Laser Skin Resurfacing

Reviewed by Mitchel Goldman, MD

Here you'll find information on:

• Comparing laser skin resurfacing
• When treatment may not be appropriate
• The procedure
• Complications and risks
• Consult a qualified doctor
• Costs

One of the most recent innovations in anti-aging remedies has been laser skin resurfacing, which improves the appearance of fine lines or wrinkles, scars, and hyperpigmentation (discolored areas of the skin), primarily around the eyes and mouth. It can also be used to treat large areas of the face.

Laser skin resurfacing has gained popularity recently because of its advantages over alternative approaches that may cause discomfort, bleeding, and bruising, all of which mean a longer recovery time. The result of more youthful-looking skin means laser skin resurfacing can be psychologically rejuvenating as well.

Laser Skin Resurfacing Vs. Other Skin Treatments

All skin treatments work in a similar way: removal of a layer of skin so that the new skin can flourish and fill in the wrinkles and crevices. Until recently, the only options to medically treat damaged skin were chemical peels and microdermabrasion. These procedures offer the anti-aging benefits of glowing skin, reduced wrinkles, decreased areas of skin discoloration, and minimized scarring. But these procedures don't use laser light, and they remove only a thin layer of skin. Laser skin resurfacing uses laser light and treats deeper layers than does microdermabrasion.

For acne scars, a recently developed third-generation Erbium/YAG-CO2 combination laser is very effective, without the side effects of older laser types. In addition, the Fraxel laser was introduced recently for the improvement of acne scars, brown age spots, melasma (patchy or generalized dark or tan areas), fine lines, and large pores; it is proving to be very effective. During your consultation with your doctor, he or she will select the right laser for your particular scar removal procedure.

A variety of options are available for the improvement of skin through photo rejuvenation, which is the use of an energy-based device to improve skin in thermal, mechanical, and chemical ways. Thermage is an example of a thermal energy-based device and was recently FDA-approved for the improvement of sagging skin and facial lines. To learn more, please read the surgeon discussion of photo rejuvenation.

When Laser Skin Resurfacing May Not Be Appropriate

People with olive, suntanned, or black skin are not the best candidates for laser skin resurfacing. Others who do not make good candidates include those who are prone to scarring, are taking certain medications, or have a skin disorder. For example, discoloration must be evaluated to determine if it is the result of natural aging hyperpigmentation (which is treatable), or a more serious medical condition (in which case laser treatment may not be appropriate).

The Laser Skin Resurfacing Procedure

Your doctor may perform laser skin resurfacing in the office, an outpatient surgery center, or a hospital. Typically you would receive local anesthesia, while you are sedated but awake; however, you might receive general anesthesia for treatment of deeper layers of the skin.

Treatment time ranges from a few minutes to an hour and a half, depending on the amount of resurfacing you need.

The doctor moves the laser precisely over the area of skin requiring treatment. Depending on the depth of the wrinkle, scar, or discoloration, the laser may be moved over the area repeatedly. The laser penetrates and removes the number of outer skin layers necessary to uncover the layer not affected by imperfections. Once that layer is exposed, healing can begin to rebuild new skin that looks younger and does not have the imperfections.

The procedure may be performed in two or more sessions to penetrate deeper areas, but one procedure is usually enough.

Aftercare for Laser Skin Resurfacing

You will probably experience some mild swelling and discomfort after laser resurfacing. This can be controlled with ice packs and medications prescribed by your surgeon. There may be a red, crusted appearance for 10 or more days.

If a bandage was applied after your procedure, it may be replaced with a fresh one after a day or two. After about a week, your bandage will be removed, and a thin layer of ointment may be applied to your skin. At this stage your surgeon will provide instructions on how to gently wash and care for your healing skin.

During this phase of healing, it is very important that you not pick the crusts off the treated area, or scarring may result. Most patients are free of crusts after 10 days, but redness may persist for several weeks.

Complications and Risks of Laser Skin Resurfacing

Complications in this procedure are rare, but when they occur they may include skin discoloration, burning, or scarring. In rare cases, dormant viruses or infections can be triggered. Laser skin resurfacing does not stop the aging process. Wrinkles, discoloration, and other imperfections can reappear throughout your lifetime.

Consult a Qualified Doctor

Consult a plastic surgeon and a dermatologist who have extensive experience using a laser. There's a lot to know. For example, acne scars may be best treated with a CO2 laser, while other lasers may be preferred for other types of scars. A variety of lasers are also available for anti-aging skin care, including the UltraPulse, SilkTouch, and erbium. The intense pulsed light system or IPL, also known as the SpectraPulse light system, removes facial veins, brown spots, and benign lesions. Only experienced and knowledgeable doctors will know which laser is most appropriate for each condition and will have received appropriate training on the device. Using a qualified doctor will increase your odds of success and reduce the risk of complications.

Here are some tips to consider when consulting a doctor:

• Ask about credentials, training, and the number of times the procedure has been performed in the practice. Laser skin resurfacing is typically performed by a doctor who is certified to use a CO2 laser and has privileges to use the laser at a fully accredited hospital.
• Find out which type of equipment will be used, where the procedure will be performed, and the extent of the procedure.
• Doctors can show you photos of other patients with similar skin issues, who have undergone laser skin resurfacing, chemical peel, or microdermabrasion. You can compare these photos to help decide if laser skin resurfacing is best for you.
• Each case is different. Before deciding on laser skin resurfacing, discuss the options and develop a long-term plan with a qualified doctor.

The Cost of Laser Skin Resurfacing

According to the American Society of Plastic Surgeons, the national average cost for laser skin resurfacing is $2,378. This fee includes only the physician's costs, and this estimate is only for one treatment session, but multiple sessions may be needed. You can arrive at a better total estimate after your doctor has evaluated your condition and goals, and created a treatment plan.

The cost of laser skin resurfacing generally includes certain ointments, dressings, and creams. Antibiotic medications and other prescription pills such as pain medication are not normally included in the estimate that your doctor will give you. The treatment cost also does not cover the camouflage makeup that some practices offer for use after surgery.

The extent of treatment makes a cost difference. For example, if deeper layers of the skin must be penetrated to remove the imperfection, the use of general anesthesia and a hospital may be required. General anesthesia in a hospital costs a lot more than local anesthesia in a doctor's office or outpatient surgery center.

If the cost is too much to pay at once, ask your surgeon about monthly payments. For financing options and tips, read about patient financing.

Related Topics

• Chemical peel
• Microdermabrasion
• Vibraderm
• Skincare for teens and adults
• Skin disorders
• Thermage
• Surgeons discuss photo rejuvenation

[page updated May 2008]