Laser Resurfacing

SKIN RESURFACING WITH THE DERMA-K LASER

Definition of skin resurfacing: Skin resurfacing is a term used as opposed to re-contouring and re- draping. Re-contouring means changing the contour of the tissue underneath the skin, Re- draping is tightening of the sagging skin with a face-left. Skin resurfacing amounts to making wrinkles less visible and improving the texture of the skin. Ten years ago the only tools to resurface the skin were chemical peels and dermabrasion. These two modalities work pretty well. However, a chemical peel can be either too superficial or too deep, because the depth of the burn inflicted to the skin cannot be controlled well. The result of the deep chemical peel was fraught with complications and a long recovery period. Dermabrasion has its merit, too, but again the depth cannot be controlled that well, cannot do certain areas on the face and the recovery period is also long.

Within the past 10 years, the CO2 laser has become useful. With technological advances it became the most popular tool for skin resurfacing. In spite of its improvements there were some adverse effects resulting from the thermal injury to the surrounding tissue inherent to the CO2 laser. That thermal injury was a source of complications as well as of a prolonged recovery. The main advantage the CO2 laser has over a chemical peel and dermabrasion is that we can control the depth of the skin ablation better, That's why we were waiting for a newer, more advanced laser that would cause less thermal injury, i.e. less complications with a more rapid recovery. In 1996, a newer more technologically advanced laser emerged: The Derma-K laser. The Derma-K laser delivers a combination of CO2 and Erbium wavelengths resulting in less thermal injury to the surrounding tissue as compared to the straight CO2 laser. This gives us a larger safety margin with accurate control of the treatment delivered to the skin. Therefore, the Derma-K laser provides more safety and a faster recov3ry than the CO2 laser.

For the same re4ason, a second treatment can be done earlier with the Derma-K laser than we could with the CO2 laser. The treatment with the Derma-K laser can be repeated at 3 months as opposed to 6 months with the CO2 laser.

During the laser treatment, the surgeon carefully passes an activated laser beam back and forth over the skin until the safest level is reached. Deep wrinkles and acne scars require more than one laser treatment to achieve the best results. Also, as your face continues to age after a laser treatment, you may repeat the treatment to maintain a more youthful appearance.

The factors that will influence the result, like with the CO2 laser, are technology dependent, technique dependent, skin dependent and patient dependent. Indeed, the patient like with the chemical peel and dermabrasion will have to be compliant and follow instructions in order to avoid complications and maximize the results.

The way to enhance the result of the laser resurfacing is as follows:

At least 2 to 3 weeks of skin pre-conditioning with a laser prep cream is required prior to treatment.

There are 3 stages you will need to go through:

Pre-conditioning of the skin before laser treatment, - This pre-conditioning will help obtain better and faster results from the laser treatment. It consists of applying special creams containing Retin-A, hydroquinone and kojic acid. It will be given to you and explained during your pre-operative visit.
Laser treatment. Performed in the operating room, under general anesthesia to avoid any pain during the treatment. It takes about an hour. Afterwards, Vaseline will be applied.
Post-laser treatment. - The acute phase of healing usually takes 10-14 days. During this time you will be applying Vaseline on the treated area several times a day to keep moist. Usually at about 10 days post-op make-up can be applied to camouflage the redness pf the skin that lasts about two months. Absolutely NO SUN EXPOSURE. You must wear a total sunblock and hat for at least 6 months after the laser treatment.

It may sound like a long process, but it is worthwhile. Another advantage the Derma-K laser has over the CO2 laser is the cost for treatments. The cost of treatments with the CO2 laser is more expensive than with the Derma-K laser due to the extended post-operative follow-up care with more risks for the patient and the surgeon that is inherent to that type of laser. At first, it was believed that the CO2 laser triggers more skin tightening, but further studies showed that the Derma-K (Erbium/CO2) laser does the same.

In conclusion, skin resurfacing with the Derma-K laser has definitely lowered the risks as compared to the CO2 laser with this advanced technology, complications have become very rare and are usually related to over-treating.

SUMMARY: CO2 laser vs. Derma-K laser

The Derma-K laser provides a more precise beam of laser energy for more control of the laser treatment, meaning less risks and a shorter recovery than the straight CO2 laser. I cannot over-emphasize the fact that it is far better treating a patient for 3-4 months without problems than spending 6 months or longer treating a patient with a complication resulting from technology that is less advanced than the Derma-K laser.

The skin is our bodies' largest organ. It protects us from infection and shields us from harmful substances. However, as we age, the effects of wind, time, and hormones begin to show. At first, fine lines appear, after which, as the collagen beneath our skin wears out, deeper wrinkles appear. Surface irregularities may also occur, such as pigment discoloration and acne scarring.

The Derma-K state of the art laser combines erbium and CO2. This laser is used for treatment of aging and sun-damaged skin. The Derma-K laser provides a safe, accurate, and less painful method of restoring softer, smoother, more youthful-appearing skin. This laser is designed to remove superficial and moderately deep lines and wrinkles on the face. It produces less heating or burning of the surrounding tissues than many other lasers used for resurfacing, allowing Dr. Carli to remove the damaged skin cells layer by layer. The procedure is done under general anesthesia and takes about 1 hour. After surgery the skin is red, and swelling is normal. Normally patients can return to most normal activities in about 2 weeks with make-up on to camouflage the redness that can last for over 3 months.

Sun block must be applied if you will ever be in the sun, and makeup can be worn after the first week or 2. Over the next few weeks, your fresh, new, pink skin will fade to a normal tone revealing a softer, smoother, younger look.