DERMATOLOGY >> SKIN RESURFACING
WHAT IS SKIN RESURFACING?
Skin resurfacing is a term used to describe several types of skin care procedures performed by a dermatologist or plastic surgeon, in order to improve skin texture and appearance.
EXAMPLES OF SKIN RESURFACING PROCEDURES?
- Laser
- Microneedling
- Radiofrequency
- Microblading
- Chemical Peels
- Dermabrassion
are the most used skin resurfacing procedures in dermatology and plastic surgery
WHAT IS LASER SKIN RESURFACING?
Laser skin resurfacing is a type of skin care procedure performed by a dermatologist/plastic surgeron or physician. It involves using lasers to help improve skin texture and appearance.
Commonly laser therapy is used for the treatment of wrinkles, solar lentigenes, sun damage, scars (e.g. acne), stretch marks, actinic keratosis and telangiectasias (spider veins).
- Ablative lasers remove the top layer of the skin as they penetrate deep into the dermis. Therefore, ablative therapies are considered more invasive and painful with more side effects and a longer recovery, or healing time. The recovery time can extend up to 6 weeks. However, the number of treatments, required to achieve a result, are minimal and the results are arguably more significant. The target depth into the dermis is determined by the wavelength chosen. Topical anesthetics are required, and most devices have cooling methods to help reduce the extreme pain associated with the burning of the epidermis.
- Non-ablative laser therapy uses wavelengths that focus the target point into the tissue ie the dermis, sparing the epidermis from ablation. Non-ablation lasers usually use radiofrequency to achieve this. Non-ablation is less invasive and more convenient for patients in terms of downtime required post procedure. Although there is no surface ablation there is still associated swelling, pain and redness from dermal insult. However, the healing time, or recovery period is measured in days, not weeks. More treatments are required to achieve an optimal result, and in general this method is used more for mild to moderate skin conditions.
- Fractional lasers (fractional photothermolysis) are a type of new-generation ablative device that are considered intermittent between ablative and non-ablative therapies. Unlike selective photothermolysis where the whole selected area is ablated, fractional photothermolysis damages tiny dot areas of ablation on the skin leaving the other skin zones intact, hence only a fractional portion of the skin is damaged.
What to expect from the procedure?
Laser skin resurfacing targets the outer layer of your skin, while simultaneously heating the lower layers in the dermis. This will promote collagen production.
Ideally, new collagen fibers will help produce new skin that is smoother in texture and firmer to the touch.
The procedure involves the following steps:
- Before laser skin resurfacing, your skin needs to be prepared. This involves a series of treatments done several weeks prior to the procedure. The purpose is to increase your skin’s tolerance to professional treatments. It can also decrease your risk for side effects.
- On the day of the procedure, your doctor will apply a topical anesthetic to the area being treated. This is used to reduce pain and make you more comfortable during the procedure. If a large area of skin is being treated, your doctor may suggest a sedative or pain killers.
- Next, the skin is cleansed to remove any excess oil, dirt, and bacteria.
- Your doctor begins the treatment, using the selected laser. The laser is moved slowly around the designated area of skin.
- Finally, your doctor will dress the treatment area in wraps to help protect the skin at the end of the procedure.
WHAT ARE THE CHEMICAL PEELINGS?
Chemical peelings use a topical chemical agent, most commonly Trichloroacetic Acid (TCA) to remove the top layers of the skin (epidermis down to the dermal level), to stimulate cell metabolism and induce new collagen and elastin growth. The strength of the peel will determine the level of achieved insult. Peeling of the superficial layers usually occurs within the first 48 hours of application. Once the acid solution has been applied, there is a brief period of discomfort/pain, heat production and skin redness which occurs.
Chemical peelings are most commonly used to remove superficial blemishes, mild acne scarring, remove wrinkles and age spots and promote the regrowth of fresh newer looking skin.
Chemical peelings are most commonly used to remove superficial blemishes, mild acne scarring, remove wrinkles and age spots and promote the regrowth of fresh newer looking skin.
WHAT IS DERMABRASSION?
Dermabrasion is a mechanical treatment, designed to remove the superficial skin layers, by mechanisms such as sandpaper. The skin is first frozen prior to controlled planing of the skin. The downtime required for healing and the amount of anesthetic required to reduce the pain associated with this surgical procedure depends on the depth of dermal removal. Microdermabrasion is a much less invasive form of dermabrasion which requires no anesthetic or downtime. It usually involves using a fine sand to abrade more superficially.
Commonly, dermabrasion is used for the treatment of small scars (as from acne), moles (nevi), tattoos and fine wrinkles.
ARE THERE ANY SIDE EFFECTS AFTER THE PROCEDURE?
Like other cosmetic procedures, laser skin resurfacing, chemical peelings and dermabrassion do pose the risk for side effects, like:
- burning
- bumps
- rash
- swelling
- infection
- hyperpigmentation
- scars
- redness
By following your doctor’s pre- and post-care instructions, you may reduce your risk for these types of complications.
WHAT IS THE DURATION OF SIDE EFFECTS?
Healing usually takes between 3 and 10 days. As a general rule, the bigger the treatment area and the deeper the laser, the longer the recovery time. Recovery from ablative laser treatment, may take up to three weeks.
During recovery, your skin may be extremely red and scab over. Slight peeling will occur.
While you don’t need to be at home during the entire recovery process, you’ll want to avoid known areas of germs that could increase your risk of infection.
WHAT IS MICRONEEDLING?
Microneedling is the insertion of very fine short needles into the skin for the purposes of rejuvenation. The tiny needles of the device make invisible perforations in the top layer of the skin. Collagen and elastin are reactivated to heal the skin and thus rejuvenate the appearance of the skin.
WHAT IS MICROBLADING?
This form of permanent make-up is performed by depositing pigment superficially, in the upper region of the dermis, with the use of a hand tool with needles, fused together in a blade shape.
WHAT IS VAGINAL REJUVENATION?
Vaginal rejuvenation is essentially a tightening of the vaginal wall, usually performed with specially adapted laser devices.
WHAT INSTRUCTIONS TO FOLLOW AFTER A SKIN RESURFACING PROCEDURE?
The proper instruction will be given by your doctor, but , in general, when you have undergone any of the procedures mentioned above, the outer layer of your skin (epidermis) has been damaged. This outermost layer (stratum corneum) acts as the protective barrier of the epidermis. When this barrier is broken, water can evaporate more easily. It can no longer protect the skin from the environment which may cause dryness, itching, redness, discomfort, infection and increases the risk of abnormal scarring. Protection and hydration of the skin are the primary goals of a physician after a skin resurfacing procedure is done. Use of sunscreen is also required for a long time after the treatment.
Recommendations for skin resurfacing procedures:
- Treatment should be initiated immediate after the wound formation, in order to help and shorten the healing process.
- Follow the doctor’s advice to prevent possible complications that may occur at the wound level.
- Do not apply non-sterile or healing products that have not been authorized to be applied directly to the wound. There is a very high risk that the wound will become infected.
- Apply the treatment directly on the wound, and do not combine with other products except at the advice of the treating physician.
- Do not expose yourself to the sun in the first months after surgery, there is a risk that the scar formed after the healing process to have a changed color due to extensive pigmentation.
- Clean the treated area two, to five times per day.
- Use new dressings to ensure your skin stays clean.
- The more the dressing stays in touch with your skin and hydrates, it the better the overall outcome.
