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Family Health

Laser Resurfacing - Part 1

Laser resurfacing is a skin resurfacing procedure that uses a laser to improve the appearance of your skin or treat minor facial flaws. Laser resurfacing can be done with two types of lasers:

 

  • A wounding (ablative) laser, which removes thin layers of skin
  • A nonwounding (nonablative) laser, which stimulates collagen growth and tightens underlying skin

 

Although nonablative laser resurfacing is less invasive and requires less recovery time, it's less effective than ablative laser resurfacing.

 

Laser resurfacing can decrease the appearance of fine lines around your eyes, mouth and cheeks. Laser resurfacing can also treat loss of skin tone and improve your complexion if you have scars or sun damage. Laser resurfacing does have limitations, however. Understanding the specific techniques, risks and possible results can help you decide if laser resurfacing is right for you.

Why it's done

Laser resurfacing can be used to treat:

 

  • Wrinkles
  • Liver spots or age spots (solar lentigines)
  • Uneven skin tone or texture
  • Sun-damaged skin
  • Scars caused by acne, chickenpox or injuries

 

Laser resurfacing can't eliminate excessive or sagging skin (jowls).

Risks

Ablative laser resurfacing can cause various side effects, including:

 

  • Itching, swelling and redness. After ablative laser resurfacing, treated skin will be itchy, swollen and red. Itching and swelling don't last long, but redness — the degree of which is related to the depth of resurfacing done — can be intense and may last for several months. The aggravation of a previously existing skin condition, such as rosacea or contact dermatitis, also can contribute to redness.
  • Acne. Applying thick creams and bandages to your face after treatment can worsen acne or cause you to temporarily develop tiny white bumps (milia) on treated skin.
  • Infection. Ablative laser resurfacing can lead to a bacterial, viral or fungal infection. The most common infection is a flare-up of the herpes virus — the virus that causes cold sores. In most cases, the herpes virus is already present but dormant in the skin.
  • Changes in skin color. Ablative laser resurfacing can cause treated skin to become darker than normal (hyperpigmentation) or lighter than normal (hypopigmentation). Hyperpigmentation is more common in people who have darker skin. The first signs of hyperpigmentation and hypopigmentation typically occur weeks after treatment and may go away without treatment. Use of topical retinoic acid or glycolic acid can help treat hyperpigmentation after the treated area has healed. Hypopigmentation that persists is difficult to treat.
  • Scarring. Ablative laser resurfacing poses a slight risk of permanent scarring.
  • Turning of the eyelid (ectropion). Rarely, ablative laser resurfacing near the lower eyelid can cause the eyelid to turn out and expose the inner surface. Surgery is needed to correct the problem.

 

Nonablative laser resurfacing also can cause side effects, including:

 

  • Infection. Nonablative laser resurfacing can cause a flare-up of the herpes virus.
  • Changes in skin color. If you have darker skin, nonablative laser resurfacing can cause your skin to become temporarily darker (hyperpigmentation).
  • Mild swelling and redness. Swelling and redness typically only last hours or days.
  • Blistering and scarring. Rarely, nonablative laser resurfacing can cause blistering or scarring.

 

Laser resurfacing isn't for everyone. Your doctor may caution against laser resurfacing if you:

 

  • Have taken the acne medication isotretinoin (Amnesteem, others) during the past year
  • Have diabetes, a connective tissue or autoimmune disease, or a weak immune system
  • Have a history of radiation therapy to your face
  • Have a history of ridged areas caused by an overgrowth of scar tissue (keloids)
  • Are pregnant or breast-feeding