The treated skin may swell, itch, or have a burning sensation. The skin may appear inflamed for several months after ablative laser treatment. The prevention of complications must be taken into account throughout the treatment process. During the initial consultation, the patient should be evaluated for factors that may predispose him to developing an adverse effect.
A history of poor wound healing, keloids, or hypertrophic scars may be an indication to avoid aggressive skin rejuvenation. Patients who tan easily may be at risk of hyperpigmentation after the laser session. A person with severely sun-damaged skin may need a full facial treatment (rather than a partial treatment) to ensure an aesthetic blend of skin color. In addition, patients with a weakened immune system are at greater risk of infection. A detailed history obtained during the consultation is vital to predict these risks and select the right candidates.
If you have very dark skin, some laser rejuvenation techniques may cause swelling or discoloration after treatment. It's worth noting that deeper skin tones also have the potential to leave keloid scars. Almost any type of laser therapy can cause burns, scarring, dissegmentation, eye injuries, and infections. These complications are the result of selective photothermolysis and, in some cases, can even be used for the doctor's benefit, for example, to reduce hyperpigmentation in melasma.
When a laser acts on a chromophore, the molecules absorb energy and heat the surrounding tissue. To reduce the risk of complications from excessive thermal injury, many lasers use pulses that last less than the thermal relaxation time of the target tissue, which is the time needed for the tissue to cool down to the reference temperature. The goal of selective photothermolysis is to provide enough energy to destroy the chromophore without damaging the surrounding tissue. It follows that surrounding non-target tissue can therefore be injured by overheating.
Burns can result from prolonged pulses, excessive fluence (the amount of energy supplied to the target area) and inadequate cooling. The risk of burns is greater for lasers that use a continuous beam rather than a pulsed or fractured one. Newer devices reduce the risk of complications by emitting beam pulses in a range of milliseconds to nanoseconds, using multiple fast bursts almost continuously, or using extremely short pulses with high powers to allow for adequate thermal relaxation. Hyperpigmentation and hypopigmentation after laser treatments are comparatively common complications, with hyperpigmentation occurring most frequently.
The risk of dispigmentation is greater in people with darker skin (Fitz Patrick type III-VI) or who are excessively tanned. It can be reduced by avoiding sun exposure before and after laser treatments and by using a fractional laser delivery system or cooling devices. However, ironically, overuse of cooling can cause inflammation and also cause hyperpigmentation. Hyperpigmentation may be due to the accumulation of extracellular melanin due to the destruction of melanocytes or to increased melanin production due to post-treatment inflammation.
As such, it doesn't usually last more than three to four months. Usually, the best way to treat hyperpigmentation is with topical 4% hydroquinone, a whitening agent, but it can also be treated with chemical surface peels or cosmetics. It is also useful to avoid exposure to sunlight; for this reason, it is best to avoid laser facial rejuvenation, especially full field ablation, during the sunny summer months. Burns are caused by tissue overheating due to excessive heat generation or insufficient cooling.
Proper patient selection and conservative environments reduce the risk of adverse outcomes. Testing the configuration on a small area of skin two to three weeks before the main treatment also reduces the chance of developing complications; this technique is frequently used in laser hair removal. During treatment, an indication of excessive fluence and, therefore, of excessive heating is the graying of the tissue, which is more evident during non-ablative vascular treatments, in particular pulsed dye therapy for erythematous lesions or scars. If graying occurs, the procedure should be stopped and the settings and cooling systems reevaluated.
Most laser devices have fail-safe systems that prevent more energy from being supplied than the settings indicate, even in the event of a malfunction. However, a laser can supply less energy if it malfunctions, which can cause the rating to adjust to incorrect settings and, subsequently, cause excessive fluence once the device has been repaired. For this reason, it is essential to apply conservative adjustments in the first treatments after a qualified technician repairs the laser. When burns occur, bleeding crusts and ulcerations may appear several days after treatment and may be warning signs of additional complications, such as scarring and dispigmentation.
Excessive overlap of treatment areas can cause burns and dispigmentation, but too much space between treatment areas can cause visible areas of untreated skin to appear. Scars and dispigmentation may appear weeks or months after treatment. Proper technique and conservative adjustments are essential to reduce risk of burns. When using a vascular laser, it is important to keep in mind that more erythematous lesions have higher concentrations of chromophores (oxyhemoglobin) and, therefore, will absorb more laser energy than less erythematous lesions; therefore, lower settings are effective for treatment.
Likewise, lower adjustments are recommended when treating an injury with the underlying bone, such as on the forehead or orbital border, because energy will reflect back into the bone and go back through the target tissue. In addition to adjusting power supply settings, several cooling devices, when properly used, also reduce the risk of skin burns. Burns that follow laser therapy can be treated with immediate cooling and then with mild emollients and topical steroids to promote re-epithelialization. Antibacterial prophylaxis for laser rejuvenation is controversial.
If an infection is suspected, the culture threshold should be low, but it is rare that antibiotics are routinely prescribed before laser rejuvenation. Because of the risk of scarring, antibiotic treatment should be initiated promptly if a bacterial infection is suspected. Empirical antibiotic treatment should include Staphylococcus aureus, such as doxycycline or trimethoprim-sulfamethoxazole, but ciprofloxacin may be necessary if cultures reveal the presence of Pseudomonas aeruginosa.
Laser skin rejuvenation is a proven way to
help reduce wrinkles, age spots, acne scars and other imperfections, as well as tighten skin and balance tone.But precisely because lasers can do so much and vary so much in the way they act on the skin, it's hard to know where to start when seeking treatment, even the most superficial search reveals a large number of competing devices and methods. We want you to be informed, not overwhelmed. Before you dive too deep into the Google trap, we suggest that you get away from all this hype and read the following key things to know about laser skin rejuvenation. Did you know that fall is considered the “laser season”? Because laser-treated skin is hypersensitive to sun exposure for up to a year after some procedures, many cosmetic surgeons recommend undergoing laser rejuvenation during the fall or winter months, when daylight hours are shorter and most of the time is spent indoors.
Regardless of what time of year you have laser surgery, use broad-spectrum sunscreen with a sun protection factor of 30 or higher every day and reapply as needed. Not only does this help maintain the best results, but it also provides protection against skin cancer and helps prevent further premature aging. Patients and doctors often compare the feeling they feel during laser treatments to the feeling of an elastic band breaking against the skin. However, the feeling of laser rejuvenation depends on the laser, the depth and area of the treatment, and the person's tolerance for pain.
Deeper ablative laser treatments (in which some outer layers of the skin are removed) may require local anesthetic injections or intravenous sedation to make the patient feel comfortable. Examples of ablative lasers include CO2 lasers and erbium YAG lasers. What's the best way to ensure a safe and effective treatment for your skin type? Consult with a provider who has extensive training and knowledge in laser rejuvenation procedures and experience working with darker-skinned patients. In the hands of a highly trained and knowledgeable professional, laser rejuvenation is a safe way to dramatically improve the appearance of the skin.
In the hands of a poorly trained person, lasers can be ineffective or even dangerous. Choose a laser rejuvenation provider based on the person's experience, training, and qualifications. Don't make your choice based solely on who offers the best deal or has a branded laser platform. Choose a laser rejuvenation provider based on experience, training and qualification, don't just search for the best deal or the newest laser platform.
Your best bet? Choose a cosmetic surgeon certified by the American Board of Cosmetic Surgery. All ABCS certified surgeons have received a rigorous training grant that includes non-surgical treatments, such as laser skin rejuvenation. You can use our Find-A-Surgeon tool to locate cosmetic surgeons nearby of you. Always be honest and honest with your provider about your medical history and any medications or supplements you are taking.
For example, if you're prone to cold sores or fever blisters, laser treatments can cause outbreaks. Acne medications that contain isotretinoin (e.g., the most common over-the-counter products, such as aspirin), may increase the risk of bleeding after the procedure; other medications may cause poor healing or cause scarring after laser treatments. Diabetes and other chronic conditions can also affect the safety and results of laser rejuvenation. You should also stop smoking at least 2 weeks before and after laser treatments to avoid complications with scarring and to give your body the best chance of getting optimal results.
While in some cases, a single laser treatment will address a patient's concerns, most non-ablative lasers require a series of treatments to produce the most satisfactory results. This is a compensation that comes with no downtime treatment, but once the series of treatments is complete, the results are long-lasting. While laser treatments are generally considered non-surgical, not all are free of interruptions. The recovery time from laser rejuvenation varies depending on the type of laser used, as well as a person's health and healing rate.
Non-ablative lasers often don't require any downtime, while ablative lasers may require a healing process of 2 to 3 weeks, depending on the depth, before the new skin has fully healed and the final results are apparent. This doesn't mean you have to stay home for a month; it just means that your skin will become raw, red, and crusty as it heals. You may not feel comfortable in certain social situations, and you will have to modify your activities to avoid situations where you can become infected (swimming, exercising at the gym, etc.). If you are thinking about undergoing laser treatments to improve your skin, we recommend that you contact a board-certified cosmetic surgeon.
Our member directory is an easy way to locate a surgeon near you. In the meantime, you can learn more about lasers and other skin rejuvenation treatments at our ABCS learning center. A new generation of CO2 laser rejuvenation uses very short pulsed light rays (ultra-pulsed) or continuous beams of light that are distributed following a scanning pattern to highly accurately remove thin layers of skin with minimal heat damage to the surrounding structures. In the hands of a board-certified dermatologist, laser treatment can safely treat many types of scars.
You won't have any downtime with this laser, but to see the desired results, you may need some laser treatments. Because of the comparatively high risk of HSV reactivation after perioral laser rejuvenation procedures, antiviral prophylaxis is recommended for 7 to 14 days after surgery. Technically, IPL (intense pulsed light) treatments are not lasers, but are often used to treat several of the same skin problems as treatments with laser. Laser skin rejuvenation is a safe and effective treatment option for many men and women with signs of aging or skin imperfections.
Erbium laser rejuvenation is designed to eliminate superficial and moderately deep lines and wrinkles on the face and should only require local anaesthesia. Even in the era of prefractured rejuvenation, it was recognized that a wide variety of creams, ointments, cleansers, and other skin care products can cause contact dermatitis after laser rejuvenation. Pulsed dye lasers, which are sometimes referred to as vascular lasers, are used to treat skin problems related to blood vessels. Fractional CO2 laser rejuvenation involves the use of the laser to drill numerous narrow columns of holes in the layers of the skin, but without treating and intact the surrounding skin.
The reason why there are so many different laser options is that no single laser can treat all patients and all skin problems. Laser rejuvenation is a procedure that uses an energy-based device to improve the appearance and feel of the skin. Laser procedures should be performed with great caution, as most laser procedures are performed for aesthetic purposes, which increases the stakes a bit due to patients' high expectations for optimal results.
