Laser skin resurfacing usually refers to the skin resurfacing done by ablative lasers, although confusingly, some non-ablative skin tightening lasers makers also call their treatments as “resurfacing”, despite no skin surface is removed in the process.

During the process, the laser vaporises thin layers of skin, leaving a denuded, raw surface. Then the skin will heal, providing:

1. a newly regenerated epidermis, which is smoother, with wrinkles, scars and other facial imperfections becoming less noticeable, and
2. re-modeling of new collagen in the dermis, and skin contraction

Types of Lasers Used

There are only two types of lasers used for (ablative) skin resurfacing in aesthetic medicine. They are CO2 laser and Erbium-YAG laser.

CO2 laser is the first, and has been the gold standard in skin re-surfacing for many years as it achieves unparallel smoothness and reduction of wrinkles that no other modality can match. It is capable of more dramatic corrections by removing layers of skin down to a deeper level, but with a longer downtime. Because it contracts skin immediately with blood clotting ability, bleeding is much less of a problem.

Erbium-YAG laser is relatively superficial (although it can go deep too), and was developed to minimise the risk of burning the surrounding tissues. It causes less post-operative side effects such as swelling, bruising and redness caused by inflammation, therefore it has a shorter downtime. This laser works best for small areas, minor or superficial wrinkles.

They can be applied to single areas or the entire face. The conventional method will use the laser to cover 100% of the area being treated. This method means a large denuded area, with rather long recovery time, typically about 3 - 4 weeks for the full face with the CO2 laser, which is really not acceptable to many people. General anesthesia may be needed when the entire face is treated. This also has a higher chance of leaving marks, or uneven pigmentation on the skin, particularly for people with darker skin types (post-inflammatory hyper-pigmentation). Because of these, this type of skin resurfacing has not been very popular among either doctors or patients.

Now the new fractional method has made a revolution, and has hit the market with great anticipation and hope. The laser will only deliver thousands of small laser beams to create microscopic wounds, which will heal up in a matter of 1 - 2 days, and scabs coming off in 4 - 7 days. The result is close to the conventional treatment, while avoiding the long downtime and potential side effects.