After laser resurfacing, a thin, clear, plastic wrap-like dressing is applied to the areas treated. This bandage is left on for 3 days. This bandage helps keep resurfaced skin protected and alleviates any discomfort. It has tiny perforations through which hydrating and soothing soaks may be performed. During the first few days, significant swelling and oozing will occur. It is essential to keep crusts or scabs from forming. This is achieved by applying soaks to the skin every 1 –2 hours. As your skin gradually heals, the frequency of soaks may be decreased. During the healing phase, most patients experience no pain or only mild discomfort. For the first 24 – 48 hours ice packs or frozen pea packs may be used to cool and soothe the skin and reduce swelling.

On day 3 the clear bandage is removed; however, soaks must be continued and Vaseline is applied to keep the healing skin moisturized. At the end of 7 – 10 days, most patients completely stop soaks or only do a soak 2 or 3 times a day. Vaseline may be gradually changed to a moisturizing cream. At the end of 2 weeks, the resurfaced skin has completely healed in most patients and makeup may be applied. At this point, most patients return to work or normal activities. Significant redness is normal and expected at this point. This redness typically lasts for 4 to 8 weeks but may last as long as 6 months in a few patients. This is easily covered with makeup.

The ideal candidate for resurfacing is a person with fair complexion to light brown complexion with a moderate to severe degree of sun damage or wrinkle. In persons with very deep wrinkles, a single resurfacing procedure will not completely smooth all wrinkles. In such cases or in cases of sever acne scarring, a second procedure to the whole face or just to problem areas such as around the mouth is often done 9 months to a year after the first procedure.

In patients with severe skin laxity or skin drooping, laser resurfacing is not a substitute for a face lift (rhytidectomy); however, resurfacing may be performed in conjunction with or following a face lift. The face lift procedure removes excess skin and the laser resurfacing smooths wrinkles and eliminates brown spots and blotchy pigmentation.

Patients with darker skin complexions (such as Hispanic, Asian, middle Eastern skin types) may undergo the laser resurfacing procedure; however, all patients of this skin type will experience some degree of temporary skin darkening or hyperpigmentation. This hyperpigmentation typically lasts 2 – 3 months but may last as long as 9 months to a year. It is treated with bleaching agents, Retin-A, and sunscreen.

For the treatment of sun damage and wrinkles there are number of topical agents that may be used to improve the skin’s appearance. These include alpha-hydroxy creams, tretinoin – the ingredient of Retin-A and Renova, retinol, vitamin C serum and sunscreens. Also superficial chemical peels may help improve the skin’s appearance, enhance texture and lighten blotchy pigmentation. Deeper peels (TCA or phenol peels) may achieve greater improvement in sun damage, but do not achieve the skin tightening and wrinkle improvement seen with laser resurfacing.

There are currently a number of non-ablative laser techniques that may be used to enhance skin smoothness, reduce blotchy pigmentation and improve wrinkles. These techniques have the advantage of no healing or down time; however, the degree of improvement noted with does not approach that of laser resurfacing. These non-ablative techniques include: Photofacial , CoolTouch, Vbeam, and Smoothbeam.

Filler agents such as collagen, fat and other agents may be used to fill in wrinkles and lines. All these agents have one major disadvantage in common – they are not long lasting and must be repeated every 3 to 4 months, although fat can be longer lasting.