Laser facial resurfacing
Your health expert: Dr Anton Alexandroff, Consultant Dermatologist
Content editor review by Victoria Goldman, March 2021
Next review due March 2024
Laser resurfacing is a procedure to remove the outer layers of skin from your face and encourage new skin to grow. Most people have it to make their skin look and feel better by reducing wrinkles, scars and blotchy patches.
What is laser facial resurfacing?
If you have laser resurfacing, your doctor will direct an intense laser beam onto your skin. This may be able to:
- reduce or remove fine wrinkles
- tighten your skin
- even out the colour of blotchy patches of skin
- smooth rough skin
- make your scars look better – including shallow acne scars
Your surgeon can direct the laser on particular problem areas such as wrinkles around your eyes, mouth or nose. Or they can treat your whole face. You can have laser resurfacing treatment on other areas too – for example, on the skin of your neck, chest, arms and hands.
This topic covers laser resurfacing on your face.
Types of laser resurfacing
Ablative and non-ablative lasers
There are two main types of laser resurfacing – ablative and non-ablative. This topic mainly describes ablative laser resurfacing.
Ablative laser resurfacing removes the top layer of your skin (the epidermis). This exposes the deeper layer of your skin (the dermis). The heat from the laser makes your skin tissue tighten, which triggers new collagen fibres to grow. Collagen is a long fibrous protein that gives your skin its structure and strength. As the wound heals, you’ll form new skin that’s softer and less wrinkled or scarred than before.
Non-ablative laser resurfacing doesn’t remove the top layer of your skin. Instead, it heats up the dermis to encourage new skin to grow and trigger collagen growth. Non-ablative laser resurfacing has a gentler effect on your skin than ablative laser resurfacing but the results aren’t as noticeable. For more information, see our FAQ: What is non-ablative laser resurfacing?
Types of ablative laser
There are two different types of ablative laser:
- carbon dioxide (CO2) laser
- Erbium:YAG (Er:YAG) laser
Carbon dioxide lasers go deeper into your skin than the Er:YAG lasers. Your skin absorbs more of the Er:YAG lasers, which causes fewer side-effects. Your doctor will choose the best laser type for you. Sometimes, they may use both types together or one after the other to get a better effect.
Fractional ablative lasers remove a small part of your skin rather than all of your skin. These lasers are newer and don’t usually damage surrounding skin.
What are the alternatives to laser resurfacing?
Your doctor may recommend other treatments instead of or before laser resurfacing.
- Chemical peels – these use acid to remove layers of your skin.
- Dermabrasion – in this procedure, your surgeon will remove the top layer of your skin using a rotating surgical instrument.
- Microdermabrasion – abrasive substances such as crystals are directed onto your face to treat wrinkles and sun-damaged skin.
If you have very deep wrinkles or sagging skin, your doctor may recommend a facelift instead of laser resurfacing. A plastic surgeon will discuss the different options with you.
Preparing for laser resurfacing
You’ll meet your surgeon before your procedure. They’ll check your skin type and look at the areas of skin that are being treated. They’ll see where your wrinkles are and how thick they are. This will help them to decide which type of laser resurfacing to use.
Your doctor will tell you if there’s anything you need to do before your surgery – for example, use any special creams on your skin.
Laser resurfacing is usually done as a day-case procedure in a clinic or hospital. This means you’ll have the procedure and go home on the same day. If you’re having a general anaesthetic, you’ll usually be asked not to eat or drink anything for several hours before your procedure. Your doctor will give you specific advice.
Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you feel happy to give your consent for the operation to go ahead. You’ll be asked to do this by signing a consent form.
What happens during laser resurfacing?
You’ll be given an anaesthetic before laser resurfacing to stop you feeling any pain during the procedure. This may be a local or general anaesthetic, depending on how much of your face is being treated and which laser your surgeon uses.
If you’re having small areas of skin treated, you’ll usually be given local anaesthetic creams or injections into your skin. The local anaesthetic will numb the skin on your face, so you won’t feel pain – but you’ll stay awake during the procedure. You may also be offered a sedative – this helps you relax and stops you feeling anxious.
Sometimes, you may have laser resurfacing under general anaesthesia, which means you’ll be asleep during the procedure. This is usually the case if you’re having your whole face treated.
You may need to wear an eye shield if your surgeon is treating the skin near your eyes.
Once the anaesthetic is working, your surgeon will pass the laser beam over the areas of your face being treated. They’ll be able to control where the laser points and how deep it reaches. They may keep directing the laser onto your skin until they’ve removed enough skin or have gone deep enough.
After laser treatment, your surgeon may cover your face with an ointment or dressing to protect your skin while it heals.
What to expect afterwards
If you’ve had a local anaesthetic, it could be a few hours before you get the feeling back in your face. Your skin may feel raw and you may need painkillers to help with any discomfort. If you’ve had a general anaesthetic, you’ll need to rest until the anaesthetic has worn off.
You’ll usually be able to go home when you feel ready. Your surgeon or nurse should give you some information about how to look after your healing skin before you go home.
If you’ve had a general anaesthetic or a sedative or if your dressings cover your eyes, make sure someone can take you home. Ask them to stay with you for the first day or so, while you recover from the anaesthetic and get back to normal. General anaesthesia can make it harder to coordinate your movements and to think clearly. Don’t drive, drink alcohol, operate machinery or sign legal documents during this time.
Recovering from laser resurfacing
Your skin is likely to be swollen and red for the first few days after the procedure. These are normal side-effects after laser resurfacing – and shouldn’t be anything to worry about. Your skin should heal after a week or so, and the redness should fade completely after two to six months. This varies from person to person though, and also depends on which type of laser your surgeon used. If the redness or swelling isn’t getting any better after a few days, speak to your surgeon.
Pain relief
You may have some pain after laser facial resurfacing and once your anaesthetic wears off. But if you’re in a lot of pain afterwards, let your surgeon know.
If you need pain relief while your skin is healing, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and, if you have any questions, ask your pharmacist for advice.
You may find it helpful to keep your head raised on pillows at night and to put some ice on your face. Use a covered ice pack or wrap ice in a towel. Don’t put ice or an ice pack directly onto your skin.
Caring for your healing skin
Your surgeon may advise you to wash your face gently with a special cleanser, beginning a couple of days after the procedure. You may need to do this two or three times a day and moisturise your skin too. This will keep your skin clean and supple, and stop it drying out. Ask your surgeon which skin products you should use.
Your surgeon may give you a course of antibiotics to take after the procedure to prevent an infection.
Sun care
You’ll usually be advised to stay out of the sun until any redness has faded. This is because you may get dark patches, especially if you have olive, brown or black skin. Once your skin has settled down, make sure you apply sunscreen of at least factor 30 and with both ultraviolet A and B protection. It’s important to keep using sunscreen when you go out for at least a year after your laser resurfacing.
Following your surgeon’s advice will help to make sure your skin heals quickly and give the best results.
Complications of laser resurfacing
Laser resurfacing can cause some complications.
- Redness that lasts a long time. Your skin is likely to be red after laser resurfacing, but this may be worse or last for longer than you were expecting. You may find it bothers you more than the reason you had the procedure in the first place (for example, noticeable wrinkles). The redness should settle down over time. You may find camouflage make-up helps to make it less noticeable.
- An infection. If your skin suddenly feels very sore a day or so after your procedure, you may have an infection. It’s important to let your doctor know. An infection can be treated with antibiotics or antifungal medicines.
- Changes to your skin colour – this is more likely if you have dark skin. If your skin gets darker, this may go away on its own or your doctor may be able to treat it. Some people notice their skin gets lighter after the procedure.
- Scarring – this is rare but damage from the procedure or an infection can cause scarring. Some things can make you more likely to get scarring after laser resurfacing. These include recent radiotherapy on the same area, being prone to keloid scars (overgrown scar tissue) or recently taking an acne medicine called isotretinoin.
- Cold sores – if you’re prone to cold sores, you may find you get these after the procedure. Your surgeon may suggest you take a medicine called aciclovir to stop this happening.
Ablative laser resurfacing can’t treat active acne (that is, when your acne is causing lots of spots and making your skin red and inflamed). It won’t help with deep acne scars either. But it can help to reduce any shallow acne scars. Non-ablative laser techniques may be able to treat acne scars and some types of acne too.
If you’re taking the medicine isotretinoin for acne or have used it in the past two years, you won’t be able to have ablative laser resurfacing. This is because isotretinoin makes you more likely to get scars after the procedure.
If you have acne, your pharmacist or GP will be able to give you advice and recommend the best treatment for you. There are many treatments available, including creams, lotions and antibiotics that can control any infection and prevent new spots forming.
Non-ablative laser resurfacing is similar to ablative laser resurfacing but it doesn’t destroy the top layer of your skin (the epidermis). It uses several different techniques and types of laser.
Non-ablative laser resurfacing doesn’t work as well as ablative laser resurfacing – the changes to your skin may not be as noticeable. But your skin will recover more quickly afterwards. For example, your skin may look red for only a couple of days after this procedure.
Non-ablative resurfacing is often better for younger people who want their skin to look and feel better. It may also be a better option if you have darker skin.
Acne
Acne, or acne vulgaris, is a common skin condition that causes spots.
Wrinkle treatments
There are lots of different treatments which aim to reduce the appearance of wrinkles, and make your skin look smoother and more youthful.
Other helpful websites
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This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
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