Laser resurfacing (CO2 and fractional lasers)

What it is

• It is usually used on the face, and it cannot fix sagging skin.
• Ablative lasers include CO2 lasers, erbium lasers and combination systems.
• A fractional laser treats the skin in tiny columns.

Source: Mayo Clinic: Laser resurfacing - Mayo Clinic ↗

How it's thought to work

An ablative laser destroys the outer skin layer and heats the skin below, which stimulates collagen, a protein that improves skin firmness and texture. As the wound heals and skin regrows, the treated area is smoother and tighter.

Source: Mayo Clinic: Laser resurfacing - Mayo Clinic ↗

What people use it for

Laser resurfacing is used to treat fine wrinkles, age spots, uneven skin color or texture, sun-damaged skin and mild to moderate acne scars.

Source: Mayo Clinic: Laser resurfacing - Mayo Clinic ↗

What the research has found so far

On Laser resurfacing and aging, PubMed lists 249 trials in people, 327 studies that watched people over time, 62 animal and lab studies. See the counts and searches

Side effects and risks

• Treated skin may swell, itch or have a burning sensation.
• It can lead to bacterial, viral or fungal infection; the most common is a flare-up of the herpes virus.
• Treated skin can become darker or lighter than before.
• Ablative laser resurfacing carries a slightly higher risk of scarring.
• One source lists pain, swelling, bleeding, scarring, crusting, discoloration and infection as possible risks.

Sources: Mayo Clinic: Laser resurfacing - Mayo Clinic ↗ · American Society for Dermatologic Surgery: Laser Resurfacing for Aging Skin ↗

Who should be careful, and drug interactions

• People with brown or Black skin have a higher risk of long-term skin color changes.
• People may be cautioned against it if they took isotretinoin in the past year.
• People with a connective tissue or autoimmune disease or a weak immune system may be cautioned against it.
• People with a history of keloid scars may be cautioned against it.
• People who had radiation therapy to the face may be cautioned against it.
• People who are pregnant or breastfeeding may be cautioned against it.
• People prone to cold sores may be cautioned against it, since the procedure can trigger breakouts.
• One source lists aspirin, ibuprofen and vitamin E as things that can affect blood clotting before surgery.

Sources: Mayo Clinic: Laser resurfacing - Mayo Clinic ↗ · American Society for Dermatologic Surgery: Laser Resurfacing for Aging Skin ↗

What to expect: sessions, results and recovery

• Ablative resurfacing typically takes 30 minutes to two hours.
• Without a fractional laser, ablative treatment usually needs only one session.
• After ablative treatment, new skin usually covers the area in 7 to 10 days, and full recovery takes at least a month.
• Recovery after nonablative treatment is very short.
• One source gives recovery of generally up to two weeks for CO2 laser and one full week for erbium laser.
• Healing typically takes 10 to 21 days, depending on the size and location of the procedure.
• The effect may last for years.

Sources: Mayo Clinic: Laser resurfacing - Mayo Clinic ↗ · American Society of Plastic Surgeons: Laser Skin Resurfacing Recovery ↗ · American Society for Dermatologic Surgery: Laser Resurfacing for Aging Skin ↗

Roughly what it costs

We don't have prices for this yet.

Questions to ask your doctor

• Is Laser resurfacing a sensible option for me, given my health and the medicines I take?
• Could Laser resurfacing interact with any medicine or supplement I already take?
• What side effects should I watch for, and when should I stop or call you?
• How would we tell whether it is helping, and when should we review it?