Laser Resurfacing

Surgery Overview

Laser resurfacing is a treatment to improve the look of the skin. It uses a laser to send out brief pulses of high-energy light. This light is absorbed by water and substances in the skin called chromophores. The light is changed into heat energy. The heat then destroys (vaporizes) thin sections of skin, layer by layer. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment. Some lasers only tighten the skin by heating it but do not destroy the skin.

The CO2 (carbon dioxide) laser is the most common type of laser used for resurfacing. Erbium lasers are also used often.

In most cases, laser resurfacing is very precise and causes little damage to the surrounding skin and tissue. It is done most often on the face, but it may be done on skin in other areas of the body, such as the hands, neck, and chest.

Newer laser methods

Newer methods of laser resurfacing cause fewer problems and have faster recovery times. These methods include:

• Fractional laser skin resurfacing. This treats microscopic columns of skin. The treated areas of the skin are surrounded by untreated areas. The result is visible improvement without much bleeding or scabbing.
• Plasma skin resurfacing. This technique uses plasma energy to destroy the lower layers of skin. It does not affect the top layer of skin. This top layer protects the lower layers of skin as they heal.
• Superficial erbium: YAG laser resurfacing. This is a mild laser treatment method. It works best for minor wrinkles and other skin problems.
• Infrared laser resurfacing. It targets deeper layers of the skin with heat to smooth and tighten the skin.

How it is done

The areas to be treated are cleaned and marked with a pen. A nerve block with a local anesthetic is usually used to numb the area before treatment. You may also get medicine to help you relax. If your whole face is going to be treated, you may need pain relievers, sedation, or stronger anesthesia. (In some cases, general anesthesia is used.) You may need to wear goggles to prevent eye damage by the laser. And wet towels will be placed around the area to absorb excess laser pulses.

The laser is passed over the skin, sending out pulses. Each pulse lasts less than a millisecond. Between passes with the laser, the skin will be wiped with water or a saltwater solution. This is done to cool the skin and remove tissue that the laser has destroyed. The number of passes needed depends on how large the area is and what type of skin is being treated. Thin skin around the eyes, for instance, needs very few passes with the laser. Thicker skin or skin with more severe lesions will need more passes.

The pulses from the laser may sting or burn slightly. You may feel a snapping feeling against your skin. In most cases, there is little or no bleeding. Severely damaged skin is more likely to bleed. When the treatment is done, the area is covered with a clean dressing or ointment.

Laser resurfacing is usually done in a doctor's office or an outpatient surgery center.