|
Laser facial resurfacing
This factsheet is for people who are considering having laser
facial resurfacing.
Laser facial resurfacing is a technique that can remove the upper
layers of the skin on your face using a laser. This can improve
the look of your skin without having full cosmetic surgery. It
can be a very effective treatment for reducing mild scarring,
or the effects of sun damage, such as fine wrinkles.1
What is laser facial resurfacing?
A laser is a beam of light radiation, which delivers intense
energy to a specific area of skin. This destroys the surface layer
of skin in a carefully controlled manner, exposing the lower layer
(the dermis, which is pink). Then, at lower power, the laser heats
the dermis, which stimulates the growth of new collagen fibres.1
As the wound heals, new skin forms that's softer and less wrinkled
or scarred.2
For deeper wrinkles, parts of the dermis can also be removed.
There are several different types of laser, each with advantages
for certain types of treatment.
Pulses of laser light can be used to treat skin lesions such
as port wine stains and spider veins. These lasers can also be
used to remove the colour from tattoos and do not seriously damage
the surrounding skin.3
Carbon dioxide or YAG lasers (YAG is the type of crystal that
is used to generate the laser) are often used for resurfacing
procedures.1,3
Illustration showing the three layers of skin
Why have laser facial resurfacing?
Laser facial resurfacing can improve the appearance of your skin
and is most effective for:
- removing superficial wrinkles
- tightening your skin
- evening out pigmentation (colouring)
- smoothing rough skin
- improving the look of shallow acne or chicken pox scars
The laser can be directed on problem areas, for example wrinkles
around your eyes, mouth or nose, or the whole surface of your
face can be treated.
Laser facial resurfacing can cause changes in the pigmentation
of your face, which means that doctors do not normally use laser
techniques on dark skin. Surgery may be advised instead.
What are the alternatives?
Fine wrinkles and some of the milder signs of ageing skin can
be improved with creams and gels. Chemicals related to vitamin
A such as tretinoin (eg Retin A cream) and chemical peels containing
alpha-hydroxy acids (eg glycolic and lactic acids) are commonly
used for this.1
Laser facial resurfacing generally isn't suitable for treating
the neck, or very deep wrinkles, sagging skin and extra fat. A
surgical facelift is a more suitable option.4
Excess skin around the eyes can be treated with cosmetic eyelid
surgery.4
What happens before laser facial resurfacing?
Your surgeon will discuss how to prepare for your operation.
For example, you may be asked to give up smoking as this increases
your risk of infection and slows the healing of wounds.5
Before treatment you will talk to your doctor about the procedure
and you will usually be asked to sign a consent form. This confirms
that you understand the risks, benefits and possible alternatives
to the procedure and have given your permission for it to go ahead.
Your doctor can perform laser resurfacing in his or her clinic
or in an operating room, depending on the amount of treatment
needed and type of anaesthetic. It is often done as a day-case,
which means that you can have the operation and go home the same
day.
The treatment
Laser facial resurfacing is usually done under a local anaesthetic
which numbs the area but you will be awake. If needed, your anaesthetist
can also give you an injection of a sedative, which will make
you feel relaxed and possibly drowsy.
If you are having your whole face treated or having another cosmetic
procedure, such as eyelid surgery, done at the same time, a general
anaesthetic may be preferable. This means that you will be asleep
throughout the procedure and will feel no pain.
Before treatment begins, your face will be cleaned thoroughly.
Your surgeon will then pass a laser beam over the treatment area,
with precise control over how deep the laser penetrates.
The procedure lasts from a few minutes to an hour or so, depending
on the size of the area being treated.2
After the treatment
After treatment, your face is likely to be covered with antibiotic
ointment. A dressing may be put on the treated area too, or it
may be left uncovered.4
Your operation will usually be a day case and you will usually
be able to go home once you have made a full recovery from the
anaesthetic. If you have had a general anaesthetic, you will need
to arrange for a friend or relative to drive you home and stay
with you for 24 hours.
Before discharge, your surgeon will give you advice about how
to care for your skin as it heals.
Recovering from laser facial resurfacing
Your will need to wash your face several times a day with a gentle
cleanser, and apply antibiotic ointment or cream to aid healing.
To help ensure the skin heals quickly with good cosmetic results,
it is important to do the following.
- Stay out of the sun. If you need to go out, apply a sunscreen
with a SPF factor of at least 25, and with both ultraviolet
A and B protection. You should use sun screen for at least six
months after treatment.2,4
- Avoid making exaggerated facial movements.
- Moisturise your skin frequently with a simple preparation
such as aqueous cream.2 This will keep the skin supple and help
to prevent it drying out.
- Wash your hair with a mild baby shampoo to avoid irritating
your skin.
Deciding on treatment
It is important not to rush into the decision to have any cosmetic
treatment. And, it is sensible to discuss the options with your
GP, who may be able to recommend reputable surgeons or give advice
about how to choose which hospital to be treated in.
Laser facial resurfacing is a commonly performed and generally
safe procedure. However, in order to give informed consent, anyone
deciding whether or not to have this procedure needs to be aware
of the possible side-effects and the risk of complications.
Side-effects are the unwanted but mostly temporary effects of
a successful procedure. For laser resurfacing, side-effects include:
- discomfort from the treated area until it has healed2
- swollen skin that may ooze for the first 7-14 days after treatment1
- skin redness that may last for 6-12 weeks1,4
- scabs forming as part of the healing process1
It can take 10 days or more for the skin to heal, and two to
six months for the redness to fade completely.4 You
can use make-up to disguise the redness.
Complications are unexpected problems that can occur during or
after the procedure. Most people are not affected. Specific complications
of laser facial resurfacing are uncommon but can include those
listed below.
- Skin infection.1
- Reduction or increase of facial pigment.1,4
- Scarring - this is rare with normal skin but the risk increases
for people who have recently had radiotherapy in the same area,
who are prone to keloids (overgrown scar tissue at the site
of an injury) or have recently had a course of the acne medicine
isotretinoin (Roaccutane).1,4
- Cold sores can be reactivated, but preventive medicine such
as acyclovir (eg Zovirax) taken in tablet form can help to stop
this happening. Your surgeon will advise you whether this is
necessary.4
You should bear in mind that although wrinkles or scars may subside
after only one laser session, more sessions may be needed to complete
the therapy. Also, the effect of laser resurfacing on wrinkles
is not permanent, since the ageing process continues as normal
after the procedure.
References
- Stratigos AJ, et al, Advances in cutaneous aesthetic surgery.
JAMA 1998;280:16.
- MayoClinic.com, Laser resurfacing: One way to treat wrinkles.
www.mayoclinic.com
accessed 31 March 2005
- Alam A. Aesthetic surgery: coming of age. The Lancet 2000;356:S60.
- British Association of Aesthetic Plastic Surgeons (BAAPS),
Lasers in plastic surgery.
www.baaps.org.uk
accessed 31 March 2005
- Smoking and wound healing. Am J Med. 1992 Jul 15;93(1A):22S-24S.
Published by BUPA's health information team, healthinfo@bupa.com,
July 2005
|
