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Information About Laser Skin Resurfacing

HALO laser skin resurfacing technology provides patients with significant results and minimal downtime.

Laser skin resurfacing for changes associated with sun damage and aging has grown significantly in popularity. The aesthetic market has experienced a surge in this segment due to innovative technologies and their successful outcomes.

Lasers deliver energy to the treatment area at specific wavelengths and can target pigment, red areas, or water contained in tissues. The laser energy produces heat within the targeted tissue which leads to the improvement in appearance. With earlier laser devices it was necessary for patients to attend multiple sessions and the recovery time was extensive.

Recently, HALO laser skin resurfacing treatments have become the preferred technology of many physicians for the treatment of a variety of dermatological problems which include: sun damage/ dyschromia, signs of aging, enlarged pores, discoloration, fine lines on the face, poor texture, scars, and uneven skin tone. This cutting edge technology gives physicians the ability to customize treatment for each individual patient based on the desired effects. In addition, the method is safe, easy, and has less discomfort compared to older technology. As a result, patients generally require fewer prescribed treatments, and their recovery time is minimalized.

If you are considering HALO or a traditional laser skin resurfacing here is some information that will be helpful in making your decision.

Potential Side Effects from Laser Resurfacing Procedures

In some cases patients will experience temporary side effects from a laser resurfacing procedure. Potential complications commonly experienced are acute skin reactions like itchiness and redness. These occur as a result from the heat of the laser on the skin. It can take a few days for these reactions to subside.

While burns, blisters, and infections may occur with any laser resurfacing procedure, these are relatively rare with HALO, especially when utilized by an experienced physician familiar with the appropriate settings.

Most skin types can be treated with HALO. Gentler settings are used for darker skin types to minimize the risk of post inflammatory hyperpigmentation (PIH). Therefore, darker skin types often will require a higher total number of treatments for optimal results. Hypopigmentation (lighter areas) was relatively common with the earliest CO2 laser resurfacing devices in the 1990s, but this is exceedingly rare with fractionated resurfacing lasers like HALO.

Misunderstandings About Aesthetic Laser Resurfacing

  1. The stronger the laser the better.

Some people believe the myth that the redder their face is, the better the treatment. This is incorrect. Redness occurs from over- stimulation by the laser energy. Your dermatologist physician specializes in the treatment of skin and will know your dermatological tolerance. While they preform your treatment, the physician is paying close attention to how your skin is reacting and will determine the depth and energy level of treatment for each session. Treatments are usually spaced 4-6 weeks apart.

  1. Why do I need more than one treatment?

Deeper pigment is more stubborn and will require more time to treat while superficial pigment can be removed by the laser more easily. Your physician can educate you on your pigmentation and help you understand what to expect for a prescribed treatment.

  1. Should I avoid the sun while I am undergoing resurfacing treatment?

Although daily sun protection is advised in general, sun protection is critical one month before and during the days of recovery after treatment. Strict daily application of zinc containing sunscreen, sun avoidance, or physical barrier protection during these periods will help minimize the risk of postinflammatory hyperpigmentation (PIH).

  1. Lasers will cause my skin to thin.

This is incorrect. Today’s lasers do not have the ability to cut or burn layers of skin. In many cases, today’s technologies actually generate skin growth through the production of new collagen and will cause the skin to feel more firm!

AboutSkin Dermatology provides many laser skin resurfacing solutions. Our experienced physicians and supportive staff are here to help answer questions and guide you to the best option for your skin. Call us and schedule your appointment today!

 

 

Laser Resurfacing for Lines on Lips“What can we do about the lines on my lips? I’ve never been a smoker, but they are just getting deeper.”

 

 

Laser Skin Resurfacing for Lines Under eyes“I found this cream at the store that covers the lines under my eyes pretty well – but, is there something better we can do for this?”

 

 

Bumpy Texture on Cheeks“I’m starting to notice these lines and bumpy texture on my cheeks.  I used to only see them when I smile, but now they are there all the time.  Can we just do some Botox here?”

 

All of these questions were posed to me earlier this year by my mom, who I’ve treated over the past 12 years with various combinations of botulinum toxin, fillers, and chemical peels (she is 63).  Like most of the patients I see, she regrets all the time she spent as a young woman laying out on the lawn in the Minnesota sun.  When I first started treating my mom she had decent skin texture and minimal lines at rest.  The volume changes, folds, and lines that she did have responded well to injectable filler and botulinum toxin; her pigmentation evened out nicely with chemical peels and intense pulsed light (IPL).

A few years later, as she began to develop etched in lines, I performed a series of fractionated laser skin resurfacing procedures with nice reversal of these mild early changes.

Laser Resurfacing Procedure
“After a single fully ablative Erbium laser resurfacing procedure, she was able to reverse the clock by a few years and is very pleased with her results.”

Later, the inevitable signs of aging, particularly loss of elasticity and collagen, caught up to her, and the etched in lines and texture changes became more prominent.  For her to see the degree of improvement she wanted, I explained she would have to consider a more aggressive laser resurfacing procedure, the fully-ablative Erbium laser.  She certainly wasn’t excited about laying low for nearly 2 weeks (and she even had some regrets 3-4 days into her recovery – it’s not easy), but she now says she’s so pleased with the results and is so happy she did it.

 

As winter approaches, this is the perfect time to consider a laser resurfacing procedure;  lower temperatures and decreased sunlight exposure make for a more comfortable recovery and improved outcome.  In the next three blog posts I will be reviewing the latest technologies and applications of laser resurfacing.

Achieving flawless, smooth skin is the holy grail of any skin rejuvenation program.  Unfortunately, perfect skin will always be as elusive as the holy grail itself.  Fortunately, though, we live in a time when there are new technologies and devices entering the marketplace, each one inching us closer in our quest for youthful skin.  Laser resurfacing is usually a critical component in a person’s skin rejuvenation regimen.

Laser devices have been used for the improvement of the signs of aging and sun damage since 1989.   Nothing is more effective than laser resurfacing for all-around improvement in fine lines and wrinkles, texture, pigment, pores and scars due to acne or surgery.

So, how does laser skin resurfacing work?

During the laser resurfacing procedure laser energy is absorbed by water in the skin leading to either vaporization or heat damage within the superficial and deeper skin layers.  Collagen and elastin, damaged over years of sun exposure and normal skin aging, is removed and replaced by the body’s wound healing response with new, healthier collagen and surface epithelium.   The result is smoother, brighter, and overall younger-looking skin.

Many patients considering laser resurfacing on the face express concern that their face will appear white compared to their neck.  It is true that many patients undergoing this in the 1990’s experienced this—when the fully ablative CO2 laser was first widely used.  Today, with the advent of newer laser technologies like Erbium fully ablative laser, fractional ablative, fractional nonablative, and hybrid fractional laser, there is speedier recovery and greatly reduced risk of pigment change and scarring.

Laser skin resurfacing is just one component of a complete rejuvenation plan.  Fillers, chemical peels, microdermabrasion, botulinum toxin, laser resurfacing, skin resurfacing products, and topical products (especially daily sun protection, nightly retinoid, and daily antioxidants) all focus on unique features of aging and combine to give a natural and optimal results.

In part two of this blog series I will review the different types of laser skin resurfacing.  At Aboutskin Dermatology we have acquired the latest technologies from each of the laser resurfacing categories.  What that means for you is a broad-array of options and a personalized approach to your skin rejuvenation goals.

 

Laser skin resurfacing has been refined significantly since it was first introduced. Early problems such as pigment loss in the treated areas are nearly unheard of these days. The way that laser energy is delivered to the skin with modern devices allows for excellent clinical results with decreased healing time and overall decreased risks.

Laser skin resurfacing is categorized in different ways, and to someone not familiar with the different options, it can be confusing and overwhelming. Adding to the confusion is the fact that there are many different laser manufacturers, each of them marketing their particular device as “the best” for wrinkles, pigment, sun damage, etc. I want to try to simplify this by reviewing the basic categories of laser resurfacing. Remember that each category will have many different devices on the market, all with similar functions. This review should help you to narrow down your options when deciding on a laser resurfacing procedure.

The first categories to review are ablative versus non-ablative laser resurfacing.

Ablative laser resurfacing of the face for sun damage and aging was first performed with a Carbon Dioxide (CO2) laser in 1989. The target of ablative lasers is water contained in the skin; when heated by laser energy the skin tissue is vaporized and removed from the skin surface. A wound healing response is initiated by the body to replace the lost tissue with new collagen, elastin, and skin cells. In this way textural abnormalities, wrinkles, and pigment can be erased. However, the treatment goals must be balanced by the risk of scarring, which was more common with the original devices and with more aggressive treatment settings.

Non-ablative laser resurfacing was first introduced under the name “Fraxel” laser which came out in the early 2000’s. It was developed to provide a way to improve tone, texture, and wrinkles with minimal downtime. “Non-ablative” refers to the fact that there is no vaporization of the skin tissue. Instead, the laser energy heats the skin and creates columns of coagulated tissue called microscopic treatment zones (MTZs). Only a fraction of the skin surface is treated with each session, therefore multiple sessions (average of 5) are required for maximal improvement. The advantage is short recovery time, usually 3-5 days of moderate erythema and swelling, but without oozing or crusting.

The next category to review is fully ablative versus fractional laser resurfacing (Figure 1).

Fully ablative resurfacing removes the entire top surface of the skin to a depth determined by the settings chosen by the physician.   Healing time increases with the depth of treatment. Superficial depth treatments, helpful for fine textural changes and pigment, are called “microlaser peels” and heal within a few days.   Deeper treatments, particularly helpful for etched in lines around the mouth, take up to 2 weeks to heal.

Ablative fractional resurfacing was developed to improve healing time and minimize risks of scarring and pigment alteration. Columns of tissue are vaporized, often to depths greater than can be achieved safely with fully ablative lasers. Vaporized columns are quickly healed by the surrounding unaffected tissue. New collagen and elastin deposition and elimination of pigment in these columns contribute to the cosmetic result of decreased lines, diminished texture, and improved tone. Because only a fraction of the surface is treated each time, a series of 3-5 treatments is required for maximal improvement.

Laser Skin Resurfacing Categories
Laser Skin Resurfacing Categories

Lastly, the new hybrid fractional laser resurfacing (HALO) delivers ablative vaporization and non-ablative coagulation to the same tissue column (microscopic treatment zone). The result is improved healing time with less pain than traditional resurfacing lasers. Pigmentation, wrinkles, and pores are significantly improved over the course of 1-3 treatments.

HALO Laser Image
HALO Laser Image

AboutSkin Dermatology physicians provide patients with a full array of laser resurfacing options in all of the categories reviewed in this blog post. (See below)

Syneron-Candela

Sciton

  • Fully ablative Erbium resurfacing (TRL)
  • Ablative fractional Erbium resurfacing (ProFractional)
  • Erbium Microlaser Peel
  • HALO Hybrid Fractional Resurfacing

Palomar Icon

  • Ablative fractional Erbium resurfacing
  • Non-ablative fractional resurfacing (1540nm XF and XD)

Often, laser resurfacing devices are combined in the same treatment session depending on specific patient needs. For example, a single treatment session could consist of the following:

  • Erbium fully ablative resurfacing around the mouth and eyes for etched in lines
  • CO2 fractional resurfacing for the rest of the face
  • HALO hybrid fractional resurfacing on the neck and chest
  • Microlaser peel on the top of the hands

** Stay tuned for part 3 of this laser resurfacing blog series in which I will explain how to choose which laser is right for you.

Whatever your particular treatment goals are, we have the knowledge and technology to help you achieve them. Call our cosmetic coordinators at AboutSkin Dermatology at two Denver area locations (Greenwood Village and Lone Tree) to schedule your laser resurfacing consultation. 303-756-7546 (SKIN).