Laser resurfacing (laser peeling) is used to rejuvenate the appearance of the face and remove the effects of sun damage and wrinkles of old age. It may also be used to removed unwanted pigmentation. It may also be effective for minor acne scarring.

Anaesthetic

For a small area laser resurfacing may be done under topical anaesthetic (EMLA cream) or local anaesthetic injections. For larger skin areas the procedure is best performed under a general anesthetic.

Length of Operation

This varies with the area of facial skin involved. Normally the procedure takes between 20 minutes and an hour.

Technique

Carbon dioxide laser is used for the laser resurfacing. Normally it is only the outer layer of the skin known as the epidermis that is removed. Occasionally for severe scarring part of the dermis may be removed.

Time in Hospital

Laser resurfacing is normally done as a day case but if extensive facial resurfacing is required the patient may be kept in between 1-2 days. Immediately after surgery the skin is very raw and requires treatment either with a dressing or antiseptic ointment for the first 7-10 days as healing occurs. During this time the skin will appear very red as if one is suffering from severe sunburn. The redness normally reduces between 2-6 months. However during this time the skin is similar to that of a baby's skin and is very sensitive to sun damage, therefore sun block should be used.

Time off Work

Time off work is really due to the need for constant application of ointment and dressings in the first few days. Ten days off work may be necessary due to the bright red appearance of the skin.

Risks and Complications

Scarring is very unusual in normal skin types but is a serious risk in patients who produce keloid scarring and those who have undergone radiotherapy or Roaccutane treatment. Change in skin pigmentation has been known to occur and can either be areas of darkening, which normally resolves spontaneously, or occasionally generalised lightening of the skin can occur. Activation of cold sores (herpes infection) can occur which may require treatment with either ointment or antiviral tablets.

Outcome

The treatment is usually successful for fine wrinkles and sun damage.

Alternative Treatment

Previous treatment has involved either chemical peels or dermabrasion. It is important that treatment is performed by an accredited plastic surgeon or consultant dermatologist

Cosmetic surgery guide

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