Skin Resurfacing With Lasers

The use of lasers is a non-surgical way to rejuvenate the skin. Skin rejuvenation with laser is known by many different names: laser resurfacing, laser peel, laser rejuvenation, and laser surgery. “Laser” is an acronym that stands for Light Amplification by Stimulated Emission of Radiation. Lasers rejuvenate the skin by increasing the temperature of the targeted area. This heat in the targeted tissue causes causes tissue changes depending on how deep the heat reaches. Different types of laser can penetrate to different depths. The depth of treatment depends on the issue that needs to be addressed.

Lasers are divided into two major categories - ablative and non-ablative. It is important for people to know the difference between the two types of lasers. Why? Recovery time differs significantly between the two types of laser categories. Additionally, there is a difference in not only the end result, but how the end result is achieved.

Ablative resurfacing makes skin smoother, decreases the appearance of fine and moderately deep wrinkles, skin irregularities and scarring, and improves discolorations of the skin. It is the more intense treatment of the two - people undergo an unpleasant healing period of one to two weeks. There is discomfort, which is accompanied by oozing and crusting of the skin and swelling.

Meanwhile, non-ablative skin resurfacing improves skin texture and tone as well. However, unlike ablative lasers, not all non-ablative lasers can improve wrinkles, scarring, and pigmentation issues (age spot, sun spots, etc.). The advantage, though, of non-ablative lasers is that because the skin is not visibly affected, the recovery time is shorter.

So should you have have non-ablative or ablative skin resurfacing? The answer to that question will depend on the problem you wish to address.

Non-Ablative Skin Resurfacing

Non-ablative skin resurfacing is best for patients who are relatively young (25 to 65 years of age) and who have very minimal sagging of the skin of the face. With non-ablative skin resurfacing, there will be improvement in skin texture. Fine lines will be decreased, but they will not be completely removed. Multiple treatment are necessary and the cumulative effect of non-ablative skin resurfacing will not be as dramatic as the results of ablative skin resurfacing. Results will not be immediate. If you cannot afford extended downtime, a non-ablative route may be your best option.

For people of color, non-ablative lasers tend to be an effective therapy without causing the discolorations that can occur with ablative skin resurfacing.

Ablative Skin Resurfacing

If you have deep lines and wrinkles, discolorations, age spots, deep or pitted facial scars, more significant skin sagging, sun-damaged skin, desire a more dramatic result, and have the time to recover, ablative skin resurfacing may the treatment for you. There are two ablative resurfacing lasers: carbon dioxide (CO₂) and Erbium:Yag (Er:Yag). CO₂ lasers produce the most effective results in facial resurfacing when compared to chemical peels, dermabrasion, and non-ablative laser resurfacing. However, it also has a more intense recovery period. The Er:Yag laser has a less intense recovery, but the outcome is more modest than with the CO₂ laser.

In general, ablative skin resurfacing is not recommended for people of color. Unsightly lightening or darkening of the skin in an uneven manner may be a consequence of ablative skin resurfacing.

The type of laser you need will depend on your particular issue, how much downtime you are willing to endure, and your skin pigmentation. Regardless, if you decide to undergo laser skin resurfacing, make sure it is done by a healthcare provider experienced with lasers.

_Sources:

_{Alam, M, Dover JS. Nonablative Laser and Light Therapy: An Approach to Patient and Device Selection. Advances in Dermatologic Surgery 8(4). April-May 2003.}

_{Alster TS, Lupton JR. Laser Skin Resurfacing and Fillers. In: McCarthy JG, RD Galiano, Boutros SG, eds. Current Therapy in Plastic Surgery, 1st Ed. Philadelphia: Elsevier, Inc, 2006.}

_{Horn K, Garden J. Laser Resurfacing. In: Kryger ZB, Sisco M, eds. Practical Plastic Surgery. Austin, TX: Landes Bioscience, 2007.}