Laser for skin rejuvenation

LASER FOR SKIN REJUVENATION

We use laser for skin rejuvenation to combat the signs of aging and this is becoming more and more popular. Lasers work by directing a high-energy beam of light at a particular area of the skin to selectively heat and disrupt skin cells, while leaving other areas of the skin unaffected. The technical term for this process is ‘selective photothermolysis’.

Different types of lasers have different uses. There are commonly three types of laser treatment available:

• Ablative laser
• toNon-ablative laser
• Fractional laser

All three can be used to treat a wide range of signs of aging on your skin, including:

• Fine lines
• Wrinkles
• Sun damage
• Age spots
• Pigmentation
• Scarring

Laser for skin rejuvenation is used to combat these skin conditions on many different areas of the skin. Lasers can be deployed across much of the face, including around the eyes, the cheeks and the areas around the mouth, but can also be used on the neck, chest and hands.

Consulting an experienced, qualified practitioner is the best way to ensure you get the right treatment regime for your skin type, condition you wish to treat, and the results you want to achieve.

ABLATIVE LASER FOR SKIN REJUVENATION

Ablative lasers are used to remove cells from the surface of the skin. It acts much like a chemical peel or a treatment of microdermabrasion. It can be used to treat wrinkles, scars and birthmarks.

There are two main forms of ablative laser:

1. CO2 laser
2. Erbium:YAG laser

Either can be used to treat the same range of conditions. However, the CO2 laser is generally used for more severe instances of skin complaints, as it can penetrate deeper into the epidermis. The flipside of this is that a CO2 laser treatment typically requires longer downtime for recovery than the Erbium:YAG alternative.

One advantage of an ablative laser procedure is that while the outer layers of the epidermis are treated, a lot of heat is generated within the skin. This heat causes the collagen matrix to contract, and so tightening the skin, giving it a firmer, tauter and smoother appearance. The deeper layers of the skin also treat the heat as though it were a kind of wound. This stimulates a healing response, generating a stringer underlying matrix to the skin, improving the strength and elasticity of your skin.

NON-ABLATIVE LASER FOR SKIN REJUVENATION

Non-ablative lasers heat the deeper layers in the skin while at the same time cooling the surface so that it doesn’t get damaged by latent heat. So while a gel, cooled handpiece or a spray keeps the epidermis cool, the laser penetrates into the matrix below the skin stimulating collagen production in order to rejuvenate the skin from below. The results are not as immediately obvious or generally pronounced as with ablative lasers, but this method does have a lower risk of side effects than its ablative counterpart, and the downtime for recovery is typically less.

FRACTIONAL LASER FOR SKIN REJUVENATION

Fractional lasers work by treating only a small proportion of the skin cells in a target area. Thousands of microscopic beams are used to target approximately 20 percent of skin cells in a target area. It essentially creates many tiny wounds that stimulates the skin’s healing mechanisms, resulting in newer cells in both the matrix and the epidermis that give strength, resilience and a smoother, fresher appearance to your skin.

WHAT HAPPENS DURING A FRACTIONAL LASER TREATMENT?

All three types of laser treatments are performed in essentially the same way. Preparation is minimal but important. For two weeks prior to the procedure, avoid excessive exposure to the sun and regularly use a moisturising sun block with an SPF of at least 30. You should also avoid artificial tanning agents and refrain from exfoliating s for at least a week beforehand. Some practitioners may also recommend that you cease topical and oral retinoids and vitamin A. For the treatment of pigmented skin, it is often recommended that topical bleaching agents (like hydroquinone), or preparations with pigment reducing antioxidants such as vitamin C and E are applied to the area being treated for at least a fortnight prior to the procedure, then resumed once the skin has healed and continued for at least six months. This can help reduce the risk of excessive pigmentation.

Often a practitioner will take photographs prior to the treatment for comparison and to calibrate subsequent treatments and establish their success. Typically, they will also perform a skin analysis in order to help ensure the correct calibration of the laser machinery for your skin type.

The target area of skin will first be thoroughly cleansed. For some treatments – particularly those using an ablative laser – a topical numbing cream may be applied to the skin prior to the deployment of the laser. You will also be given eye protection to wear throughout.

The laser device is then placed over the target area of skin, and it releases pulses of the laser into the skin. The treatment can last anywhere from 20 minutes to two hours, depending on the size of the target area. The laser device may be applied over an area several times and increases in heat with each pass.

Nerve blocks are sometimes required for ablative therapies or fractional laser on high settings (to treat deep wrinkles). This involves an injection of an anaesthetic agent adjacent to the nerve that runs under the area being treated. This prevents pain signals from reaching your brain.

AFTERCARE FOR LASER TREATMENTS

For all laser therapy, it is important to stay out of the sun for a few days after the procedure. This is because the new skin cells that emerge during the healing process are more prone to sun damage, and stimulation of melanin cells by the sun may cause excessive, unwanted pigmentation.

Each type of laser treatment has different aftercare requirements due to the differing intensity of the procedure.

Ablative laser

This form of laser treatment requires the most recovery downtime and post-procedure care to prevent complications. The treated area will be red and sore for a few days after the procedure. Painkillers can be taken as required (up to the recommended dosage) while a short course of broad-spectrum oral antibiotics – and occasionally anti-viral tablets – may also be necessary. A couple of weeks off from your usual activities is often required. Redness and swelling may take a month or two to fully settle.

Non-ablative laser

The non-ablative laser treatment is much less disruptive than its ablative counterpart. There is typically little or no recovery downtime and you can return to your daily activities almost immediately. Your skin may well be slightly pink and/or swollen, but this will subside in a few hours. However, if it feels uncomfortable, you can use a cold compress to relieve any pain. Be advised that your skin will be more sensitive to higher temperatures for a couple of days after the treatment so avoid taking very hot baths or showers.

Fractional laser

You are likely to look a little sunburnt and swollen after a fractional laser treatment. This is entirely normal. It will usually fade over a week or so following the treatment session. Use cold compresses as needed to reduce discomfort. Because this treatment works by making tiny wounds in the skin, you may experience minimal bleeding and crusting at the wound sites. Keep the area well moisturised while this heals. (Note that if you notice any wounds growing in size, seek medical attention.)

ARE THERE ANY SIDE EFFECTS WITH LASER FOR SKIN REJUVENATION?

Because of the invasive nature of laser treatments, there is a risk of side effects. However, with an expert practitioner administering the treatment and the correct aftercare, these can be minimised. The degree of risk varies depending on the type of laser treatment, with ablative lasers carrying higher risks (although the results are, correspondingly, generally better).

Potential side effects include:

• Break out of cold sores (herpes simplex virus)
• Prolonged redness
• Textural change
• Scarring
• In addition, ablative laser treatments – because they disrupt the outer layer of the skin which is what protects it from contaminants – can leave the skin prone to bacterial, fungal or viral infection. Your practitioner can advise on ways to avoid this.

Some patients, with any of the three laser treatment options, may experience whitening of the skin, which is known as hypo-pigmentation. Very tanned individuals are particularly at risk of this side effect. If you are tanned, your practitioner is likely to perform a spot test to check if the procedure will cause any lightening of the skin.

When using laser for skin rejuvenation, some patients may experience an increase in the pigmentation of treated areas, which is referred to as hyper-pigmentation. This is more likely when treating the neck and chest rather than the face. However, any hyper-pigmentation is usually transient and the rejuvenating skin will typically return to its normal skin tone within two to three months.

LAST REVIEWED 19-Nov-2016