Laser skin treatments is one of the resurfacing methods by which layers of damaged epidermis ( lines, wrinkles, acne scars, pigmentation and skin unevenness ) is removed using laser energy. Even though precision of laser is one of its advantages over other methods, treating only part of the skin with any resurfacing procedure may not produce an even complexion. Those who still have acne breakouts, are at no considerable risk to try YAG treatments. Some may see some improvements in their breakouts. Because its effects are less deep, the erbium laser does not cause collagen shrinkage in the dermis of the skin (the layer right below the epidermis), and some studies have shown that this is necessary for better long term effects to remove damaged layers. Proper classification is important because differences in clinical acne scars characteristics determine the treatment protocol. Color, texture, and morphology, of lesions as well as previously applied treatments, will affect the laser parameters and number of treatments required for optimal improvement. Progress in laser skin technology and refinements in technique have made laser skin resurfacing a preferred choice for hypertrophic lesions, keloids as well as acne scarring.
Overview of Efficacy of Different Laser beams
Scar reduction is one of the most common uses of laser skin resurfacing. CO2 lasers can vaporize skin layer-by-layer, causing minimal damage to other skin tissue. Special scanning devices move the laser light across the skin in predetermined patterns, ensuring proper exposure. Revision of the outer layers of facial skin is followed by formation of a new skin as a result of work of healing mechanisms. The result is a smoother, somewhat tighter skin. Lines around the eyes, mouth, and cheeks are the primary uses for face resurfacing. Smile lines or those associated with other facial muscles tend to reappear after a treatment with a YAG beam. Laser for acne-caused scarring appears to achieve its best results as a spot treatment; patients expecting complete elimination of their acne scars will not be satisfied. Complete eradication is closely correlated with lesions types, depth and their locations. Deep-seated lesions may not be well affected, atrophic lesions benefit most. One study (Langsdon et al) suggest that Phenol peel is as effective as the laser in removing damaged epidermis in the thin-skinned areas of the face.
Healing laser produces improved results in the thick, glandular areas of the face, but also produces more intense hypo pigmentation, longer periods of patient discomfort, and longer periods of postoperative red skin. Both phenol peel and resurfacing by laser remain useful clinical tools. As a consequence of the risks associated with ablative laser, great interest has been shown for less invasive methods to effectively treat atrophic lesions. Among them YAG laser has been enjoyed a better recognition. Protocols often include three consecutive monthly laser sessions with the greatest clinical improvement noted between 3 to 6 months after the final treatment. One study suggests use of laser punch out for acne scarring treatment. Lasers of various types are used in treating stretch marks and seem to be a promising mode of treatment. This has been associated with an increase in dermal elastin. The pulsed dye laser has a moderate beneficial effect in the treatment of stretch marks. Intense pulsed light is also useful, and has minimal side effects. Short pulsed carbon dioxide laser has been tried as well. Lasers and light sources emitting UVB radiation have been shown to repigment striae distensae. Modalities other than laser skin resurfacing has been shown to improve the appearance of stretch marks.
Who is Laser resurfacing for?
Those with active acne inflammation, infection such as active acne are not good candidate for facial scars resurfacing by laser. Also those who have been using Accutane for the past twelve months may consider other resurfacing techniques such as peeling. Keloid prone skins also are not considered best applicants. Olive and darker complexions are more likely to develop hyperpigmentation following laser resurfacing. However, YAG laser for acne-caused scarring my prove otherwise according to one study.
Risks and Side Effects
Burns, obvious lightening or darkening of the skin, scarring and herpes infections are among side effects. These side effects shouldn't discourages you to choose to laser resurface the skin unless your surgeon suggest you so.
Procedure
Diverse penetration levels allows treatment of different layers of the skin. In a deep laser peel dermis specifically targeted while in a more superficial peel only epidermis ( outer layer of the skin ) is affected. More frequent superficial treatments may produce the same result as the one seen by deeper peels. Antiviral medications should be started several days before treatment. Procedure. Scarring reduction laser is performed under local anesthesia. An oral sedative may also be taken. The patient's eyes must be shielded, and the area surrounding the face should be shielded with wet drapes or crumpled foil to catch stray beams of laser. The physician will mark the damaged areas for resurfacing prior to beginning of the procedure. Side-effects and complications of non ablative reduction with laser for atrophic lesions are generally mild. Transient post-treatment erythema is observed in almost all patients, resolving within 24 hours. Blistering, crusting, and skin residues are rare and although the risk of post-inflammatory hyper pigmentation is substantially reduced with non ablative laser procedure.
After Laser Care and Recovery Time
Skin moisturization is of crucial importance after skin damage reduction with laser revision as it is in any other type of procedure for scar reconstruction such as peeling with Glycolic acid %30. Moisturization promotes more rapid healing and reduces the risk of infection. Some physicians favor application of ointments only to the skin; others prefer the use of dressings. In either case, care of the skin is similar to that given following a chemical peel for acne scarring reduction. The face is washed with plain water to remove ooze, and an ointment is reapplied.
Recovery time is closely correlated with intensity of laser. Deeper treatments take longer period of recovery. In general healing will take approximately two weeks. Pain medications and a steroid to reduce swelling may also be taken. Laser resurfacng for scar removal appear to be more successful in convex areas of the face. Lateral cheek and the temples do not benefit from this technique as much.
Cost of Laser Procedures
Cost of a treatment of laser scar revision varies between $2000 to $4000 depending on the size of the affected area. Time for recovery may vary between 4-6 weeks
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