must heal. Any areas not covered by dressing will be covered with a greasy ointment for several days. It is important that the areas remain moist until healing is complete (usually one week.) The area will ooze, and there may be swelling. When healed, the skin will look pink and this gradually fades over 2-12 weeks. Redness normally fades more quickly after Erbium than C02.