Laser Resurfacing

What conditions are treated with lasers/energy-based devices? 
Fractionated resurfacing therapy is intended to enhance the skin’s tone, texture and possibly improve pigmentation issues.  The overall goal of the treatment is to provide a fresher more youthful appearance while accomplishing the task with a minimal amount of “downtime." 

Description of treatment
There are two overall types of treatments for laser resurfacing therapy, ablative and non-ablative. An ablative treatment results in some degree of interruption of the outer layer of the epidermis resulting in a wound.  The non-ablative treatment is accomplished without disrupting the outer layer of the epidermis – without creating a wound.

What devices are used for laser resurfacing? 
Fractionated Ablative therapy is generally achieved using laser technology.  The two most common fractionated ablative lasers are the Carbon Dioxide and the Erbium YAG. Manufacturers of these devices design their products to deliver the energy so that small fractionated perforations or channels are created into the skin.  There is spacing between them.  Most devices can be adjusted to change the spacing or percentage of perforations and the depth of the channels delivered.  Because the epidermal integrity is interrupted, it will take a few days to heal.  The amount of time it takes for the epidermis to heal is directly related to the level of therapy provided.

Non-ablative therapy can be accomplished using numerous technologies: (1) infrared lasers, (2) high impact light sources or (3) radiofrequency devices.   Each device manufacturer designs their product to deliver the therapeutic treatment in such a way to protect the skin’s outer layer.  The device may deliver the energy as “micro-beams”, as “pulses of light” or isolated “high energy waves”.  These products generally incorporate some type of built-in or add-on cooling mechanism.  Even so, the skin may appear red and swollen for a bit of time following the treatment.

What outcome should patients expect? 
Irrespective of ablative or non-ablative, the overall objective of each is to impact some type of “controlled injury” within the skin layers.  This results in “dermal remodeling."  The key to this treatment seems to occur from dermal remodeling.   This remodeling process is thought to stimulate new collagen production and/or reorganize the collagen matrix.   After the skin heals from the ablative approach, the bulk of the desired outcome is accomplished through dermal remodeling.   Even undergoing the non-ablative technique, the remodeling process will take time to complete its progression.  Many clinicians indicate they continue to see changes and improvements several months following the treatment.

Updated july 3, 2016