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Laser skin resurfacing is an aesthetic procedure that rejuvenates the skin and treats various superficial irregularities, such as:

• Scars
• Age spots
• Sunspots
• Blemishes
• Stretch marks
• Actinic keratosis
• Uneven texture, and
• Fine wrinkles

The process causes controlled skin trauma to boost the skin’s natural self-healing ability (new skin cells).

Physicians in primary care can perform laser resurfacing with proper training. The procedure is safe and not complicated. However, side effects such as hypopigmentation and scarring are possible.

What is laser resurfacing?

In aesthetic medicine, laser resurfacing is a surgical technique that uses light to treat skin conditions and improve signs of ageing.

There are two main types of laser skin resurfacing:

Ablative laser: An invasive technique. It removes parts of the epidermis (the outer layer of the skin) and heats the deeper layer (dermis). That causes trauma on the surface of the skin but boosts collagen production. Once the epidermis heals, the “new skin” looks smoother and younger.

Types of lasers used for ablative skin resurfacing are:

• CO2 laser
• Erbium laser
• Hybrid systems

Non-ablative laser: A much less aggressive and less effective method. It stimulates the growth of collagen fibres and improves skin texture over time. The technique uses various lasers and IPL devices. In comparison with an ablative laser, it causes minimum discomfort. The recovery time is also significantly shorter. However, the results take longer to become visible and are not as satisfying.

Laser skin resurfacing procedure

Laser skin resurfacing may improve most signs of ageing and photodamage on the skin’s surface. It can also help with minor scars and stretch marks.

The procedure usually lasts between thirty minutes and two hours. It can cause discomfort and pain. That’s why local anaesthetics use is common, especially in ablative laser techniques.

A hospital stay is not necessary. But, follow-up check-ups and a self-care regimen for the patient are essential for proper recovery.

Potential side effects

Patients in primary care should be aware of the risks associated with laser resurfacing. Physicians should not recommend this aesthetic procedure for pregnant and breastfeeding women, people who are on acne medications, and those individuals who have:

• Weak immune system
• Autoimmune diseases
• Darker skin tone
• Cold sores (herpes virus)
• Tendency to form scars

The severity of potential complications differs according to the technique.

Ablative laser

• Acne formation – especially if the treated skin area suffers exposure to heavy makeup, thick creams, bandages, etc.
• Redness and itching – As the skin heals, it can become itchy and intensely red. The redness may last up from few days to several months.
• Skin infections – The absence of the epidermis facilitates viral, bacterial, and fungal infections. Flare-ups of the herpes virus are common (cold sores).
• Hypopigmentation and hyperpigmentation – The treated area of the skin may become lighter or darker. In most cases, this is not permanent.
• Scaring – Ablative skin resurfacing laser is an invasive aesthetic procedure, so a small risk of scarring is present.
• Ectropion – The skin around the eyes is sensitive to laser treatments. A poorly perform laser resurfacing near the lower eyelid can cause it to turn out.

Non-ablative laser

• Swelling and redness – With non-ablative technique, these are usually mild and short-lasting.
• Darkening of the skin – Temporary hyperpigmentation can sometimes occur.
• Herpes virus flare-ups – A dormant herpes virus in the skin can become active after laser treatment.

Learn more with the Certificate Courses in Aesthetic Medicine

Read more recent research.

References:

• Taher M, Srivalli N, Yusuf M. Comparative Evaluation of Clinical Outcomes of Laser Skin Resurfacing Using an Ultra-Pulse Carbon Dioxide Laser and Manual Dermabrasion Using a Medium-Grit Drywall Sand Screen for Scar Revision in Adults: A Split-Scar Prospective Study. J Oral Maxillofac Surg. 2019 Feb;77(2):411.e1-411.e8. DOI: 10.1016/j.joms.2018.10.013. Epub 2018 Oct 27. PMID: 30458126.
• Koch RJ. Laser skin resurfacing. Otolaryngol Clin North Am. 2002 Feb;35(1):119-33, vii. DOI: 10.1016/s0030-6665(03)00098-7. PMID: 11781211.
• Tajirian AL, Goldberg DJ. Fractional ablative laser skin resurfacing: a review. J Cosmet Laser Ther. 2011 Dec;13(6):262-4. DOI: 10.3109/14764172.2011.630083. Erratum in: J Cosmet Laser Ther. 2012 Apr;14(2):122. Tarijian, Ani L [corrected to Tajirian, Ani L]. PMID: 22091797.
• Sachdeva S. Nonablative fractional laser resurfacing in Asian skin–a review. J Cosmet Dermatol. 2010 Dec;9(4):307-12. DOI: 10.1111/j.1473-2165.2010.00528.x. PMID: 21122050.