Laser Skin Resurfacing

LASER FRACTIONAL RESURFACING
Information Sheet


How does the laser work?
•    Fractional laser resurfacing is used to improve fine wrinkles, sun damage, acne scars, and melasma.  Because fractional laser treatments only treat a fraction of the skin’s surface at a time, healing is faster than with previous resurfacing procedures.  
      
•    There are 2 types of fractional laser resurfacing treatments: nonablative and ablative.  Nonablative fractional resurfacing does not remove the top layer of the skin, whereas ablative fractional resurfacing does.  Because nonablative fractional resurfacing does not remove the top layer of skin, there is less downtime and faster healing.  However, the trade off is that multiple treatments are needed and less dramatic results are often noted (relative to ablative fractional resurfacing).   

What can I expect during the treatment?
•    Topical numbing cream will be applied to your skin for 30-60 minutes prior to the procedure.  Your eyes will be protected with goggles during the procedure, and you will be fully awake.   Each pulse is stingy but should not be painful.  If you are uncomfortable or having pain, please let your provider know so that your treatment can be adjusted.  

•    The duration of the treatment depends on the size of the area treated and the type of fractional resurfacing.  Nonablative fractional resurfacing takes longer because multiple passes are required; in contrast, ablative fractional resurfacing takes less time as fewer passes with the laser are needed.  (Please note, estimates of duration of the procedure are listed on the fee schedule).  Following the procedure, an ice pack or gel may be applied to minimize the stinging sensation.    

How do I prepare for a treatment?
•    It is mandatory to avoid any sun exposure for 4 weeks prior to and 4 weeks following each treatment.   In addition, if you have a history of cold sores, please let your provider know prior to your treatment.

The following questions are addressed in the chart entitled “Nonablative versus Ablative Fractional Resurfacing: Which treatment is best for me?”  
•    What conditions are the procedures used to improve?        
•    How many treatments will I need and how often should I have them?
•    How quickly will I see results?
•    What is the healing process like for a typical patient?
•    Can I drive myself to and from the procedure?    

What are some options to fractional resurfacing?
•    Medium depth chemical peels, prescription strength creams, and intense pulsed light treatments may also improve sun damaged skin.   BOTOX® Cosmetic, which lasts 3-4 months, is effective for wrinkles in certain areas, such as the crows feet, frown lines, and forehead lines.  Fillers, such as Juvederm and Restylane, are effective for treating smile lines, lip lines, and some acne scars and last 6-12 months.  These procedures may be performed instead of or in addition to fractionated resurfacing.  Ask you provider if you are interested in them.    
What are some things to consider before pursuing fractional resurfacing?
•    Fractionated resurfacing is relatively new technology.  While these technologies are FDA approved, data continues to evolve regarding this treatment.  It is important to understand the risks of a procedure especially if it is not medically necessary.  Common side effects of fractionated resurfacing include pain, redness, swelling, scabbing, and peeling.  Uncommon though potential risks include but are not limited to increased or decreased pigmentation (which may be permanent), failure to heal, infection, and scarring.  Furthermore, because this treatment is somewhat dependent upon your body’s ability to heal itself (and create new collagen), results may vary among patients.

Nonablative versus Ablative

Nonablative versus Ablative Fractional Resurfacing: Which treatment is best for me?”

  Nonablative Fractional Resurfacing Ablative Fractional Resurfacing
  • What conditions are the procedures used to improve?
  • Skin texture (including crepe texture), melasma, and some acne scars
  • Fine lines, sun damaged skin, and some acne scars.
  • How many treatments will I need and how often should I have them?
  • 3-5 treatments spaced at least 4-6 weeks apart
  • 1-2 treatments spaced at least 4-6 weeks apart
  • How quickly will I see results?
  • Results are gradual and mild. The full benefit of the procedure takes 4-6 months following the last procedure.
  • Results can be evident within 1 week
  • Can I drive myself to and from the procedure?
  • Yes
  • If having your full face or similar size area treated, we suggested having someone drive you home. The stinging is most intense during the first 1-2 hours after the procedure and you will want to apply ice almost continually.
  • What is the healing process like for a typical patient?
Day 1

 

Day 2 Day 3-4 Day 5-7 1-4 weeks Day 1 Day 2 Day 3-4 Day 5-7 1-4 weeks
Stinging + _ _ _ _ + + + _ _
Swelling + + +/_ _ _ + + + _ _
Raw Skin _ _ _ _ _ + + + _ _
Pain Intensity (on 0-10 Scale; 0=no pain and 10= worst pain) 4-5 2-3 1-2 0-1 0 6-7 3-4 1-2 0-1 0
Redness + + + _ _ + + + + +/-
Peeling and Flaking _ + + + _ _ _ + + + up to 10 days
When is the earliest I can apply makeup if desired? Day 3 Day 7 -10