Are you confused by all the different options you hear about
making your skin look younger? Laser Skin Resurfacing is the most effective non
surgical approach to achieve drastic results. Few laser technologies and
techniques belong to this category. This paper will help you understand the
different Laser Resurfacing options and determine what option fits you best.
Skin Resurfacing - Introduction
First of all you must know that every new resurfacing laser or device
is measured against the industrys most powerful machine for the past
40 years, the carbon dioxide (CO2) laser. It was invented in 1964 and
has been the most widely used laser in medicine. In the area of
dermatology, its use has been predominantly for facial resurfacing. It
often achieves desired results in a single treatment, works on fine and
intermediate lines and acne scars, maximally tightens the skin and
delivers results that last. Its drawback is a long, 5-14 day social
downtime, making it less desirable for any working person. To overcome
this handicap, many devices have been developed by the aesthetic
industry. There are ablative and non-ablative strategies that
rejuvenate your skin and you will learn about the benefits and
downsides of each of these techniques.Fractionated Ablative lasersCarbon dioxide laser - CO2 LaserAs
an ablative laser, it vaporizes the tissue and is able to eradicate
fine and intermediate lines, smoothes overall skin texture and acne
scars, eradicates uneven pigmentation as well as tightens the skin. It
lets you appear about 10 years younger and easily replaces the need for
a face lift unless skin sagging is severe. Preparation and
postoperative care most closely resembles a full fletched surgical
procedure, however, CO2 laser resurfacing can be performed under local
anesthesia. The price you pay for the results is one to two weeks of
social downtime while the skin reepithelializes. In addition, the
resurfaced skin may appear pinkish for several months thereafter.Fractional CO2 laser (ActiveFX(TM), DeepFX(TM), Fraxel re;pair, Mosaic eCO2)Since
the beginning of 2007, refined systems with partial degrees of ablation
have revolutionized the resurfacing market. Amongst these, the
combination of DeepFx and ActiveFx, manufactured by the leader in CO2
technology (Lumenis) give results most closely comparing to the
traditional laser resurfacing. This new technology offers faster
healing times with still excellent results. In the meantime, a number
of laser companies have now developed their own permutations of a
fractionated CO2 laser and include Fraxel re:Pair, Slim MIxto/SX, Exelo
2, Mosaic.Erbium YAG lasersThe
traditional erbium laser has produced results that were absolutely
comparable to the CO2 laser yet it fell out of favor because of
significant post operative bleeding. As with the fractional method
developed for the CO2 laser, todays erbium laser treatments are almost
exclusively fractionated and may also be called pixilated. Names that
you may read about are Pearl, Pixel, ProFractional and Starlux 2940.
However, they do not deliver results that mirror the original. While
downtime is typically limited to 1-4 days, the downfall of the
fractionated erbium technology is the very superficial nature of the
resurfacing results, being excellent at improving sun damage, and skin
texture, but will target only the finest lines. Several treatments are
necessary to achieve such results. These fractionated lasers do not
significantly contribute to skin tightening, removal of wrinkles, let
alone acne scars.Non ablative fractional lasersProtecting
the epidermis, the upper most layer of our skin, and thereby minimizing
social downtime, non-ablative lasers deliver energy in the lower layers
of skin, ideally only causing swelling which is socially much more
tolerable than oozing. Amongst the non-ablative lasers, FRAXEL is the
most marketed. Other brands include Affirm, StarLux-Lux, Mosaic. Using
a wave length lower than that of a CO2 laser,
these lasers drive energy into the skin, stimulating collagen
production and thereby tightening skin. Results after a single
treatment are minimal and it can easily take 4-8 treatments to observe
an effect. While its effects on wrinkles and lines after 4-8 treatments
is fairly close to the results of a single CO2 laser treatment, it does
not seem to deliver on scars as well. In addition, the Fraxel has been
FDA approved for the treatment of melasma, also known as the mask of
pregnancy, which shows as symmetric pigmentation on the face as a
result of sun exposure with increased estrogen levels.Non-laser fractionated resurfacing devicesPlasma
and radiofrequency devices belong to this category. Because of the more
convincing results, plasma technology will be discussed here. The
plasma device is not based on laser principle. Plasma is pushed into
the skin to induce partial ablation of the epidermis and renewal of
collagen beneath the surface of the skin. Treatments can be delivered
in 1-2 aggressive sessions, results mimicking nearly those of
fractionated CO2 laser resurfacing. When energy levels are minimized to
allow for as a little as a few-hour lasting redness, several treatments
will be needed for an effect. With the latter technique however,
results tend to be much less dramatic. Having gained FDA approval in
the second half of 2007, the technology is fairly new and long term
results are not known yet. Skin Resurfacing - SummaryIn
sum, many exciting technologies are available nowadays. The general
rule of little downtime little results still applies but ultimately,
your goals, your ability to tolerate social downtime and your wallet
will steer you and your treating physician to a resurfacing plan that
is tailored to you.
Results
CO2 Laser ****
ActiveFX ***
Fractional Lasers **
TCA Peel **
Glycolic Peel *
Microdermabrasion *
Social downtime
CO2 Laser 5-14 days
ActiveFX 3-5 days
Fractional Lasers 1-6 days
TCA Peel 5-7 days
Glycolic Peel None
Microdermabrasion None
# Treatments
CO2 Laser 1
ActiveFX 1-2
Fractional Lasers 4-8
TCA Peel 1
Glycolic Peel 6-8
Microdermabrasion 6-8
Lasting results
CO2 Laser 10 years
ActiveFX 10 years
Fractional Lasers Unknown
TCA Peel 2 years
Glycolic Peel 1 year
Microdermabrasion 1 year
Average Cost
CO2 Laser $3000
ActiveFX $3700
Fractional Lasers $5000
TCA Peel $500
Glycolic Peel $700
Microdermabrasion $1000
