Like it or not, interest in cosmetic treatments and plastic surgery is at an all-time high. However, there is still a lot of misinformation, stigma, and misunderstanding associated with people who choose it. Regardless if they only wanted a wrinkle gone, or did a full-on facial reconstruction, the judgment persists. We at Misumi are of the opinion that we fear what we don’t understand, so today we’ll try to shed light on a specific cosmetic treatment - laser resurfacing.
Not your usual visit to the beauty salon, laser resurfacing is a treatment that’s done under the watchful, professional eye of a dermatologist. Laser resurfacing is mostly used in treating surface skin irregularities, like acne scars, discoloration, blemishes, and wrinkles due to aging or other reasons (such as prolonged stress). Last but not least, laser resurfacing is also used in removing any tattoos that you once desired, but you now regret. You can imagine why laser resurfacing treatments are becoming more and more popular, and why more and more people want to know about them.
The technique consists of employing a specific type of laser that fires short, but regular pulses of concentrated light at the desired area of the skin. These pulsating beams of light, also known as lasers, act in such a way that they only remove a single layer of skin. The technical, medical term for laser resurfacing is lasabrasion, but it is also known as laser vaporization or laser peeling.
Since lasers are basically different modulations of light, they are differentiated by several key features.
The first feature is wavelength, or in other words, the combined width and rate at which the light beam is emitted at the skin. In laser resurfacing, using the correct wavelength is crucial because it is exactly that which allows dermatologists to use the laser efficiently.
One wavelength targets the surface layers of the skin, but another wavelength enables the light to penetrate the lower levels of the skin and target the desired, deep skin layers. The general rule of thumb is that the lower the wavelength, the deeper the laser resurfacing can penetrate. Conversely, the faster the rate of the laser’s pulse, the more precisely it can be used - such as for example small amounts of pigment residue.
Once the light beam hits its target, the target resonates to the light frequency. This, in turn, makes the targeted material become so hot, that it vanishes in a microscopic fiery explosion under the skin. (Yes, you read that right.) While this sounds scary, laser resurfacing inflicts very minuscule amounts of suffering, and it is perfectly bearable for most people that have used the treatment. Basically, it’s like someone using an invisible, immaterial, super thin needle to touch tiny places in your skin and make them disappear. Or, you can think of laser resurfacing like a magician wielding their magic wand over your skin, making all your scars, wrinkles, and blemishes disappear.
But fragments of melanin (which is a skin pigment) aren’t the only target for the light beams of laser resurfacing. It is actually the water molecules inside the skin, connected to all the collagen that holds your skin together. By aiming the laser beam with precision, and at the required wavelengths, dermatologists heat the water molecules at a certain depth in the skin. This doesn’t cause the tissue to vaporize, but instead, the heat tricks the skin to restart its self-repair process, by producing more collagen and smoothing itself out.
At the moment of writing this, laser resurfacing technology recognizes two types of lasers: CO2 lasers, and Erbium lasers. CO2 lasers are the older technology, and at the beginning, patients needed for up to a month to recover from the procedure. That was because the original CO2 laser produced more heat - but modern CO2 lasers are a perfected technology. Called fractioned CO2, contemporary CO2 laser resurfacing methods induce less heat, resulting in shorter recovery time (around two weeks).
Erbium lasers, on the other hand, use a different method for doing the same thing - and burn, hurt, and damage less. They’re mostly used for smoothing over the deeper kinds of wrinkles, but they find use in removing scars and blemishes as well. Erbium laser resurfacing also works better for people with a darker skin tone. Recovery usually takes a week, but as is always the case with these things, you should seek the professional opinion of your dermatologist.
In short, laser resurfacing works like this. A laser beam is fired in short intense pulses over an area of your skin. This laser targets specific anomalies - such as wrinkles, spots, blemishes, scars and so on. The tissue in question becomes vaporized and leaves microscopic empty spaces behind itself. The laser simultaneously heats the water molecules inside the skin, prodding the skin to produce collagen, initiating an intense process of self-repair. The laser burns out the uneven or unwanted tissue formations on your skin, while the self-repair process then smoothes it over. Ingenious, isn’t it?
But what about you - is laser resurfacing a suitable treatment for you? Let’s see.
There’s a short answer, and there’s a long answer. The short answer is that laser resurfacing is an appropriate treatment for any person, of any age, who has blemishes, scars, or wrinkles they want to get rid of. Keep in mind, however, that laser resurfacing works best for fairly shallow skin irregularities - deep scars or deep wrinkles may need repeated laser treatments, or the use of different medical treatments, or employing different skin care routines altogether. Whether young or in a ripe age, it doesn’t really matter. Age is not an obstacle to using the benefits of laser resurfacing.
So what would be an obstacle to trying out laser resurfacing, if anything? Well, several factors are regarded as contraindicated when considering laser resurfacing therapy. First, people with a significantly darker skin tone don’t usually see good results from laser resurfacing. That comes down to the fact that the laser is sort of limited, in a sense - it can burn melanin (skin pigment), but not add it. However, as we mentioned above, the latest generation of CO2 lasers, and especially Erbium lasers, show better results with people with darker skin tone.
The other obstacle to using laser resurfacing is if you’re currently suffering from a case of acne. Since your skin is already suffering, so to speak, from the acne inflammation, it would be unwise to use laser resurfacing at the same time. The intense light will only introduce new micro-wounds inside your skin, making your acne problem much worse, and increasing the likelihood of ending up with severe scars.
Lastly, dermatologists don’t recommend using laser resurfacing for stretch marks. The rationale behind that is logical - stretch marks occur due to the skin being stretched, i.e., it is already damaged. It needs time to recover, and burning new tiny holes inside it won’t improve its appearance or health.
If you’re serious about trying out this procedure, it is always a good idea to schedule a visit to your doctor and dermatologist and ask their professional opinions. They probably know something you don’t, and they’re the authority you should listen to when it comes to undergoing treatments like laser resurfacing. If possible, seek the opinion of a dermatologist or a doctor who have experience with laser resurfacing.
After they take your medical history, current health, and desired results into account, they will be able to determine which laser treatment would work best for you. For example, people who experience fever blisters or cold sores around their mouth may experience the same thing after going under the laser. If you have a history with those skin conditions, please inform your doctor so they will be able to take all the necessary precautions.
Next, your doctor, or dermatologist, will probably order you to stop taking certain pills, medicines, or supplements. Usually, the problematic ones are those that affect the clotting of your blood, like Vitamin E, ibuprofen, or aspirin. Your skin can’t recover if your blood is prevented from doing its job - which is clotting up and closing your wounds. So, in case you’re taking ibuprofen, aspirin and Vitamin E, you will have to stop taking these medications before you undergo your laser resurfacing treatment. Generally, it is enough if you stop taking them 10 days before the treatment.
Another risk factor, and a potential thing to prepare for, is smoking. If you’re a smoker, your skin will find it more difficult to heal. So if you plan to have a laser resurfacing treatment, it is best to stop smoking at least 2 weeks before going under the laser. Why suffer a month and a half of sore skin, when it can heal in a week or two?
Finally, your doctor may decide to prescribe you an antibiotic, in order to prevent bacterial infections. As a preventive measure, you will need to take these antibiotics for a week or several days before your laser resurfacing treatment. Additionally, doctors may sometimes even prescribe you antiviral medication, especially if you are susceptible to breakouts of cold sores or fever blisters.
So, let’s say you read a ton of articles on the subject, consulted with everyone you know, and finally, even your doctor, dermatologist, and plastic surgeon gave you the green light. You took every advice they gave and took all the necessary preparations for your first laser resurfacing treatment. What happens then?
There are several things you might want to keep in mind, which will (we hope) also reduce any anxieties you might have.
The short answer is no. Laser resurfacing is not a heavy, or invasive treatment that requires special medical care. You won’t need to stay in a hospital for a period of time, which makes laser resurfacing an outpatient procedure. The process itself doesn’t inflict any serious wounds that would require medical oversight.
Laser resurfacing can generally take anywhere from 30 minutes to 2 hours, depending on what you are trying to treat. Targeting the occasional wrinkle, blemish, or scar around this body part or another is pretty localized, which means that the procedure will take a short amount of time. However, if you chose to have a full-face laser resurfacing treatment, the process can take 2 hours or more.
Don’t worry - laser resurfacing is a pretty painless process. That’s because doctors often use anesthesia to numb parts of the body when it comes to laser resurfacing. Why? Well, we’re not going to lie - getting thousands of tiny burns inside your skin without anesthesia can be a somewhat painful experience. The pain isn’t unbearable, but it depends on the area of the body that’s treated - the wider the skin being lasered, the greater the pain.
For this purpose, doctors use anesthetics. If the targeted features are few and far between, your doctor will use a local anesthetic to numb your sensitivity there. If you are treating wider areas of skin or entire body parts, for example, your face, the doctor may offer to give you general anesthesia. So, while in reality the procedure is supposed to be painful, you won’t feel a thing because you will be given anesthesia.
After the doctor is done using the laser on the desired areas, the area will be cleaned and bandaged. The bandages are supposed to be removed after 24 hours, after which point you will need to take good care of your sore skin.
It is essential that you clean the area several times a day - doctors recommend doing this at least 4 or 5 times every day. After the cleanup, you will need to apply petroleum jelly (or another type of ointment) as a means to prevent the formation of scabs. Scabs can complicate the benefits of the laser resurfacing procedure. Healing time depends on a combination of factors, such as the area that you treated, the severity of the scars, wrinkles, or blemishes, and the type of the laser used (CO2 or Ebrium). Depending on those factors, the recovery process from taking a laser resurfacing treatment can take anywhere from 10 to 21 days or more.
Furthermore, swelling is a normal reaction as well. Laser resurfacing is a treatment that works with even the deep layers of the skin, so this is an expected reaction. To mitigate this, you can use ice packs. Just put them over the affected area and leave them there for a while. In addition, doctors may prescribe steroids to reduce the swelling of the skin, especially around the eyes. Sleeping in an elevated position, which will make your blood move away from your head and face, can also help with preventing swelling. An extra pillow can be a lifesaver during the recovery process.
Another normal reaction is itching and redness. Around a week after the laser resurfacing treatment, your skin will probably start to peel off and feel dry. This is normal and expected - don’t worry. When that process passes, you will be able to put on some makeup, but you have to make sure it’s oil-free. Many women choose to do that to reduce the redness, but if you’re not too worried about your appearance, you should just let your skin take its time to heal. The redness should completely go away in a couple of months, sometimes three. Again, this is normal, so you can just wait it out.
Finally, your skin will heal itself, and the final result will be a brighter, lighter skin tone. While this may please you, there are a couple of important changes that you need to be aware of. A lighter skin tone makes you more vulnerable to solar UV radiation, leading to vulnerability to sunburns.
To prevent this, doctors and dermatologists recommend that you should use a broad-spectrum sunscreen, which shields you from the sun’s ultraviolet A and B rays. The recommended strength of the sunscreen is at least 30 SPF - so use a sunscreen that guarantees that level of protection or higher. Developing good habits can be of use too. Try not to stay in direct sunlight for a prolonged period of time, especially between 10 AM and 2 PM, when solar radiation is the strongest and most direct. Light clothes and wide hats can also help you protect yourself from the sun.
Finally, after doing your laser resurfacing treatment, your new skin needs to be well moisturized and taken care of. A high quality, naturally based moisturizer is the best option here, as well as skin care solutions that contain glycolic acid or Retin A. However, you shouldn’t rush to moisturize your skin too early in its healing process. This takes some time, so dermatologists recommend that you should begin using moisturizers at least 6 weeks after the laser resurfacing treatment.
As you might expect, today’s market offers a wide palette of choice when it comes to laser resurfacing treatments. Not every laser resurfacing treatment will target, or even affect the same skin problems, so it’s important to figure out the appropriate laser treatment for you. Here is a breakdown of some of the laser resurfacing treatments out there.
The name gives it off - these lasers are best suited for reducing redness on the skin. People turn to anti-redness laser resurfacing treatments in order to get rid of rosacea, sunburns, young stretch marks, reddish scars, wine stains, certain types of red-hued bruises, cherry angiomas (a special kind of red skin mole), spider veins, even some types of basal and squamous skin cancer cells.
So how does anti-redness laser resurfacing work? It targets hemoglobin, one of the main proteins in red blood cells and blood vessels. Two types of lasers - the PDL (pulsed dye laser) and the KDL (using a potassium-titanyl-phosphate crystal to focus light), are used to heat and destroy microscopic blood vessels. These lasers are specifically designed to operate at wavelengths that move through the surface layers of the skin harmlessly, but only remove blood vessels. The fewer the microscopic blood vessels, the lower the redness.
Usually, the lasers used for anti-redness laser resurfacing are almost not painful at all. With the PDL laser there is a skin sensation, for sure, like prickling, but not intense pain. The KTP laser, on the other hand, should feel like a tiny wave of coldness hitting your skin, followed by a short pinching sensation. After the treatment, you should expect your skin to be sensitive, puffy and pink-ish for several hours. Remember, only trust professional, medically certified dermatologists when undergoing any kind of laser-resurfacing treatment.
The price for anti-redness laser resurfacing will depend on your local economy. But usually, it should cost anywhere between $300 and $1000 per session. The price difference is due to the difference in the skin area that you want to be treated.
As the name might tell you, pigment-pulverizing laser treatments target fragments of skin where an increased amount of melanin, the skin pigment, is present. Additionally, pigment-pulverizing laser resurfacing is used in the removal of tattoos made by ink of any type of color.
As with the anti-redness lasers, pigment-pulverizing laser resurfacing treatments employ two broad categories of laser technologies. The Q-Switched lasers (known as Nd:YAG, Alexandrite, the Ruby and more) and so-called Picosecond lasers (product names include PicoWay, Pico Genesis and PicoSure).
The Q-Switched laser is best suited to target specific skin features, such as sunspots, and it often gets rid of them in a single shot. Laser resurfacing by Q-Switched lasers offers a broad selection of wavelengths, making them a suitable option for all skin tones. The Nd:YAG laser is better suited for targeting deeper deposits of skin pigment, which is helpful for people of African American, Indian, Asian, Hispanic and Native American complexions. For people from the Mediterranean area, taking laser resurfacing with the stronger Ruby laser is the better alternative.
But those feeling remorseful for their tattoos shouldn’t worry either - the Picosecond lasers fire at rates even faster than the Q-Switched ones. While the latter lasers fire at a rate of one billionth of a second (a nanosecond), the Picosecond lasers fire acoustic waves 1,000 times faster than that - earning the ‘picosecond’ moniker. The faster the laser pulses - the less heat, pain, and less recovery time. Additionally, the sound waves of the Picosecond lasers are super efficient at deconstructing ink pigments in tattoos too. The complete removal of the tattoos, however, may need several pigment-pulverizing laser resurfacing sessions over the period of a few months.
Is this painful though? As we said, not so much. Having a Q-Switched laser hitting your skin feels like getting slapped by a snapped rubber band. However, when it comes to using a Picosecond laser to remove tattoos, the pain can become palpable and sometimes even unbearable. For this purpose, dermatologists usually apply a local or general anesthetic, depending on the area of the skin that’s being treated.
But how long does it take to recover from a pigment-pulverizing laser resurfacing procedure? Well, your skin will be pretty bruised by this treatment. Initially, it will turn pink or white and irritated, forming a dark, purple scab later as the skin heals itself. This scab should be left alone to do its work. After a week or so, it will fall off on its own, revealing healthy, clear skin below. For people who are removing their tattoos, the wounds by the pigment-pulverizing laser resurfacing treatment will become less intense with every subsequent procedure. This is because the pigment is less and less - which creates fewer and fewer explosions. After a week or so, your skin should be fine.
Before you decide to use a pigment-pulverizing laser resurfacing method, however, make sure that you are in good, experienced hands. Doing so will help you avoid some of the side-effects associated with this sort of laser treatment, like hyperpigmentation (unintended darkening of the skin due to inflammation) or hypopigmentation (your skin becoming too light from overdoing the laser).
You should expect the price for pigment-pulverizing laser resurfacing treatments to go around $300 to $1000 per session, relative to the area being treated.
Non-ablative lasers are designed to treat light scars, melasma (grey or brown patches on the skin), or often times, moderate sunburns or sun damage.
So what is non-ablative laser resurfacing? If you recall, the anti-redness and pigment-pulverizing lasers work in a way that they heat up specifically targeted tissues in the skin and destroy them. That makes them somewhat mild ablative lasers (more on proper ablative lasers later), which stands for “removal” in medical jargon. So, by contrast, non-ablative lasers are non-removal lasers. The cool thing is that ablative lasers can work as non-ablative ones just by attaching a so-called diffractive lens. The lens reduces and spreads out the intensity of the laser, enabling this non-ablative laser resurfacing method to only heat up the targeted tissues instead of vaporizing them.
This method doesn’t inflict any skin damage or wounds, but still makes the skin restart its rejuvenating processes and produce more collagen. Picosecond lasers create a vibration rather than heat, producing much the same effect.
Note, however, that this doesn’t mean that the treatment is entirely painless. These lasers can induce sensations of zapping, or static electricity shocks accompanied by intense heat. Doctors and dermatologists would often apply a local numbing cream, and even painkiller medications like ibuprofen and acetaminophen beforehand to make it a bearable experience. However, since the treatment doesn’t actually damage the skin, recovery takes much shorter. Non-ablative laser resurfacing delivers intense vibrations and heat, and the skin can recover from this within a single day, up to a week.
Non-ablative laser resurfacing is a bit pricier than the aforementioned anti-redness and pigment-pulverizing laser treatments. Depending on the area treated, the type of laser and diffractive lens, non-ablative laser resurfacing treatment can cost anywhere between $500 to $2500.
Ablative lasers, contrary to non-ablative ones, don’t spare your skin. However, that is exactly what makes them perfect for treating more severe skin features, such as severe sun damage, large scars, and deep wrinkles.
The heat that an ablative laser resurfacing treatment produces are more intense than all the previous types of lasers. While anti-redness laser resurfacing and pigment-pulverizing laser resurfacing treatments are technically ablative, their energy output and tissue damage are negligible when compared to the ablative method. The ablative lasers are specifically designed to create intended wounds in the skin and the surrounding tissues. This simultaneously reorganizes your tissues and provokes the body in super-recovery mode at the same time. The intentional tissue removal, combined with the flood of collagen, makes ablative laser resurfacing a powerfully efficient, but very slow and intensely painful method for skin rejuvenation.
Is it painful? Well, in reality, yes, but you’ll be so anesthetized and numbed down that you won’t feel a thing. Valium, Percocet, nerve-numbing lidocaine injections and numbing creams are the preferred tools of the doctors and dermatologist during ablative laser resurfacing.
And the recovery time? At least a few weeks, up to a month or two. You won’t look very different from a burn victim after trying ablative laser resurfacing, your face painful, swollen, sore and scabby. However, despite the looks, doctors assure patients that the recovery period is surprisingly painless. So, put yourself in the hands of a professional and all will be fine.
Pricing for ablative laser resurfacing treatments is similar to the non-ablative ones, if not a little more expensive. Treatments begin at $500 for the area around your mouth, and from then on - the sky is the limit, depending on the area you want to be treated.
Well, that about wraps up our ultimate guide to laser resurfacing. Please note that as new technology becomes available, we update our articles accordingly. Feel free to check back after a while, and in the meantime - keep being brave! Laser resurfacing is an efficient, and very safe method for removing unwanted skin features - especially when done by professionals. Always make sure to consult with your doctor and dermatologist before making a decision, and good luck!
This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances, and its goal is to offer a general view of the subject. In case you are suffering from a severe case of acne, you should consult with a dermatologist or a certified medical professional.