There are a variety of lasers that are now available for rejuvenation of the skin. I will try to explain how they differ, and what they are used for.
CO2: this is still the most powerful rejuvenation laser available. It is an “ablative” laser, which means that the beam is absorbed by water in the skin, and the skin is vaporized. This results in a type of burn on the skin which will slowly heal over about 10 days. A bandage is placed over the treated area for 2-3 days, and then Vaseline or Aquaphor ointment is placed onto the skin. While not painful, the recovery requires time and commitment, as there will be a fair amount of discharge, crusting and itching. The redness can last from 2 weeks to several months, but can be covered with make-up.
This type of resurfacing is best for fair skinned individuals with fine lines and wrinkles. It also works well to improve the appearance of acne scarring. It is not indicated for people with darker skin tones as there may be some permanent lightening of the skin post-op. It can only be used on the face.
Fractionated CO2 resurfacing: This is a laser which uses the CO2 technology, but fractionates (divides) the light into microscopic beams. By doing this, there is treated skin adjacent to untreated areas. This allows the skin to heal more quickly, with most patients having only 5-7 days of downtime. The results will not be quite as impressive as the regular CO2, but for many patients, it achieves an excellent tightening and improved skin texture. While usually used on the face, it can be used cautiously in other body areas such as the neck.
Non-Ablative fractionated resurfacing: 1540nm laser – With this laser, there are microscopic channels of heat which are delivered to the skin. This causes contraction of the deeper collagen, and stimulates new collagen growth. The procedure is done with a topical anesthetic cream, and the skin will usually be slightly red and swollen after the treatment. Two to three monthly treatments are usually recommended for maximum results. This laser has shown great promise for scarring, such as acne scarring or post-surgical scars. It can be used anywhere on the body, and in any skin color.
Other lasers:
Nd:YAG 1064: this laser is used for removal of small red and blue spider veins on the legs. It is a great alternative to having injections, and the results are usually excellent. The vessels absorb the laser energy and the heat closes the vessel. Initially it will look like a red raised scratch on the skin, and the vessel will then gradually disappear over the next 8 weeks. Some stubborn veins may need a second treatment. If you have larger, deeper veins, the laser will not help. People with a tendency to spider vains usually develop new spider veins with age, so you will need to intermittently retreat the veins.
Deep IR: Infrared laser is a new modality used to tighten the skin. The laser handpiece is placed over the skin, and the infrared light penetrates into the dermis to tighten existing collagen and stimulate new collagen production. Three monthly treatments are performed, and results are often not completely evident until about 6 months later. The IR laser works very well on loose abdominal skin, necks, and arms.
With so many choices available, and not every choice right for every patient’s skin or desired outcomes, come in to discuss what laser option is right for you.