Laser Resurfacing

Skin resurfacing provides significant and long lasting improvement of sun damaged, unevenly pigmented or coarsely wrinkled facial skin. Usually you will undergo a single procedure rather than the series of treatments commonly recommended for milder skin revitalising techniques. Laser skin resurfacing is a popular technique. Like other resurfacing methods, the laser is effective in treating wrinkles, blotchiness or age spots, and scars from acne or other causes. It can be used on the entire face or specific areas. The laser also has a mild tightening effect on the skin, particularly in the lower eyelid area. There are a variety of lasers in use today. Dr scamp can advise you about the specific treatment that would be most effective in meeting your goals. A few days following laser resurfacing your new skin emerges. Its bright pink colour will fade over the next few months and in the meantime, may be covered by makeup. In most cases, you should be able to return to work within a week or two.

There are a number of possible complications, the major ones are listed below:

SENSATION OF TIGHTNESS

This is quite common in the first one to two months after treatment. Use of specific moisturiser creams can help to relieve this and it is generally not something to be concerned about but is expected as part of the process.

MILIA

These are small obstructed oil glands in the skin. They can occur normally or after laser resurfacing. They are usually not a major problem and respond to “de-roofing” with a small needle.

RECURRENCE OF LINES

It is not possible with the laser to remove all lines on the face without inflicting a burn to a depth that has a substantial risk of causing scarring. The philosophy of treatment is that it is best to accept remaining lines rather to run the risk of major scarring. In general an 80% improvement is hoped for, but may be less than 50% with acne scarring.

ACNE

Both the swelling and the use of occlusive dressings and creams may exacerbate acne after treatment. Usually, after approximately 6 weeks of treatment, recommencement of Retin A is possible to help control this.

SYNECCHIA

These are small webs of skin that occur as the skin heals. They are uncommon and are usually not much of a problem. They occasionally require gentle removal.

SKIN ERUPTIONS

Laser resurfacing may cause an outbreak of cold sores (herpes). These can affect any area that has been resurfaced and are more common in patients who have a history of cold sores. They can, however, occur with anybody.

These outbreaks can result in skin scarring and it is therefore recommended that you take anti-cold sore medications for a period of approximately ten days around the time of resurfacing. These medications are supplied to you by our rooms. Infections may result in the skin after laser resurfacing. These may be fungal or bacterial in origin. Antibiotic tablets or antibiotic or antifungal cream may be required if these arise.

DERMATITIS

Skin that has been resurfaced is very sensitive and prone to allergic reactions. Dermatitis that results in this way usually responds to topical steroid creams.

PIGMENTATION DISTURBANCES

Resurfacing the skin may result in dark patches or a general darkening in the colour of the skin. This is particularly true if sun exposure occurs within the first few months after the resurfacing or if you are of a darker skin type. Utmost care to prevent sun exposure is required and Retin A is usually recommenced 6 weeks after resurfacing.

Subsequently, chemical peels or other topical medications may be required to help fade this pigmentation, but it is rarely permanent. Conversely pale patches (hypo pigmentation) or a general paling of the treated skin may result after laser resurfacing. This is uncommon and it occurs in approximately 1 in 50 patients. Deeper treatments to eradicate resistant lines are more prone to this problem.

OBVIOUS BLOOD VESSELS

Laser treatment does not lead to large blood vessels appearing on the face. It can, however, expose the underlying spider veins as the pigmentation fades with treatment. Treatment with a different laser can often improve these vessels.

SCARRING

Scarring occurs in less than 1% of patients treated for laser resurfacing. Treatment with steroid injections may be required and it may take a year or more for these scars to fade. Permanent scarring is a small but definite risk.

FADING OF THE LIP

The redness along the lip border may fade with treatment from the laser around the mouth. This is generally easy to mask with lipstick.

ECTROPION

Treatment of lower eyelids with laser resurfacing may cause a tightening in the skin below the eyelids in the lower lid being pulled down. This is uncommon and usually settles spontaneously, but it may take up to four months to do so. A support procedure (lateral canthopexy) may be recommended to reduce this risk.

Report to Dr Scamp if you have any of these unexpected side effects or any other concerns regarding a possible side effect from treatment:

* Fever (more than 38°) or chills

* Increasing pain or redness in the treated area

* Any other problems or concerns