Skin Resurfacing

As you age you will notice a change in the overall quality and texture of your skin.  Fine wrinkles begin to develop.  The outer layer of skin may thicken and become more rough whereas the deeper layers lose elasticity and begin to droop and thin.  Sun damage leads to pigment (color changes) and even early skin cancers.  A complete facial rejuvenation involves addressing the skin.  The first part of skin rejuvenation is protection.  Protection from the sun with a sun screen of at least SPF 30 is recommended.  The use of a Retin-A type product is the next step for skin improvement.  With more advanced damage, more advanced treatments including skin resurfacing are needed.
There are three ways to resurface the skin: chemical peels, dermabrasion, and lasers.  In turn, each resurfacing technique can be superficial, medium, or deep.  As you can imagine, the recovery time takes longer the deeper the resurfacing, but the results can be longer lasting and more dramatic.  In addition to the restoration of a youthful appearance to the skin, a further benefit is that these can help treat and prevent early skin cancers from developing into a true skin cancer.

Chemical peels involve using a specially formulated mixture that is applied to the skin.  This leads to a blister forming which will lead to a “peeling” of the skin several days after the treatment.  On the first day the skin will darken and almost brown.  This then proceeds to the peeling process.  As the skin peels you will see a pink, more youthful skin develop.  The pink color will begin to fade depending on the depth of the treatment leaving the final result.

Dermabrasion involves using an instrument to buff and abrade the skin layer by layer.  This leads to an immediate resurfacing of the skin with a red coloration and the production of an amber color fluid.  Dermabrasion is the gold standard for acne scar treatment in that it works by lowering the surrounding skin closer to the level of the acne scar.   For small areas to treat and scar revision this is usually done in the clinic.  For more extensive dermabrasion treatments this is usually done in the operating room.

Lasers are a specialized device that concentrates a beam of light to a single spot on the skin.  This, in turn, heats up these “cylinders” of skin by being absorbed by either water, skin pigment, or blood vessels depending on the type of laser being used.  There are different types of lasers for different skin conditions.  The first lasers were fully ablative.  These were very effective at resurfacing, but, unfortunately, had an unacceptably high side effect rate.  The next devices created were non ablative meaning they would not affect the top layer of skin.  These include devices such as Thermage, Ulthera, IPL (intense pulsed light), and other devices using either radiofrequencies or other forms of heat.  Newer lasers combined the benefits of the original ablative lasers but lessened the side effects by creating fractionated lasers.  This involves treating only a fraction of the skin at a given time.  This allows the untreated skin to help the treated area heal faster.  The benefit is there are fewer risks of side effects when compared to the original ablative lasers.  A commonly used fractionated laser is the carbon dioxide or CO2 laser.  This has been the gold standard for skin resurfacing with lasers and is offered in our office.  Another laser that we carry is the Erbium:YAG laser.  This also resurfaces the skin nicely but not as deeply as the CO2 laser.  This can either be used alone or be used at the end of a CO2 laser resurfacing to heal the skin faster.  On the day of treatment the skin has little dots that will soon fade into a more pink color simalarly to dermabrasion.

Dr. Guy has expertise with all three methods, and he can discuss each of them with you during a consultation.