Laser resurfacing: One way to treat wrinkles

Are your laugh lines no longer amusing? Your crow's - feet something for the birds? Wrinkles — whether they line the sides of your mouth or etch the corners of your eyes — are inevitable signs of aging.

Due to constant sun exposure as you age, your skin gradually loses collagen and elastin, fibrous proteins that keep your skin taut. Your skin over time also thins and loses its plumping layer of fat. The end result: wrinkles.

Though nothing fully stops the aging effects of time, you have options to help lessen the appearance of wrinkles, from Botox injections to prescription creams to various surgical procedures. One option is laser resurfacing, a technique that uses a laser to remove the aged or sun-damaged outer layers of skin to allow younger skin to grow in its place.

But is laser resurfacing a safe and effective skin treatment? Learn more about this cosmetic procedure, to decide if it's the right option for you.

  What is laser resurfacing?

Laser resurfacing is a surgical procedure that uses an intense, pulsating beam of light to vaporize the outer layer of skin (epidermis). Then, at lower power, the laser heats the underlying skin (dermis), which stimulates the growth of new collagen fibers. As the wound heals, new skin forms that's smoother and tighter.

Compared to other resurfacing methods, such as chemical peels or dermabrasion, laser resurfacing gives doctors more control over how deep the treatment penetrates your skin. And lasers allow doctors to more precisely treat delicate facial areas, such as those around your eyes and lips.

In addition to reducing the appearance of mild to moderate wrinkles, laser resurfacing also helps treat other signs of sun-related skin changes, including brown liver spots and uneven or dull skin tone. Laser resurfacing can also help treat facial scars and blemishes.

 
What to expect during the procedure

Your doctor can perform laser resurfacing in his or her office, in a hospital procedure room or in an operating room, depending on the amount of treatment needed. First, your doctor numbs the skin with local anesthesia and may provide a sedative to help you relax. For extensive resurfacing — such as treatment to your whole face — or if you're undergoing other cosmetic procedures, your doctor may give you general anesthesia. In this case, you're asleep during the surgery. Laser resurfacing can take a couple minutes or up to two hours, depending on the size of area treated.

After the procedure, your skin may appear red or pink and thinly crusted. You may also experience:

•  Mild swelling and discomfort

•  Lighter or darker skin tone in the treated area

•  A mild sunburn-like sensation  

Recovery: Results sometimes immediate, sometimes not

Your skin takes about five to seven days to heal. During this time, keep your skin moist by using protective creams and ointments and covering the area with bandages. During recovery, remain at home and engage in limited activities while the crust is present — about one to two weeks. After this time, you can apply cosmetics to conceal any lingering redness. After two weeks, you can return to your normal schedule.

Your skin may stay red or pink for up to six months following laser resurfacing. In addition, your skin may be sensitive to sunlight for up to a year after the procedure, so it's important to minimize sun exposure and to use sunscreen liberally.

You may notice an immediate difference in your skin quality and appearance. And gradually during the next six to 12 months, you'll likely see continued improvement. Although the effects of laser resurfacing can last for years, wrinkles and expression lines recur as skin ages. Repeat procedures may be necessary.

Complications and risks involved

The most common complication of laser resurfacing is hyperpigmentation — skin tone that turns darker than normal. It may start three to four weeks after surgery and can last up to several months. You may be at increased risk of hyperpigmentation if you have a dark or very light skin tone.

Another possible side affect is a herpes virus infection — the virus that causes cold sores. In most cases, herpes is already present and the surgery causes the virus to flare up. If you have a history of cold sores, shingles, or herpes, your doctor can prescribe a medication to prevent these infections after laser surgery.

Other complications include acne flares and dermatitis — inflammation of the skin. Scarring can also occur although it's rare, especially for less aggressive procedures.

Lasers are now available that produce less chance of scarring and pigment changes, create less discomfort and require a shorter recovery time than older lasers. For example, nonablative — nonwounding — lasers actually avoid injury to the surface skin and treat the underlying layer. This technique still stimulates the production of collagen, but requires less recovery time because the upper layer of skin isn't damaged. However, because these lasers are less powerful, they usually require multiple sessions, and it may take longer to notice results.

  Have realistic expectations

Laser resurfacing is an effective treatment for minor facial flaws. For example, it can lessen the appearance of fine lines around your eyes, mouth and cheeks. It can also improve your complexion if you have yellowish or grayish skin tones.

But laser resurfacing has its limits. It can't remove deep wrinkles or eliminate excessive or sagging skin (jowls). In addition, the effects aren't permanent because as you age, you continue to acquire expression lines — lines that result from the natural movement of your face, such as when you squint or smile. Talk with your doctor about your goals and find out whether this procedure can meet your needs.