Laser skin resurfacing, also known as a laser peel, is the removal of the top layers of the skin via focused laser light energy. Some types of lasers also penetrate into deeper layers of skin to provide additional benefits. The main goals of laser skin resurfacing are to make the skin smoother, tighter, and more even in tone, texture, and color.
Laser peels are most often performed using a Co2 (carbon dioxide) laser, although other lasers have been developed to address more specific skin concerns, including the Erbium YAG and fractional lasers, among others.
Who Is a Good Candidate
The best candidates for skin resurfacing are light-skinned non-smokers who are in generally good health and who have a positive outlook and realistic expectations about the outcome. You should be free of any active skin infections, including acne. Those who are unsuited for the procedure include people who take or have taken certain medications (including but not limited to Accutane and some steroids) within the previous 18 months. People who tend to have unusual scarring, such as keloids, are also not considered good candidates for laser resurfacing.
Who Can Benefit
Those who can benefit from a skin resurfacing procedure include patients with skin imperfections like wrinkles, loose skin, scars (including acne scars), vascular lesions (like broken capillaries or spider veins), enlarged pores, rough skin texture, dark spots (hyperpigmentation) on the skin, or unwanted tattoos, hair, or birthmarks. Even pre-cancerous lesions on the skin can be effectively removed with laser resurfacing.
Skin resurfacing is usually performed on an outpatient basis. You will be required to keep the skin moist and to stay out of the sun completely during the healing period, and you may be expected to wear some type of sterile dressing over the treated area. Your surgeon will provide instructions for washing the skin. You can expect some swelling, discomfort, and possible crusting and weeping of the skin. Do not pick at the skin, as this can lead to infection and scarring. Over-the-counter medications are often sufficient to manage pain, or you may be given prescriptions for pain medication and/or antibiotics.
Recovery and Downtime
It is generally recommended that the patient rest indoors for at least 7 to 10 days, except in the case of a very light peel. However, some people prefer to remain unseen by others until the worst of the redness, crusting, and/or peeling subsides. This time period can be from 2 weeks to 2 months, depending on the depth of your peel. Even if you do decide to return to work before healing is complete, you must absolutely continue to follow the recommendations of your surgeon in regards to sun exposure and the use of protective skin barriers.
Risks and Complications
Possible short-term risks and complications include prolonged redness of the skin, tenderness or a burning sensation, itching, increased sensitivity to light, and easy flushing. In rare cases, the procedure can trigger the re-appearance of an existing dormant virus or infection. You may also experience skin irritation caused by sensitivity to the post-procedure healing cream. This usually resolves on its own.
More long-term problems can include changes in skin color, like hyperpigmentation or hypopigmentation. It is also possible for a surgeon to go too deep during the procedure, resulting in scarring.
The average total cost for a laser skin resurfacing procedure varies between $800 to $8,000, depending on the geographical area, the depth of the procedure, the number of treatment sessions required, and the size of the area(s) being treated. The U.S. average is around $2,500, which includes not only the surgeon’s fee but also pre- and post-operative care and medications.
Skin resurfacing is usually not covered by insurance unless it is being performed to treat precancerous skin conditions or improve scars from a previous reconstructive procedure or trauma.
Laser skin resurfacing is often done in conjunction with other procedures, such as a facelift, eyelid surgery, or other anti-aging procedures, to enhance the patient’s results.
Other Cosmetic Uses for Lasers
In the past several years, lasers have become a staple in the world of aesthetic improvement and anti-aging procedures. In addition to skin resurfacing, they have been shown to be effective for non-surgical skin tightening, improvement of stretch marks, hair removal, and even teeth whitening.
Anesthesia is given. Depending on the type and depth of the procedure, skin resurfacing may be performed using only a topical anesthetic (a cream which is placed on the skin’s surface to numb it). In this case, a waiting period is usually required before beginning the actual procedure, to allow time for the anesthetic to work. For deeper peels, the area may be injected with a local anesthetic. An oral sedative may be given to help you relax. In rare cases, or when other procedures are being performed in conjunction with resurfacing, IV sedation, or even general anesthesia may be used. The skin and surrounding areas are prepared. The skin is thoroughly cleansed, and any areas that will not be treated may be marked or draped to protect them. Usually, the patient will have some sort of barrier put in place to protect the eyes during the procedure. The skin is then slathered with a special gel substance to facilitate the movement of the device over the skin and improve the conductivity of the laser energy.
Laser procedure is performed. The Co2 laser is an ablative laser, which means that it literally removes upper layers of damaged skin. Your surgeon passes a wand-like device over the areas to be treated, and the laser emits a beam of light which vaporizes the top layers of damaged skin in a precise and controlled manner. Cooling preparation is applied. Many surgeons will apply some sort of cooling preparation to the skin for a brief period post-operatively. The purpose is to reduce swelling and discomfort. Protective skin barriers are applied. Your surgeon will apply some sort of protective barrier to the skin. Sometimes, this consists only of a healing ointment and sunscreen, while other cases may require the application of bandages and/or a silicone dressing.