Medical research shows that there are, in fact, two distinct types of skin aging. Aging caused by the genes we inherit is called intrinsic aging. The other type of aging is known as extrinsic aging and is caused by environmental factors, such as exposure to the sun’s UV light.

There are few treatment modalities for aging skin and one of the well-known treatments is laser resurfacing. For most people, the significant downtime involved in undergoing an invasive laser resurfacing procedure to reverse the signs of aging skin is not realistic given today's busy, deadline-driven lifestyle. Recently with the advancement of scientifically developed new minimally invasive laser skin resurfacing technologies patients can get noticeable improvements without spending weeks under wraps, as was common with invasive treatments.

Ablative laser skin resurfacing

These treatments are 'ablative'. This means that the laser beam will remove the top layer of the skin similar to chemical peel. When the skin heals and grows back it should do so without the blemishes, wrinkles and scars which were previously there. See example of treatment results in the pictures below.

Treatment results of CO2 Laser skin resurfacing
Eyes wrinkles before CO2 Laser treatment Eyes wrinkles after CO2 Laser treatment
Wrinkles around the mouth before CO2 Laser treatment Wrinkles around the mouth after CO2 Laser treatment
Before Ablative Laser CO2 treatment After Ablative Laser CO2 treatment

Ablative lasers vaporize the skin away, and can result in some substantial downtime see picture below. Examples of ablative lasers include CO2 and Er:YAG.

CO2 laser skin resurfacing results after 4 days

CO2 laser skin resurfacing results after 4 days

A local anesthetic may be used for the treatment and the patients’ eyes must be protected with specially designed goggles. The treatment may take between 30 - 45 minutes, and there may be some pain.
The skin care regime in the week following the procedure is demanding and it is extremely important that it is adhered to rigidly. The regime will consist of rigorous cleansing of the skin every 2-3 hours initially and thorough moisturizing using prescribed products. The skin will remain red for approximately 6 months post treatment and must be protected from the sun for a year.

Fractional Laser Skin Resurfacing

Currently one of the most popular new laser technologies being used to treat aging skin is fractional laser skin resurfacing.
As opposed to traditional ablative laser resurfacing techniques which treat the whole surface of the target tissue, fractional laser uses fractional photothermolysis. Fractional technique targets tissue with a pattern of dispersed spots which results in microscopic zones of tissue coagulation that heal over several weeks while the skin retains ‘normal’ appearance.

Fractional laser skin resurfacing pattern on the skin

Fractional laser skin resurfacing pattern on the skin

Rather than creating a global tissue effect at the surface of the target tissue, or in the dermis alone, this method creates injury in a tiny fraction of the treated skin, coagulating multiple columns of tissue, 70-100 micron in diameter, extending through the epidermis and deep into the dermis reaching up to 1 mm depth. These laser columns create micro thermal zones of tissue coagulation which is surrounded by healthy tissue.

Fractional Laser Skin Resurfacing – Skin appearance immediately after the treatment

Fractional Laser Skin Resurfacing – Skin appearance immediately after the treatment

Tissue is not vaporized and the stratum corneum remains intact. The healthy tissue provides a generous reservoir of stem cells, fibroblasts and other reactive cells in the papillary dermis that are spared from wounding and accelerate the healing process. The small size of the wounds and the short migratory paths for keratinocytes from the spared tissue result in rapid reepitheliazation and fast epidermal repair. Zones of collagen denaturation in the dermis cause upregulation of the inflammatory cascade, which leads to collagen remodeling to depths of 400-700 microns resulting in skin tightening.

Fractional Laser Skin Resurfacing – Skin appearance 3 days after the treatment

Fractional Laser Skin Resurfacing – Skin appearance 3 days after the treatment

The fact that patients do not have open wounds leads to minimal downtime. Fractional laser rejuvenation and even resurfacing is therefore a minimally-ablative procedure offering a gentle yet effective method for skin resurfacing at minimal patient downtime. It offers improved skin texture, tone, pigmentation, fine lines and skin tightening. It is safe for all skin types and can be used on areas other than the face such as the neck, chest and hands which are more delicate and tend to scar. Fractional treatment requires a series of 3-5 treatments as opposed to ablative lasers that require a single treatment.
Skin resurfacing with fractional photothermolysis is rapidly gaining acceptance for a variety of conditions including the treatment of rhytides, acne scars, facial and nonfacial photodamage, melasma, scars, and striae.
Fractional Laser Skin Resurfacing – Before and after treatment

Fractional Laser Skin Resurfacing – Before and after treatment

Fractional Laser Skin Resurfacing UV picture

Fractional Laser Skin Resurfacing UV picture – Before and after treatment showing removal of age spots and freckles

Who should not go for Laser Skin Resurfacing?

Candidates with olive skin, suntanned or black skin are more vulnerable to side effects and if they choose to perform the procedure it will take more than a year to regain their normal pigmentation after laser skin resurfacing. Others who do not make good candidates include those who are prone to scarring. Only a licensed doctor and trained in the procedure can evaluate the risks in performing laser skin resurfacing and determine if you are a candidate for the treatment.

The Cost of Laser Skin Resurfacing

According to the American Society of Plastic Surgeons, in the US the average surgeon's fee for ablative laser skin resurfacing is $2,200. For non-ablative laser skin resurfacing, the national average physician’s fee is $1,350.
This only includes the physician's fees, and is only for one treatment session. Multiple sessions may be needed. These fees also do not include anesthesia, operating room facilities or other related expenses.

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