Laser Resurfacing

Many techniques have been used to resurface (renew) sundamaged (photodamaged) and ageing skin. Retinoic acid, chemica l peels and dermabrasion have had their time and continue to have a place in appropriately selected patients. The laser and Intense Pulsed Light (IPL) are the newest technically advanced methods for achieving consistent, relatively risk-free skin resurfacing. They should be regarded as another weapon in the battle against the ageing process rather than a replacement of the previously available techniques.

What is a Laser?

The word laser is an acronym for: Light Amplification by Stimulated Emission of Radiation By stimulation of certain molecules, light energy is emitted. Different molecules (and therefore different lasers) produce light of different wave lengths that are absorbed by specific tissues or pigments. This light is passed through a focusing lens to produce a beam of intense energy. Filters of different colours over the beam also modify the energy delivery to achieve results on different elements of the skin.

How Does it Work?

For resurfacing, carbon dioxide, erbium, or a combination of both gases is used to produce light energy that is absorbed by water. Because the skin is 70% water the laser beam actually vaporises the epidermis or top layer of skin. Subsequent passes of the laser beam will vaporise deeper layers (or papillary dermis) of the skin.

Fractionated laser beams pass through the skin leaving islands of normal skin unaffected by t he energy.

Extremely short exposure time to a single spot of skin reduces the collateral heat or thermal damage to the remaining skin. As the depth of the laser treatment progresses, the collagen and elastin fibres that have become disorganised and stretched by photoaging undergo a reformation process with shrinkage and reorganisation, with the result that the skin can tighten and look more youthful.

By being able to control power, spotsize and the dwell time of the laser beam, ablation of the skin can be controlled precisely, with minimal heat injury to the surrounding skin, little or no bleeding, and subsequent minimisation of the attendant risks or potential complications. Fractional laser treatment minimises risk by using many extremely small laser spots with islands of untreated skin between energy beams.

What Conditions Can Be Treated?

Changes associated with ageing and sun exposure (photoaging) such as; fine lines, wrinkles, rough blotchy patches and deep expression lines are a ll suitable for treatment with the laser. These changes are not only accelerated by sun exposure, but also by smoking, alcohol and atmospheric pollution. Other conditions that can be treated include acne scars, chicken pox scars, irregular surgical scars, pigmented lesions and some moles.

The most commonly treated areas are the eyelids, mouth, forehead and cheeks. The neck is largely unsuited for laser treatment because its microscopic architecture is such that safe re-epithelalisation cannot be predicted. The lesser invasive treatments of fractionated laser and IPL can be of some value in areas unsuitable for laser treatment.

In some cases, fine lines and wrinkles can be eliminated entirely, but other lines such as the deep laugh and frown (expression) lines may only be softened. You should think of laser resurfacing as an improvement, rather than an elimination of all lines.