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Laser resurfacing is a treatment for reducing facial wrinkles and skin irregularities, including blemishes and acne scars.

The technique directs short bursts of concentrated beams of light at irregular skin. The precisely controlled laser energy vaporizes a limited area of skin to a specific depth adequate to induce a controlled healing response. The treatment is meant to remove the upper layers of the skin, smoothing wrinkles and other architectural irregularities. As the minimally damaged skin heals, collagen production is induced which aids in building a more stable structure. The new skin produced during the healing period is tighter, smoother, and more even. The improvements in appearance and tone will continue to accumulate for up to 3 months and the visible results will last for years.

Who Is a Good Candidate For Fractional CO2 Laser Resurfacing?

If you have fine lines or wrinkles around the eyes, mouth or on the forehead, shallow scars from acne or non-responsive skin even after a facelift, then you may be a good candidate for laser skin resurfacing.

If you have active acne or if you have very dark skin, you may not be a candidate. This technique is also not recommended for stretch marks.

CO2 lasers have been used for years. The newest version of the CO2 laser resurfacing uses very short pulsed light energy that are delivered in a scanning pattern to very precisely remove thin layers of skin with minimal heat damage to the surrounding structures. Recovery time from the procedure is generally one week.

Preparing for Laser Resurfacing.

Certain problems, such as previous burns or radiation exposure, may necessitate a special evaluation to determine if you are an appropriate candidate for the procedure. You should also let the doctor know if you get cold sores or fever blisters around your mouth, as this procedure can trigger breakouts in susceptible people.

If you decide to proceed with laser skin resurfacing, your doctor will have you avoid taking any medications or supplements that can affect clotting, such as aspirin, ibuprofen, omega 3 fish oil or vitamin E, for 7 days before surgery. If you smoke, you should stop for two weeks before and after the procedure, because smoking can prolong the healing process. Your doctor may prescribe an antibiotic beforehand to prevent bacterial infections and, if you are prone to cold sores or fever blisters, you may receive an antiviral medication.

What Can Be Expected During Laser Resurfacing?

Fractional CO2 laser resurfacing is performed on an outpatient basis, using a numbing agent to minimize pain. This is usually given in the form of a topical anesthetic gel applied on the area to be treated. In some patients, anesthesia may be combined with orally administered sedative medications.

Wrinkles around the eyes, mouth or forehead may be treated individually, or a full-face resurfacing may be performed depending on the needs of the patient. Full-face treatments often last an hour while partial treatments may require 30 minutes to complete.

What Happens After Laser Resurfacing?

CO2 laser resurfacing is often performed on an out-patient basis, so patients can expect to go home immediately after treatment.

Following laser resurfacing, the patient cleans the treated areas two to five times a day with cool tap water, saline or a dilute vinegar solution. An ointment such as Vaseline or Aquaphor is then applied. This wound care is intended to prevent any scab formation. In general, the areas heal in 5-10 days, depending on the nature of the condition that was treated.

Once the areas have healed adequately (usually after the 5th day), makeup may be worn to camouflage the pink to red color that is generally seen after laser skin resurfacing. Green-based make-ups are particularly suitable for this camouflage since they neutralize the red color. Oil-free make-ups are recommended after laser resurfacing. The redness in the laser-treated sites generally fades within 2 weeks but may take as long as a month to completely disappear. The redness generally persists longer in people with fair skin.

Patients with darker skin tones have a greater risk of healing with darker pigmentation. This may be minimized by use of a bleaching agent before laser skin resurfacing as well as continued use of this agent after healing.

What Are the Complications of Laser Resurfacing?

Milia, which are small white bumps, may appear in the laser-treated areas during healing. These may be removed by opening and draining the individual lesions.


Hyperpigmentation (increased pigmentation) and hypopigmentation (decreased skin pigmentation) may result in the laser-treated areas. In general, the hyperpigmented areas may be treated with bleaching cream to speed fading of the pigment, although this may be a very slow process.


Reappearance of a cold sore may occur, especially after laser skin resurfacing around the mouth. You can prevent this by asking your doctor for an antiviral medication, which you can begin taking before your surgery and continue taking seven to 10 days after laser resurfacing.


You may be able to prevent bacterial infections by taking an antibiotic prior to the surgery and continuing for 7 to 10 days afterward, although this is no guarantee that an infection will occur after the procedure.

You should expect swelling after laser skin resurfacing. Ask your doctor about what you can do to lessen this effect.

Patients are encouraged to sleep on an extra pillow at night to help reduce the swelling after laser resurfacing. Ice pack application is also helpful in the first 24-48 hours.

Scarring after laser skin resurfacing, although very unusual, may occur in laser-treated areas.

Cessation of smoking is highly recommended, because smoking is known to have harmful effects on the healing process.

How Should I Take Care of My Skin After Laser Resurfacing?

It's important to remember that skin treated with laser resurfacing may react in different ways.

Most commonly, you may feel like you have a serious sunburn. There will be swelling and redness of the skin. You may experience itching or stinging for 12 to 72 hours after the procedure. Five to seven days after laser resurfacing, your skin will become dry and peel.

New skin will form after the treated area has been peeled. This skin will at first appear pink. It should begin to gradually lighten for up to a year after treatment. Your doctor will not consider retreating the area until the area is completely healed.

Daily sunscreen application is necessary after healing to protect the newly laser-resurfaced skin. A "broad-spectrum" sunscreen, which screens both ultraviolet B and ultraviolet A rays, is recommended. A sunscreen specifically formulated for use on the face should be chosen, with at least a sun protection factor (SPF) of 30.

Liberal moisturizer application is also recommended after healing. Patients may resume application of Retin-A and/or glycolic acid products 4-6 weeks after laser resurfacing or as directed by their physician.

Cost of Laser Skin Resurfacing

The national average cost for laser skin resurfacing is $2,378, according to the American Society of Plastic Surgeons. Because laser skin resurfacing is considered an elective, cosmetic procedure, most medical insurance companies will not cover it; however, in some cases, the procedure may be covered if the purpose is to modify scars or remove precancerous growths on the skin. It is important to speak about your precise costs with the doctor and your insurance company before the procedure.