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There are many different types of resurfacing and rejuvenating lasers available in Australia. These are generally divided into ablative and non-ablative types. The essential difference is that ablation means destruction or vaporisation of tissue. This is particularly helpful in removing unwanted or damaged skin such as in the case of wrinkles, scars, acne scars, and severe pigmentation or a combination of these conditions. The non-ablative types cause rejuvenation by heating rather than destroying the tissues. This is a good alternative but generally a less effective method of treatment. There is less down-time and lower complication rate, but, often multiple treatments are required.
Treatment with the Erbium laser may be adjusted according to the level and severity of the condition of the patient and to the level of improvement desired. The risks, potential discomfort, and the length of down-time are directly related to the depth and power of the treatment. The deeper and more aggressive the treatment, the better the results (within the limits of safety). Generally, the darker the patient's skin type, the higher the risk of complications such as post-treatment pigmentation. Mediterranean types of skin or darker, pose a higher and higher risk category.
We have discussed previously, wrinkle fillers, wrinkle relaxers and other options of cosmetic treatment. The rules are simple:
- Volume loss = replace the volume
- Muscle hyperactivity = use a wrinkle relaxer
- Surface-skin problem = use a surface-skin treatment (laser, IPL, chemical peel)
- Gravity problem = use an anti-gravity treatment (surgery)
Of course, patients don't always fit into snug and convenient categories. Usually, more than one type of problem co-exists. The doctor will diagnose and prescribe the most appropriate cocktail of treatments to best suit the individual patient.
Laser treatment is usually done in a day -theatre or hospital under local anaesthesia or under "twilight anaesthesia" Patients will usually go home the same day and are followed up post-procedure in the doctor's rooms. Pain is usually mild (sunburn like) and lasts 1 to 2 days. The new skin formation occurs within 1 week but facial redness will continue for several weeks. Once the skin is healed, make-up can be used and the patient can return to work or normal social activity.
The patient will appear very unattractive for the first few days, but will be much better by the end of the week. Further skin improvement occurs rapidly for the next 1 to 2 weeks but will improve even further for many months afterwards. Results should last for 5 years or more if the patient looks after the skin and avoids the sun, smoking etc.
Darkening of the skin several days to weeks after treatment is possible, particularly in darker skin patients or patients with a history of post-inflammatory problems.
Depigmentation of the skin to a whiter shade of colour. This occurs most commonly on the jaw-line area but may also affect other regions of the face . The risk of this is about 2% and seems to be more likely in lighter skin types. A warning sign may be the presence of pre-existing white spots on arms, legs, or the face. This effect may occur up to 2 years after treatment. However, if it occurs, it is usually of a minor nature and. it is not such a bad trade-off since you can cover it with makeup but it is much more difficult to cover wrinkles with make-up.
Is similar to the above. It usually occurs soon after treatment and generally disappears with time.
Redness usually disappears after several weeks. However, the redness occasionally persists for a number of months. It usually totally disappears.
These are rare. They can be a result of over aggressive treatment but are usually a result of postlaser infection, particularly if it is not treated early. Anything which delays the normal healing process will increase the chance of scar formation e.g. diabetes or depressed immunity conditions.
FAILURE TO RESPOND
This means that the condition of the skin does not respond as well as expected or to the patient's satisfaction. This can be due to conservative treatment, a more severe skin condition which is beyond the ability of the laser to fully correct, or, more likely, unreasonable patient expectation. This is more likely in cases of post-acne scars.
patients with a history of previous acne have an increased risk of acute juvenile type acne flare. This is treated the same as any ordinary juvenile acne. SUN SENSITIVITY --- after any type of light-based treatment, the skin is more sensitive to the sun and/or heat. Sun avoidance and the use of sun blocks is essential. If your life-style involves a lot of sun exposure, you will need to choose between your life-style and your skin.
SENSITIVITY TO FACIAL PRODUCTS
the new rejuvenated skin is now different to the older damaged skin. It may be more sensitive to some facial products and make-up. Also the skin colour and tone is different. New make-up colour may be necessary.
PAIN, BLEEDING, SWELLING
These are usually part of the normal healing process. They are usually mild and well tolerated. Any persistent or severe symptom may be a sign of infection and needs to be reviewed as soon as possible.
The normal skin is a natural barrier against infection. Once the integrity of the skin is breached, the chance of infection increases. All laser patients are therefore prophylacticlly treated with antibacterial, anti-fungal and antiviral antibiotics. This risk will be closely monitored by the doctor.
RECURRENCE OF WRINKLES etc.
No treatment is permanent. Wrinkles eventually recur with age. However, they will not be made worse because of your treatment. The results should last on excess of 5 years if you look after your skin and avoid the sun. This also applies to the other treated skin conditions.
Other alternatives to laser resurfacing will always be discussed with you before you make your decision to proceed.