What is laser skin resurfacing?
Laser skin resurfacing is a non-invasive procedure conducted within a clinic setting. It uses precise heat to target both the superficial and deeper skin layers, inducing deliberate minor skin damage to initiate the body's natural healing process. The most intensive types of laser resurfacing entirely shed the skin's outermost layer, leading to enhanced skin tone and texture as it rejuvenates.
It is a popular solution for addressing issues like wrinkles, hyperpigmentation, acne scars, dark under-eye circles, crepey skin texture, and lacklustre complexion.
Additionally, some laser treatments offer the benefit of skin tightening, promoting a more youthful look.
The difference between ablative and non-ablative laser resurfacing
Laser resurfacing treatments generally fall into two main classifications: ablative and non-ablative.
Ablative Laser Resurfacing
- Utilizing either CO2 (carbon dioxide) or Erbium lasers, these procedures work by eliminating the outer skin layer known as the epidermis. Simultaneously, they heat water molecules in the underlying layer, the dermis, to activate the natural healing process.
- CO2 lasers often surpass Erbium lasers in addressing scars and lax skin. However, as a stronger treatment, it can sometimes necessitate general anesthesia and may involve up to a fortnight of recovery as the skin heals.
- On the other hand, Erbium lasers are milder compared to the CO2 variant. This means the procedure can often be done under just local anesthesia and usually results in a shorter recovery period.
- It's important to note that ablative lasers are primarily suggested for individuals with lighter skin tones, specifically those falling under Fitzpatrick types I-III.
- A big advantage of ablative lasers is their capability to substantially enhance the appearance of deep-set wrinkles, pronounced sun-related damage, or lax skin in just one session. It is not uncommon to pair ablative laser resurfacing with another cosmetic surgery, like a facelift. This dual approach allows for concurrent healing, optimizing the recovery process.
Non-Ablative Laser Resurfacing
- Clear & Brilliant, Laser Genesis, and Neo Elite Aerolase, among others, focus on targeting the dermis without disturbing the surface layer (epidermis).
- These milder procedures are appropriate for every skin shade and seldom lead to complications. Furthermore, they usually involve minimal recovery time.
- One consideration is that multiple sessions might be required to achieve noticeable results.
Fractionated Laser Resurfacing
- Fraxel, Halo, and other fractionated lasers distribute their energy through many minuscule beams, focusing on a select portion (20-40%) of the skin during a single session. This approach reduces skin stress and accelerates recovery.
- These lasers are ablative, non-ablative, or a combination, as seen with Halo.
- Fraxel, a leading name in the fractional laser category, can be applied in an ablative manner with the Fraxel Repair CO2 laser or in a non-ablative fashion with the Fraxel Dual variant.
- While an ablative fractionated procedure may leave the skin slightly reddened and tender, the recovery period is generally faster than conventional CO2 laser treatments, ranging from a couple of days to roughly a week.
What are the pros & cons of non-ablative laser resurfacing?
- Recovery is fast. You might experience slight redness or a bit of swelling post-treatment, ranging from a few hours to several days, depending on the laser’s settings. However, resuming daily activities should be immediate.
- Committing to a package of 3 to 6 monthly non-ablative laser sessions is likely to yield remarkably positive outcomes over an extended period.
- These milder lasers are typically safe across all skin types.
- Based on the laser’s setting, you might still face visible redness lasting up to a week post-treatment.
- It's essential to complete the full set of treatments, spanning several months, to achieve substantial results.
- Any laser facial therapy has the potential to activate cold sores caused by the herpes virus. If susceptible, your physician can prescribe an antiviral drug.
- As lasers rely on using heat energy, these softer systems can still exacerbate melasma in some individuals.
What are the pros & cons of ablative laser resurfacing?
- A single session is often enough to achieve remarkable changes, especially in addressing fine lines and wrinkles.
- The induced heat promotes new collagen, gradually firming mild skin sagging.
- The risk of skin cancer is potentially lowered in the area that is treated.
- Expect a recovery period ranging from 7 to 12 days after the procedure.
- For those with a history of acne, ablative lasers could lead to flare-ups, as the protective ointment used post-treatment traps bacteria and sebum.
- There is a risk of cold sores appearing for those predisposed. It is standard for physicians to prescribe antiviral drugs as a precaution.
- Ablative laser skin treatments are best suited for individuals with fairer skin tones, who typically experience more sun-related harm. Darker-skinned individuals may encounter issues like hyperpigmentation and hypopigmentation, especially with full-scale ablative lasers (as opposed to fractional ones).
How much does laser resurfacing cost?
Average Cost: $2,450
Range: $690 - $6,900
The price of your laser resurfacing will vary based on the specific laser chosen by your provider, the number of sessions required, and the clinic location.
Consider using buy now pay later services like Afterpay to help manage the costs of the procedure.
What are the risks and side effects of laser resurfacing?
Laser resurfacing is generally safe when performed by dermatologists or plastic surgeons. However, on rare occasions, individuals may experience rare complications like infections, acne flare-ups, or other healing challenges, especially after undergoing ablative laser treatments.
Moreover, those with medium to dark skin complexions might face the possibility of hyperpigmentation post-ablative laser treatment. There is also potential concern around increased pigmentation in lighter skin that is sun-tanned or exacerbation of melasma in predisposed individuals.
It's crucial to discuss these potential risks with your physician and devise a strategy to mitigate them.
What happens during a laser resurfacing session?
The specifics of your procedure will depend on the laser chosen by your dermatologist.
What happens during an ablative laser resurfacing treatment:
- Before the scheduled date, a dermatologist or plastic surgeon may advise taking an antiviral drug (especially if you have a history of cold sores) and an antibiotic to minimize infection risks.
- Some experts also recommend using a topical retinoid or pigment-reducing cream like hydroquinone in the month leading up to the procedure. This can aid in cellular renewal and deter skin discolouration.
- It's common advice to avoid direct sun exposure for 2 to 4 weeks before the procedure and for about a month post-treatment. Tanning can result in unwanted pigment changes.
- Ablative laser procedures are typically conducted in a clinical setting or doctor’s office.
- Based on your laser’s setting, either a local anesthetic with mild sedation will be administered or, less commonly, general anesthesia.
- The practitioner will operate the laser to shed the skin's surface while warming the deeper layers. This action encourages the body's innate healing, amplifies collagen creation, and causes existing collagen structures to contract, enhancing and refining your skin's texture.
- Time taken varies between 30 minutes to 2 hours, contingent on the treatment area size.
- Post-treatment, a protective balm and often a bandage will be applied. It's advisable to have someone ready to escort you home.
What happens during a non-ablative laser resurfacing treatment:
- Your doctor might put numbing cream on your face, an hour before the treatment. Some patients prefer extra pain relievers such as Advil or medications to alleviate anxiety.
- When the targeted area is sufficiently numbed, the operator will sweep the laser over the treatment site, warming the collagen deep within to boost production and firm up existing structures.
- Depending on the chosen laser and the coverage area, the procedure can range from 15 minutes to 2 hours.
How long is recovery after laser resurfacing?
Your post-treatment recovery and care guidance will vary based on the specific laser technique used.
Ablative laser resurfacing recovery
- Anticipate a recovery period of up to 2 weeks as your skin undergoes its healing process.
- Your skin will resemble an intense sunburn, and you might observe rawness, swelling, itching, and even some blistering.
- Some pus oozing might occur for several days, transitioning to crust formation and eventual peeling. It's crucial to avoid tampering with or scratching your skin during this period to prevent scars.
- In the initial days, prioritize cleanliness and consistent skincare. Rinse your skin with a saline or vinegar blend multiple times a day, sealing in moisture with a doctor-recommended moisturiser.
- Retaining the skin's moisture helps expedite recovery. Popular moisturising creams like Vaseline are known for their minimal sensitivity reactions. In situations with heightened infection risks, vinegar soaks can also be beneficial.
- It's typical to experience some puffiness. Raising your head on an extra pillow while sleeping and using an ice pack can help reduce this swelling.
- For excessive swelling, medical professionals might prescribe steroid creams to mitigate the inflammation.
- After 2 weeks when the peeling phase finishes, you can introduce oil-free cosmetics to conceal lingering redness.
- Especially for those with pale complexions, a pinkish hue might persist on the skin for several months.
- Commit to daily application of a high-SPF sunscreen (preferably 50+), don protective headwear, and minimize sun exposure to safeguard your rejuvenated skin.
- A considerable number of individuals opt for laser resurfacing during the cooler months, as the sun's UV intensity decreases and accidental sun exposure is less likely. Nonetheless, diligent sunscreen application remains paramount.
Non-ablative laser resurfacing recovery
- After undergoing this type of laser resurfacing, you will not need to take time off and you can generally resume work immediately.
- Your skin might exhibit slight redness and puffiness for several hours or days, with potential localized darkening and minor flaking.
- To alleviate the redness and swelling, consider taking anti-inflammatory medications like ibuprofen, generously moisturising, and using ice packs.
- For any cosmetic enhancements, including laser treatments, safeguarding your skin from the sun and diligently applying sunscreen remains essential.
When can you see laser resurfacing results?
Ablative laser treatment outcomes will be visible after peeling and some of the redness dissipates, typically around 10 to 14 days post-procedure.
The final results might take between 3 to 6 months to fully manifest as this is the time required for new collagen to be produced.
In contrast, the results from non-ablative laser treatments emerge progressively over a couple of months, giving a more gradual change compared to ablative procedures. However, once you've undergone the complete set of treatments, you should see an uplift in both skin texture and tone, which continues to improve for a few additional months.
Many patients have positively reviewed laser skin resurfacing, ablative and non-ablative. They've cited benefits like minimized fine lines, enhanced skin tone uniformity, softer skin feel, improved texture, less scarring, and skin that feels more firm and youthful.
How long do laser resurfacing results last?
The effects of laser resurfacing are designed to last for many years, though naturally, aging is inevitable. Those who opt for ablative treatments often notice visible improvements up to ten years post-procedure. On the other hand, individuals who go for non-ablative treatments might seek a follow-up appointment every 2 to 5 years.
For both types of treatments, it's imperative to consistently protect the skin from the sun to sustain the positive effects. It's also recommended to supplement laser rejuvenation with IPL (intense pulsed light) photo facial procedures that help manage sun-induced damage or age-related blemishes.
Furthermore, periodic treatments with pulsed dye lasers can enhance the skin's look by reducing its reddish hues.
Alternative procedures to laser resurfacing
If you're aiming for enhanced skin tone and texture, also explore these non-invasive skin rejuvenation procedures:
Microdermabrasion manually exfoliates the skin, utilizing either crystalline substances or diamond-tipped microparticles.
Chemical peels, available in varying potency, shed skin layers to unveil the healthy skin underneath.
Microneedling uses tiny needles to produce micro-injuries on the skin's surface, leading to a natural healing effect that boosts the creation of collagen and elastin.
RF microneedling uses the same tiny needles to introduce radiofrequency energy into the dermis, amplifying collagen production.
Sources & Studies
Elsaie, ML & Lloyd, HW 2008, ‘LATEST LASER AND LIGHT-BASED ADVANCES FOR ETHNIC SKIN REJUVENATION’, Indian Journal of Dermatology, vol. 53, no. 2, pp. 49–53, viewed 13 September 2023, <https://www.e-ijd.org/article.asp?issn=0019-5154;year=2008;volume=53;issue=2;spage=49;epage=53;aulast=Elsaie>.
Preissig, J, Hamilton, K & Markus, R 2012, ‘Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface’, Seminars in Plastic Surgery, vol. 26, no. 03, pp. 109–116, viewed 13 September 2023, <https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0032-1329413>.
TANZI, E, WANITPHAKDEEDECHA, R & ALSTER, T 2008, ‘Fraxel Laser Indications and Long-Term Follow-Up’, Aesthetic Surgery Journal, vol. 28, no. 6, pp. 675–678, viewed 13 September 2023, <https://academic.oup.com/asj/article/28/6/675/225729>.