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No Down-time Facial Resurfacing
2007-03-27
Dear Dr. Proskiw:
I am a 54-year-old woman with visible wrinkles and sun damage on my face. I admit that I was a sun worshipper and always had a good tan in the summer. I now regularly use a sun block, including a good skin care program. I have tried microdermabrasion and mild peels but the wrinkles on my face have not really diminished as far as I can see. Laser resurfacing has been suggested to me as a treatment option, but I’ve heard that there is a period of downtime associated with this procedure and I cannot afford to take any time off from my business. I have a friend who has had dermabrasion, but her upper lip looks abnormally smooth and the effect does not look natural to me. Are there any other treatment options I can look into that don’t involve downtime from my busy schedule?
Answer:
Both your lifestyle scenario and questions are common, and I address them everyday. Yes, there are treatment options available that you may want to consider. Over the past two years, new laser technologies have been developed that result in wrinkle reduction, skin tightening, and removal of signs of sun damage. The most common signs of sun damage I see are skin pigmentation, thickened skin, and visible premalignant and malignant lesions. If you are curious to see what skin looks like without sun damage, compare the skin on the inside of your forearm with the skin on the exposed surface of your forearm. The smooth, soft, and even-coloured skin on the inner forearm is a good example of what healthy skin would look like if it weren’t for the damaging effects of the sun.
The results of the most recent laser technologies are comparable to laser resurfacing but do not require a period of downtime for the patient. These technologies are known by different trademark names, however each laser has resulted in improved results and higher patient satisfaction. Every laser technique involves making microscopic holes in the skin with a specific level of laser energy. These small holes cause micro-damage to the deeper tissues, and as the skin heals, it tightens and new collagen is formed. The procedure involves a series of three to five treatments that are spaced three weeks apart. There is usually no downtime, but the skin will appear slightly red and flaky for an average time period of between six hours and five days following treatment. One can usually see visible results after approximately six weeks, or after the third treatment.
Question:
Can you give me some information about these lasers?
Answer:
The first laser that I used was the Fraxel. This laser requires the application of a colored dye to the skin, which enables the operator to adequately treat the entire face. There can be some downtime associated with this laser and the procedure requires topical anesthesia. The Pixel laser puts round microscopic holes in the skin, as was mentioned earlier. It has limitations in the depth that it can penetrate, but gives acceptable results. The newest laser is called Affirm. This is a multiple wavelength YAG laser that gives excellent results and has minimal downtime. Because this laser uses cold air as an anesthetizing agent, no topical anesthetic or post treatment pain medication is usually needed. Normal activities can be resumed immediately following the procedure, and discomfort is minimal.
Question:
My mother is 74-years-old, and has much deeper lines and wrinkles. Would she be a good candidate for this treatment?
Answer:
I would say that she would probably not benefit from this type of treatment. Deep lines that come with advancing age can be associated with skin laxity, and therefore, your mother would most likely get the best results from a face-lift or deep laser resurfacing. I hope that this information has been helpful to you, but I would suggest that you both see a physician that specializes in laser treatments and aesthetic medicine to obtain as much information as possible before you make any definitive treatment decision.
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