Laser Resurfacing can be performed by different lasers, to achieve different results, for each patient’s specific needs. At Dr Michael Rich’s – The enRich Dermatology & Cosmetic Surgery Centre we have three different laser types which can each treat the skin in a specific way to get the best results in resurfacing and rejuvenating the skin.
True Laser Resurfacing is ablative: ablative lasers remove the top layer of the skin (the epidermis) and heat the layer under the epidermis whilst preserving the skins underlying tissue. This causes smooth new skin and collagen (a substance that gives the skin plumpness). Ablative Resurfacing is performed by Ultrapulse CO2, Erbium or Plasma Lasers.
Laser Resurfacing (Light Amplification by the Stimulated Emission of Radiation) is designed to improve scarring, wrinkling, pigmentation and sun damaged aged skin by removing the outer damaged skin and preserving the skins underlying tissue. It is common to treat the whole face, or anatomical sections, for example the top lip, the cheeks, under the eyes, etc to ensure best results.
Laser Photo Rejuvenation is a newer non-ablative laser treatment and is designed for people who are too busy or do not wish to go through the recovery time of deeper laser resurfacing. The laser works by bypassing the surface of the skin and treating the layers beneath the skin. This allows the skin to respond as if it were repairing a wound where in fact the surface remains intact and only the skin tissue and collagen regenerate to cause skin tightening and plumping over time. This treatment usually involves the use of two or more lasers that specifically target vascular and pigmentary changes (open blood vessels or brown spots) in our skin that develop with age and sun damage. See Laser Photo Rejuvenation for more information.
Ablative Laser Resurfacing involves the beam of the laser being passed over the top layer of skin, emitting short intense pulses of light, which vaporizes the top layer of skin exposing the undamaged skin beneath. As the area treated by the laser heals, smoother and clearer skin is seen. Laser resurfacing is relatively bloodless and offers Dr Rich more control in the depth of penetration of the skin’s surface allowing for increased precision and safety when treating delicate areas, such as around the lips and eyes.
Currently there are three different lasers being used in Ablative Laser Resurfacing, the Ultrapulse CO2 (the first in a new generation of resurfacing lasers), the Erbium Laser (where the depth of penetration can be more precisely controlled and can be used either ablatively (deeper) or non ablatively – not breaking the skins surface) and the ‘new’ Portrait Laser (new plasma laser technology). These three different lasers now offer a variety of treatment options. Younger patients may only require / want a light resurfacing, where more mature patients may require / want a deeper treatment for deep lines, sun damage or wrinkles. The newest laser, the Portrait is beneficial for those patients who do not wish to have the inconvenience of regular trips into the clinic post operative, or who do not wish to have a deep treatment.
When treating areas with lasers it is essential to treat either the whole face or matching anatomical areas.
Ablative lasers (CO2 or Erbium) – small areas can be numbed by the injection of local anaesthetic, while full-face treatments are generally treated under light sedation at a Day Surgery centre.
The Portrait Laser requires only the application of a strong local anaesthetic cream for hour prior to treatment. In cases when treated at the Armadale clinic, light medication is possible to make the procedure more comfortable. In this case the patient is unable to drive home.
When deep Laser Resurfacing with the CO2 or Erbium Laser is performed, it is necessary to wear a special dressing over the entire treated area for usually up to seven days after the procedure. Generally two to four weeks recovery time is recommended. Swelling and oozing is expected during the initial period so it is advisable to sleep on a 45 degree angle or stay upright to reduce swelling. Once the dressings are removed it is important not to scratch or pick the skin as scarring is possible. Patients must also not expose the new skin to the sun, so when able, a sunscreen must be applied whenever outdoors. The skin may remain red for a few weeks, sometimes longer when the CO2 laser is used, over time the redness subsides and eventually fades. When the Erbium Laser is used the healing time is usually faster however this does depend on the depth of skin treated.
The Portrait Laser requires no dressing. Initially in the first 24 hours Vaseline alone is applied and reapplied to stop the skin for drying out. After 24 hours, a regime of special cleansers and moisturisers are used until the old skin is removed and the new skin is able to be treated a normal again.
Once the ‘barrier function of the skin’ returns as in all techniques of laser resurfacing, camouflage make up applied to reduce the appearance of redness. Slowly the redness fades and the new skin returns to the original skin colour.
Healing time can range from two to four weeks. It is suggested that all patients would usually take off at least two weeks from work. Once the skins barrier function has returned, patients are able to wear make-up to cover any residue redness.
Risks and Complications
Laser Resurfacing complications are planned to be minimised by patients taking all appropriate pre operative medications. These medications are given to reduce swelling, herpes (cold sores) and the possibility of infection. Provided these medications are taken as directed, the possibility of complications is uncommon. There is also a possibility of a fungal infection and post procedure hyperpigmentation. If occurring, these can also be treated. Although rare, there is a possibility of long-term depigmentation. If this occurs, any areas of concern may be concealed with make-up.
How does it work?
Using a wand-like laser hand piece, lasers work by producing an intense beam of light and heat which vaporizes the damaged skin, while also preserving the underlying skin tissue. Lasers can be varied in their intensity to suit each patients concern.
What conditions can Ablative Laser Resurfacing treat?
Laser Resurfacing is effective in diminishing the visible signs of ageing including wrinkling, pigmentation and scarring including acne scars.
It is commonly used to:
- Smooth and tighten eyelid skin
- Improve crow’s feet around the eyes
- Soften pucker marks and frown lines
- Remove brown spots and blotchy skin colour » Improve and flatten scars
- Repair smoker’s lines
Can I wear make-up after Laser Resurfacing?
With all types of lasering, once the skins barrier function has returned make-up can usually be worn. We are able to recommend an excellent range of mineral make-up which will camouflage any redness still present whilst protecting the new skin from the sun.
‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’