Can laser resurfacing erase wrinkles in your skin?

Can laser resurfacing erase wrinkles in your skin?

If you have wrinkles, scars, sun-damaged skin, liver spots, age spots or uneven skin tone or texture, skin resurfacing can improve your skin's appearance.

You can explore three options that include laser resurfacing (either ablative or the less invasive, but also less effective, nonablative resurfacing) and plasma resurfacing.

Ablative laser resurfacing

Ablative resurfacing removes the upper layers of your skin so that new, undamaged skin grows. In the past, the standard laser used was a continuous wave carbon dioxide laser that produced good results but also had significant side effects. Today, less damaging options are also available, including pulsed and scanned carbon dioxide laser systems and the erbium laser.

Ablative laser resurfacing causes itchiness, swelling and redness. While the itching and swelling go away quickly, the redness, which can be intense, may last for several months. This technique can also cause acne or a bacterial, viral or fungal infection. A flare-up of the herpes virus, which causes cold sores, is common. Another possible side effect, especially for people with darker skin, produces changes in skin color (sun protection can help prevent irregular pigmentation). Rare side effects are permanent scarring and a condition called ectropion, where the eyelid turns.

Healing from ablative laser resurfacing can take one to four weeks, and you'll need to take things easy for at least a few days after the procedure.

Nonablative laser resurfacing

Nonablative resurfacing doesn't remove any skin. Instead, this laser technique penetrates your skin to stimulate collagen growth and tighten the underlying skin. The three main types of lasers used are mid-infrared lasers, pulsed dye lasers (PDL) and intense pulsed light (IPL) lasers.

Nonablative laser resurfacing can cause mild swelling and redness that typically only lasts a few hours or days. You can usually return to your normal activities right away. Other possible side effects include a flare-up of the herpes virus and changes in skin color. Blistering or scarring can also occur, but it's rare.

Plasma skin resurfacing

Plasma skin resurfacing uses ultrahigh frequency energy to convert nitrogen gas into plasma. The plasma doesn't remove the top layer of skin but rather heats the deeper layer. This heat stimulates new collagen to grow, leading to tightening of your skin over time. Your skin peels a few days after the treatment.

Possible side effects and recovery time are similar to nonablative laser resurfacing.

Deciding on a procedure

If you're interested in skin resurfacing, your cosmetic surgeon will review your medical history, do a physical exam and discuss what you expect from the procedure. Resurfacing generally isn't recommended if you have any of the following:

  • diabetes
  • an autoimmune or connective tissue disease
  • a weak immune system
  • have taken isotretinoin (an acne medication) during the past year
  • have had facial radiation therapy, have had keloids (an overgrowth of scar tissue)
  • are pregnant or breast-feeding

If you have had herpes infections (cold sores) around your mouth, your doctor will give you an antiviral medication before and after the resurfacing procedure to prevent a flare-up. Other medications your doctor might recommend are a topical retinoid (tretinoin) applied to your skin for four weeks before having ablative laser resurfacing and an oral antibiotic at the time of the procedure to help prevent a bacterial infection.

The average surgeon/physician fee in 2012 for ablative laser resurfacing was $2,222 and for nonablative was $1,113, according to the American Society of Plastic Surgeons. Prices vary based on the type of procedure, the doctor's experience and other factors. In addition to the doctor's fee, other costs may include surgical facility and anesthesia fees and medications. The cost for plasma skin resurfacing typically falls between about $2,000 and $4,000.

You can check the going rate for laser skin resurfacing in your area with Healthcare Blue Book, a free online guide that lists fair prices for health care services. The fair price is what a health service provider typically allows from insurance companies as full payment, which is substantially less than the billed amount.