What is the laser resurfacing?
For years now the CO2 and Erbium: YAG laser technologies have represented the gold standard in rejuvenating the skin of the face. Ablative laser photo-rejuvenating (laser resurfacing) is a method which uses laser Energy with the aim of producing a deep renewal of all the cutaneous layers with the resulting remodeling of these and the rejuvenation of the skin. The laser beam causes a kind of controlled dermabrasion through the removal of the layer of the skin up to the dermis. The superficial layers that have been thus destroyed will repair themselves thanks to natural healing processes which derive from some islets of cells near to the pilosebaceous appendages. Clearly this involves a recovery time, during which the skin will be quite sensitive and will need to be cared for. This healing process achieves the desired effect exactly, that is, a smoother skin. The level of aggressiveness can be regulated by the operator according to the skin type and the results desired, but with these methods it is possible to achieve the greatest effect in the level of aggressiveness and depth, amongst all the laser techniques at our disposal.
How to prepare for laser resurfacing?
The procedure can be preceded by a roughly 20-30 day preparation period during which the skin is prepared for the treatment with the use of appropriate alpha hydroxic acid and retinoid-based creams, which are used for the purpose of making the corneous layer thinner and therefore allowing the laser to penetrate deeper. The treatment requires no particular preparation other than to turn up without make-up. It is not recommended for patients with dark skin (phototypes IV and V) or sun-tanned skin: in this latter case it is advisable to wait at least 45 days after last being exposed to the sun.
The treatment is carried out as an outpatient, after having desensitized the area to be treated with an anaesthetic, which can sometimes be completed with a light sedative. The session lasts about 20-40 minutes for the treatment of the whole face or even less for limited areas (contours of the eyes and lips). Immediately after the operation the area will be red, swollen and can produce slight serous discharge. It will just be necessary to apply antibiotic ointment and nourishing creams to keep the treated skin moist and protected from possible infections. This will also avoid scabs forming. During this period, when necessary, you can take antibiotics, and anti-inflammatory or anti-itching medicines. During the following days there will be the exfoliating process of the cutaneous layers removed and the re- formation of the new skin tissue which will be pink in colour, without marks and spots and extremely sensitive. Once the skin has healed, you must use a total sun-screen until the skin’s normal colouring and sensitivity have not returned, which may take from 6-8 months, particularly as regards thermal sensitivity (heat-cold) and environmental sensitivity (above-all the sun).
Effects of laser resurfacing
Laser resurfacing techniques allow us to act, with a variable post-operative period, according to the level of aggressiveness chosen (from 7-15 days), on the skin texture as well as on all those micro blemishes of the skin which are present on the surface (fine wrinkles, pigmentation, discolouration, small scars, etc.) The effects on wrinkles, on flaws in the tone and on scars are exceptionally good. Taking into account a greater sacrifice in terms of convalescence times, the patient obtains really significant results. Normally we carry out an aggressive type of treatment, with a high energy level and with a longer convalescence but the results are evident from the start, as soon as the exfoliating process is over. However, it is possible to carry out low energy treatments and to repeat them several times to obtain an excellent result, which improves progressively (laser refreshing). With this type of treatment the convalescence is reduced (about 4-7 days).
Laser resurfacing treatment
A treatment of this type can give rise to the possibility of some side-effects, which are almost always due to the patient’s bad handling of the post-operative period. This is why it is extremely important to keep rigorously to the post-operative instructions supplied by the specialist. After laser treatment there can be local inflammatory or irritative reactions, however they are solvable spontaneously or with appropriate treatment, the appearance of small reactive lesions of the skin, of some small blisters, milia or light dermatitis. Furthermore, the laser can encourage the evaporation of water, accentuating the sensation of a dry skin which is typical during the first few days after the treatment.
Possible adverse developments comprise: continuous redness (which continues for months, particularly after very aggressive treatments), by the reactivation of a pre-existing herpes infection, by hyperpigmentation (possible in the case of inadequate photo-protection in the days following the treatment, or by scarring (extremely rare). In general, all the possible side-effects tend to dissipate naturally in time, or are curable with appropriate treatment.