Laser
Skin Resurfacing (Laser Peel)
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.
