Laser Skin Resurfacing

In previous posts, we spoke about botulinum toxin treatments and fillers to treat wrinkles and hollows. But what about the surface changes in our skin: brown spots, blood vessels, acne scars, and dull, loose skin? That’s where laser treatments come into play. And luckily, today there are many choices at our fingertips.

Here in South Florida, we spend a lot of time outdoors enjoying the beautiful weather. But the exposure to the sun can cause all sorts of changes in our skin, including brown sunspots. There are various lasers available to treat these spots. Treatment with an IPL (intense pulsed light) system generally works best on people with lighter skin. It can be used on those with darker skin types as well, although those patients are more at risk for developing hyperpigmentation, or brown discoloration. Generally a series of treatments is recommended with 4-6 weeks in between treatments. There is little to no “downtime” with the procedure. Sunscreen and sun avoidance are recommended before, during, and after each treatment. An additional benefit of IPL is some stimulation of collagen, which helps the skin look tighter. Remember that any brown spot that is changing or new should be evaluated by a dermatologist.

Fractional resurfacing treatments also help with brown spots, and can also improve texture of the skin, and smooth fine wrinkles for an overall more youthful appearance. These lasers act by creating small zones of damage in the top layers of the skin (called microthermal zones), leaving normal skin in between the zones. The areas of damage stimulate collagen formation. Settings can be adjusted for a more superficial treatment (less downtime) or a deeper treatment, which is very beneficial for acne scars or deeper wrinkles (but more downtime). Sunscreen and sun avoidance are always recommended before, during, and after each treatment. When superficial resurfacing is performed, often a series of treatments is more effective. Examples of resurfacing lasers are the Fraxel Re:Store and the Active FX/Deep FX.

Tightening devices use radiofrequency to gently heat the deeper layers of the skin. This heating stimulates collagen and results in a tighter appearance. The top layers of the skin are not treated, so this treatment does not improve surface changes (like brown spots or wrinkles). The lower face, neck, around the eyes, chest, arms, hands, and even abdomen may all be treated. An example of a tightening device is Thermage.

Blood vessel lasers treat fine vessels called telangiectasias, spider veins, red blotches seen in photodamage, and more. The laser causes a slight injury to the blood vessel, which then further stimulates collagen growth. There is very little to no downtime. Occasionally a second treatment is needed. An example of a blood vessel laser is the Iridex.

Although laser treatments are generally very safe, complications can occur. Patients who are pregnant, have a history of keloid scars, have taken isotretinoin (accutane) in the months prior to treatment, or those with certain skin disorders are not candidates for laser treatments. As with any skin procedure, it is always recommended to see a board certified dermatologist for evaluation and treatment.

Donna Bilu Martin, MD is a board certified Dermatologist at South Beach Dermatology and Horwitz Dermatology.

This post is not intended to be used for the purpose of medical diagnosis or treatment in any shape or form. Accordingly, any information contained within should not be construed as medical advice, evaluation, or consultation and should never be considered a replacement for a formal evaluation by a physician in the office. Therefore, the information and correspondence that is involved with this weblog does not constitute a formal doctor-patient relationship. Explanation of off-label services and/or products that are mentioned herein does not reflect an endorsement nor promotion and should not be construed as such.


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