Cosmetic Surgery

Laser Resurfacing at Mayo Clinic

Laser resurfacing is an option for treating many minor skin problems, including wrinkles, scars, birthmarks, tattoos, age spots and some types of acne scarring.

Laser skin resurfacing can smooth the tone and texture of the skin, making it look more youthful. It can soften the lines around the eyes and mouth, and minimize unevenly pigmented areas of skin and facial scars. It can be used to treat an area of the face or the entire face. Laser treatment is less effective for deep wrinkles. It is often used as an alternative to chemical peel and dermabrasion.

Age, skin color and the extent of skin damage are considerations in determining whether laser skin resurfacing is appropriate.

Lasers produce an intense beam of focused, bright light. The intensity and pulse duration of lasers vary. The kind of light emitted from a laser determines what problems it can treat.

There are two major categories of lasers: ablative and non-ablative. Ablative lasers remove the top layer of the skin (epidermal). The heat also burns the skin layer under the epidermis (the papillary dermis). The skin responds as if it was repairing a wound and regenerates collagen, a protein that gives skin its texture and elasticity. Healing brings about smoother, more even skin. Non-ablative lasers affect only the papillary dermis. Healing time is shortened.

What to Expect

The surgeon evaluates the color, quality and thickness of the patient's skin and may take photographs for the medical record. Patients should discuss with the physician other resurfacing treatments they have had; any exisitng skin conditions, including viral infections that involve the face or lips; sun sensitivity; and prior or current use of vitamin A-based medications, nutritional supplements or herbal remedies.

Patients with a history of cold sores or fever blisters may have medication prescribed to prevent complications. Avoid sunburn for at least six weeks before any laser treatment. Two to three days before laser resurfacing, patients may be given an antiviral pretreatment to prevent cold sores and thereby reduce the possibility of infection and scarring. Patients will also be pretreated with hydroquine cream, a skin bleaching agent, prior to surgery to decrease the risk of hyperpigmentation (irregular coloring).

The surgeon may request six weeks of pretreatment with tretinoin, a prescription cream containing retinoic acid, a synthetic derivative of vitamin A, prior to laser treatment. This cream can improve fine wrinkling, roughness and pigment changes. Patients who have taken Accutane™ for acne or used any other facial creams should tell their surgeon about this.

When the procedure is completed, the face may be covered with a protective ointment. Some conditions may require more than one laser treatment. Treated skin should be protected with sunscreen that has an SPF of 15 or higher.

Pain is an issue with laser resurfacing. The technique creates a burn on the skin which will be red and blister and weep for seven to 14 days. Pain is managed with medications. Care following laser resurfacing is time consuming and requires a routine of washing the face two to four times a day for seven to 10 days, and applying an ointment.

Risks

Risks associated with laser resurfacing include, but are not limited to:

• Burning the skin
• Swelling lasting for weeks and redness persisting for months. As a result, time off from work is a consideration.
• Whitening of the skin (hypopigmentation) or hyperpigmentation, a blotchy discoloration, which usually fades in a few weeks, but can last longer.
• If laser resurfacing is performed near the eyes and the person has poor skin tone, the skin may contract and pull down the skin of thelower eyelids. This may require surgery to correct.
• Skin sensitivity

This procedure is performed by specialists in Dermatology and Facial Plastic and Reconstructive Surgery (Otorhinolaryngology).