As a child, your skin was soft and smooth. Over the years, the sun, wind and pollution in the air have caused significant damage to the skin. As part of the natural aging process, our skin begins to lose collagen and begins to accumulate a thicker layer of dead cells, while our healthier skin layers have become thinner. All of these changes will cause our skin to look wrinkled and leathery. Many of my clients think that their skin is always dry and flaky and have used all sorts of expensive moisturizers in hopes of "plumping" up the skin by restoring its moisture. Although it's true that as you age your skin loses its natural ability to hold moisture, this is not the reason why your skin "looks dry and flaky". The dry look is also caused by the thick dead cell layer (stratum corneum) that has built up over many years covering the underlying healthy layer of the skin.

The laser is a new medical technology which will help to restore the quality of your skin by ablating the very superficial layer of the skin. The regenerated skin will be smoother and healthier.
 

SIGNS OF AGING
The order in which the fine lines appear and the depths of the lines may vary with each individual. This depends very much on the action of the facial muscles and whether you predominantly use the upper face or the lower face during facial expression. The areas where wrinkles are likely to appear first are around the eyes, the forehead and the lips. Factors which accelerate aging is exposure to UV rays from the sun, toxins in the air, smoking, stress and poor nutrition. It has been found that those women on estrogen replacement therapy during post-menopause age less than their peers who are not on estrogen.
 

WHAT IS LASER RESURFACING?
I use CO2 laser for laser resurfacing. It works by emitting an intense beam of energy that heats and vaporizes the outer layer of the skin instantly. Fine lines and wrinkles around the mouth and eyes are smoothed. Deep creases and frown lines will be softened. The depth of tissue that it removes is so precise that it has replaced chemical peels completely. The healing is much quicker and better than in chemical peels. The results are also much more predictable. It also has less risk of scarring.
 

OTHER BENEFITS OF LASER RESURFACING
Other than wrinkle reduction, CO2 laser resurfacing has quite a few other benefits and is used to treat many other skin lesions:

• It tightens the loose skin. This is particularly beneficial in tightening the baggy and loose skin in the lower eyelids which may make you look tired.
• It stimulates collagen formation over the long term to gain back some of the skin's elasticity. This has been demonstrated histologically in volunteers who had laser resurfacing.
• I also use laser resurfacing to remove acne scars, dark sun-spots (hyperpigmentation), large moles and pre-malignant skin lesions.
   

THE PROCEDURE
The CO2 laser resurfacing is done as an in-office procedure. This is usually done under local anesthesia. If the area to be lasered involves a region or the entire face, then some IV sedation is recommended. The entire procedure takes approximately 1 1/2 to 2 hours. If you were to have conscious sedation, you should have someone drive you home and stay with you for 24 hours after the procedure until the effects of the sedation has worn off.
 

PREPARATIONS BEFORE THE PROCEDURE
I recommend to my clients to have the skin "prepped" before the laser resurfacing, This involves a series of 1 or 2 miocrodermabrasions (for information on miocrodermabrasions, ask my assistant or pick up a brochure from me) and start on a medical skin care regime such as low concentration of glycolic or lactic acid applied to the face twice a day for one week prior to laser. These products are available in my office.  If you break out in cold sores, you should start on a cold sore medication such as Famvir or Valtrex at least one day prior to laser treatment and continue it for seven days.
If you are a smoker, you do have an increased risk of poorer healing, scarring and prolonged redness. I ask my clients to stop smoking at least two weeks before the laser procedure.
 

RECOVERY
Generally, my patients enjoy a short recovery time after laser resurfacing. Because the CO2 laser I use has a superior scanning mechanism, the redness will only last on the average for six weeks as compared to three months with most other CO2 laser resurfacing procedures. Most of the healing takes place in the first week. During this time the treated areas must be kept moist or covered with an occlusive dressing prescribed by me. After the first week when the oozing has stopped, you may camouflage the redness with some make-up. By this time you will already notice the smoothness of the skin.
 

ARE YOU A CANDIDATE FOR LASER SKIN RESURFACING?
I will review your medical history, age and skin type with you during your consultation and consider your desired results to determine if you are a candidate for laser resurfacing. Results can vary from patient to patient based on different skin types and types of skin lesions, and a different form of laser may benefit you more.
 

OTHER LASERS USED FOR SKIN RESURFACING
The other laser I sometimes use is the Erbium-yag laser, which you may have heard about. It was popular because the redness lasted shorter than the CO2 laser. The healing was therefore faster. It has slightly different indications than CO2 lasers. I find it most effective in treating certain severe acne scarred patients, particularly scars that look very bumpy or depressed, because the laser works more to even out the irregular skin contour rather than for wrinkle reduction. It also has very little effect in tightening the skin.

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