MicroLaserPeel

What are types of skin damage caused by age and the sun?

The damage that develops in the skin over the years comes from two sources. First there is intrinsic damage. This is before the spontaneous age-related changes which everyone develops in varying degrees. The second type is actinic or sun-cause damage. This varies widely depending on one's skin type and lifelong sun exposure. Together these changes are the differences we see from the smooth, soft, resilient and attractive skin of our youth.

The specific skin changes include the following:

• Progressive development of fine and medium wrinkles
• Skin coarseness and irregularities of texture, larger pores, etc.
• Loss of skin elasticity and resilience
• Tissue sagging and laxity
• Thinning of the cellular layers of the epidermis
• Thickening of the dry keratin layers of the epidermis
• Pigmentary irregularities and "age spots"
• Increase in visible blood vessels and spider veins
• Loss of healthy (Type I) collagen and elastin fibers from the dermis
• Increasing deep dynamic wrinkles such as frown lines, crow's feet, etc.

What options are available for correcting this damage?  What are the alternatives to laser resurfacing?

Other procedures to treat some of these conditions include chemical peels, microdermabrasion, conventional skin or plastic surgery and electrosurgery. These techniques each have their own advantages and disadvantages. And they each carry limitations, risks and possible complications. Laser skin resurfacing is superior to and has largely replaced the use of deep chemical peels. If your condition would be better treated by a non-laser method, you will be referred to an appropriate specialist.

What are the benefits to laser skin resurfacing?

• Sun damaged epidermis is removed. The purpose of laser skin resurfacing is to precisely and safely remove sun damaged layers of skin. The Erbium resurfacing laser is the most precise method available for this. Sun damaged epidermis is carefully removed. With it goes the damage from years of sun exposure. Pigmentary changes are removed. Textural changes and roughness are removed. Benign and pre-malignant skin lesions, including seborrheic keratoses and actinic keratoses, are removed. New epidermis grows over a healthier base in a matter of days. The new cells grow from the gland and follicles deep within the dermis that have never been exposed to sunlight. So the skin is literally renewed. This results in marked improvement of the effects of photo damage.
• Wrinkles are removed or reduced. Wrinkles, especially fine to medium wrinkles, are removed or reduced during the resurfacing process with 70 to 90 percent improvement. Deeper wrinkles may be significantly improved (50 to 80 percent) but may not be completely removed.
• Skin folds and frown lines are improved. Dynamic wrinkles are caused by muscle movements from certain facial muscles. These include frown lines, crow's feet, squint lines, and brow furrows. These may be markedly improved by Erbium laser resurfacing. However, in time they can be recreated by the same facial muscles and gradually return. It is possible to improve these results and prevent recurrence of these dynamic wrinkles by supplementing laser treatment with Botox injections or Restylane.
• New collagen and elastic fibers create an improved skin foundation. The resurfacing laser can stimulate growth of a thicker and healthier layer of Type I collagen. This results in better skin texture and resiliency with a more youthful appearance.
• Collagen contraction tightens slack and sagging skin. Laser skin treatment with the Erbium laser (with diathermy effect) can cause the collagen in the dermis to contract by 20 to 30 percent. This markedly reduces sagging skin tightens laxity. This contraction effect can delay the need for a face lift in many people. The resurfacing laser also improves skin thickness and elasticity by stimulating the formation of Type I collagen and healthy elastin fibers in the dermis.
• A new and healthier epidermis grows from undamaged cells. Within days, the sun damaged epidermis is replaced from new cells growing from within the skin glands and hair follicles. These cells have never been exposed to sunlight. So the skin is literally renewed.
• Removal of benign and pre-malignant lesions.  Skin resurfacing is not usually used to treat skin cancers. But resurfacing removes most of the sun damaged cells which can give rise to certain skin cancers.

How much improvement can be expected?

While laser skin resurfacing may be the most effective method of correcting skin damage, it does not provide 100 percent improvement. Some patients may experience only moderate improvement (typically 60 to 85 percent). Different treatment plans can produce greater results in more severely damaged skin while a gentler treatment approach may be adequate for more mildly damaged skin.

Does it hurt?

At Toyos Clinic, we expect to provide all patients with an optimum experience and minimum discomfort. To achieve this we select the most appropriate approach for each individual. Shallow to medium skin resurfacing with the Erbium laser can often be done with just an anesthetic cream and oral pain medication. Some patients may require a deeper treatment (more laser passes) to obtain the best results possible. In that case, it may be better to use either numbing injections or local anesthetic. The procedure should not be painful.

What are the medical reasons for performing laser skin resurfacing?

We recommend laser skin resurfacing to improve non-dynamic skin wrinkles, especially around the eyes, mouth, and check regions. Skin peels and dermabrasion have produced disappointing results in these areas. Face lifts can improve skin laxity but have minimal effect on these wrinkles.

Who should not have laser resurfacing?

Persons taking medications which prevent healing and persons taking isotretinoin (accutane) should not have laser resurfacing. These medications interfere with the skin's ability to heal and fight infection. Six months should lapse after using Accutane or similar medications before considering laser resurfacing. Also, persons with bacterial and viral infections in the areas to be treated should not have laser resurfacing until the condition is resolved.

The following are cautions which should be carefully reviewed with the doctor before deciding on laser skin resurfacing:

• History of scarring or dyspigmentation after previous procedures
• Collagen diseases (lupus, scleroderma), immunologic diseases and certain skin conditions
• Previous lower eyelid surgery
• Tendency to form keloids or hypertrophic scars (though resurfacing can sometimes be used to help treat these)

How much do laser peels cost?

1 Treatment - $450
3 Treatments - $999 ($333 each)