If aging, acne, or too much time in the sun has left your face with blotches, scars, wrinkles, or lines, laser skin resurfacing may help your skin look younger and healthier.
Laser skin resurfacing also known as laser peel, laser vaporization or lasabrasion, removes skin layer by layer with precision. The new skin cells that form during healing give the skin a tighter, younger looking surface. The procedure can be done alone or with other cosmetic surgeries on the face.
Who Is a Good Candidate for Laser Skin Resurfacing?
If you have fine lines or wrinkles around your eyes or mouth or on your forehead, shallow scars from acne, or non-responsive skin after a facelift, then you may be a good candidate for laser skin resurfacing. You may also be a good candidate if you have:
- Age spots or liver spots
- Skin scars from birthmarks
- Sun-damaged skin
- Enlarged oil glands on your nose
- Birthmarks such as linear epidermal nevi
You may not be a candidate for laser resurfacing if you have:
- Excessive or sagging skin
- Deep wrinkles
- Active acne
- Pregnant or breastfeeding
- Weakened immune system
- Deeper skin tone
if you have very dark skin, some laser resurfacing techniques could cause inflammation or discoloration after the treatment. It’s worth noting that deeper skin tones also have the potential for keloid scarring.
Your dermatologist may use the Fitzpatrick scale, which matches the pigment level (melanin) in your skin to your risk of sun damage and skin cancer. The scale ranges from 1 to 6. If you have very brown skin, you may be a 5 or 6 on this scale. This rating also means you have less potential risk for skin damage. However, everyone has some type of risk of skin cancer.
Overall, you should discuss whether laser resurfacing is right for you by consulting with the doctor before having the procedure done.
Types of Laser Resurfacing
CO2 Laser Resurfacing
This method has been used for years to treat different skin issues, including wrinkles, scars, warts, enlarged oil glands on the nose, and other conditions.
The newest version of CO2 laser resurfacing (fractionated CO2) uses very short pulsed light energy (known as ultrapulse) or continuous light beams that are delivered in a scanning pattern to remove thin layers of skin with minimal heat damage. Recovery takes up to two weeks.
If you are a person of color, this type of laser resurfacing could cause hyperpigmentation or scarring.
Erbium Laser Resurfacing
Erbium laser resurfacing is designed to remove surface-level and moderately deep lines and wrinkles on the face, hands, neck, or chest. One of the benefits of erbium laser resurfacing is minimal burning of surrounding tissue. This laser causes fewer side effects -- such as swelling, bruising, and redness -- so your recovery time should be faster than with CO2 laser resurfacing. In some cases, recovery may only take one week. Ask your doctor how long recovery is likely to take for you.
If you have a person of color, erbium laser resurfacing may work better for you. However, there is always the risk of skin discoloration after the treatment.
Neodymium Yag Laser
If you have darker skin tones (4 to 6 on the Fitzpatrick Scale), you may want to consider a laser called Neodymium Yag or Nd:YAG. This type of laser has a longer wavelength that goes deeper into the skin, effectively bypassing the melanin in the upper layers of your skin. Here are some reasons to use this laser treatment:
- Facial or body hair removal
- Tattoo removal
- Birthmark removal
- Inflammatory acne
- Vascular reduction
You may have to have more sessions because your practitioner will generally start at a lower setting. They may also adjust the temperature of the laser, to make it cooler and more comfortable for you.
Keep in mind that the risk of injury from laser therapy can happen with any skin tone. So you want to be comfortable and confident about who is administering the laser treatment. Choose a board-certified dermatologist or expert who is familiar with treating different skin tones.
Sometimes called a vascular laser, pulse-dye lasers are used to treat skin issues related to your blood vessels. This is a good option is you have issues with reduce redness, hyperpigmentation, broken capillaries, and rosacea. The lasers are typically non-ablative and use a concentrated yellow light to heat the skin and absorb pigments.
Fractional lasers target only a fraction of the skin at a times. This option can be used to treat a number of age-related blemishes, get rid of hyperpigmentation, acne scars, and wrinkles. The laser energy is broken into thousands of tiny beams to treat only a fraction of the skin in the area, which reduces downtime. Fractional lasers can be ablative or non-ablative.
IPL (intense pulsed light)
Technically, IPL (intense pulsed light) treatments are not lasers but are often used to treat several of the same skin issues as lasers. The technique uses light energy to target a certain color in you skin. It can be used to help repair scarring, sun damage, stretch marks, acne, rosacea, birthmarks, and hyperpigmentation, as well as to get rid of unwanted hair.
Preparing for Laser Resurfacing
Start by consulting a plastic surgeon or dermatologist to find out if you're a good candidate.
Tell your doctor if you get cold sores or feverblisters around your mouth. Laser skin resurfacing can trigger breakouts in people who are at risk.
If you decide to go ahead with laser skin resurfacing, your doctor will ask you to not take any medications or supplements -- such as aspirin, ibuprofen, or vitamin E -- that can affect clotting for 10 days before surgery.
If you smoke, you should stop for two weeks before and after the procedure. Smoking can prolong healing.
Your doctor may prescribe an antibiotic medication beforehand to prevent bacterial infections and also an antiviral medication if you are prone to cold sores or fever blisters.
What to Expect During and After the Procedure
Laser resurfacing is done by a plastic surgeon or dermatologist. It's an outpatient procedure, meaning you'll not have to stay overnight.
The doctor may treat wrinkles around your eyes, mouth, or forehead individually or treat your entire face. For small areas, the doctor will numb the areas to be treated with a local anesthetic and may also sedate you. You may require general anesthesia if your whole face is being treated.
Treating just parts of the face takes about 30 to 45 minutes. A full-face treatment takes up to two hours.
Following the laser procedure, the doctor will bandage the treated areas. After 24 hours, you will need to clean the treated areas four to five times a day and then apply an ointment such as petroleum jelly to prevent scabs from forming. Your doctor may also want you to apply a cool compress or a wrapped ice pack for 15 minutes every one to two hours as needed, during the first 24 to 48 hours.
Swelling after laser skin resurfacing is normal. Your doctor may prescribe steroids to manage swelling around your eyes. Sleeping on an extra pillow at night can also ease swelling.
You may feel itching or stinging for 12 to 72 hours after the procedure. Five to seven days after laser resurfacing, your skin will become dry and peel.
Depending on the problem that was treated, healing typically takes 10 to 21 days. Once the skin heals, you can wear oil-free makeup to minimize redness, which usually fades in two to three months.
You will also probably notice that your skin is lighter for a while after surgery. It is particularly important that you use a "broad-spectrum" sunscreen, which screens ultraviolet B and ultraviolet A rays, to protect your skin during that time. When selecting a sunscreen, look for one specially formulated for use on the face with a 7% (or higher) zinc oxide content and a sun protection factor (SPF) of 30 or higher. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m., and wear protective clothing, such as long-sleeved shirts, pants, and a wide-brimmed hat. Reapply your sunscreen every two hours when you are out, and more often if you are sweating or swimming.
It is also important to keep your new skin well moisturized. If you use Retin A or glycolic acid products, you should be able to start using them again after about six weeks or when the doctor says you can.
Benefits and Risks of Laser Resurfacing
Although skin resurfacing cannot produce perfect skin, it can improve the appearance of your skin. Potential risks of the procedure include:
- Burns or other injuries from the laser's heat
- Changes in the skin's pigmentation, including areas of darker or lighter skin
- Reactivating herpes cold sores
- Bacterial infection
Cost of Laser Skin Resurfacing
The average cost for laser skin resurfacing was about $2,509 for ablative and $1,445 for non-ablative laser skin resurfacing in 2020, according to the American Society of Plastic Surgeons. However, costs vary widely depending on where the procedure is being done.
Because laser skin resurfacing is considered a cosmetic procedure, most medical insurance companies will not cover it. There may be an exception if you get the procedure to modify scars or remove precancerous growths on your skin.
Talk with your doctor and your insurance company before the procedure about what the costs will be and what, if anything, insurance will pay for. Most doctors offer financing options.