Laser Skin Resurfacing

The Development of Skin Resurfacing Lasers: Ablative, Non Ablative and Fractional Lasers

Laser skin resurfacing is a procedure performed to reduce the appearance of age spots on face, scars caused by adult acne or other injuries, rough skin texture and wrinkles of various severities. The procedure, also known as lasabrasion, laser peel or laser vaporization, basically involves removing layers of skin using concentrated light energy. Since the introduction of laser skin resurfacing in the 1980s, the technology and methods used in practice have been continuously improved to reduce risks to patients and decrease the time necessary for recovery. Nonetheless, any skin treatment involving lasers can still be dangerous in the hands of inexperienced physicians, or those professionals who are easily swayed by patients who want aggressive treatments for faster results. Even newer technologies like fractional laser skin resurfacing still pose risks to patients who have unrealistic expectations about results or who do not receive honest information from their physician.


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Ablative Laser Resurfacing

Ablative laser skin resurfacing uses powerful lasers to destroy the upper epidermis, or the outer layer or skin. This was one of the original uses for photo-energy technology, as the earlier lasers were very much focused on being an alternative to chemical peels and Dermabrasion. One of the first machines for skin laser resurfacing was the continuous wave Co2 lasers, which were very powerful and magnified infrared light waves to deliver destructive beams of energy to surface skin cells. However, although Co2 laser skin resurfacing procedures have been known to produce noticeable results, the earlier devices have also been notorious for their frequent side effects. For example, when the industry was just developing, it was not uncommon for patients to experience, painful skin inflammation, skin discoloration, scarring, and in some cases even infection. One of the biggest causes of problems with early generation ablative laser resurfacing was that it destroyed cells in the epidermis indiscriminately. The entire upper layer in the treatment area would be removed, and the body would scramble to heal skin damage which was in some cases similar to first degree burns. Over the years, laser skin resurfacing techniques would be improved in ablative technologies to mitigate this problem, and reduce healing times by shrinking the treatment area. This technology would come to be known as fractional skin resurfacing. Nonetheless, to this day, ablative laser skin resurfacing remains one of the most aggressive and effective type of photo-energy treatment, and carries the greatest risks of skin damage and painful recovery time.

Non-Ablative Skin Laser Resurfacing

Non-ablative, or non-wounding, laser skin resurfacing utilizes technology that will penetrate the dermis or underlying skin, but will not actually burn off cells from the surface. This type of treatment aims to heat up collagen fibers in the deeper layers, this stimulating protein development to tighten skin over the long term. If the ablative laser aims to simply remove skin imperfections, this weaker laser technology attempts to get rid of wrinkles from beneath. Compared to ablative laser skin resurfacing, these treatments are less effective but are safer and require less recovery time. Non-ablative laser skin resurfacing is usually performed on thinner skin areas, where the energy has fewer obstacles on its way to the dermis. This helps deliver treatment more efficiently and avoid damage to the epidermis. Such non-ablative laser technology is classified into three main groups namely: mid-infrared lasers, visible lasers and intense pulsed light.

Fractional Skin Resurfacing

Fractional laser skin resurfacing seeks to combine ablative and non-ablative techniques. It targets both the outer layer and the underlying skin by breaking the laser beam into smaller bursts of energy. Fractional laser skin resurfacing is used to treat acne scarring, skin pigmentation and wrinkles. With fractional laser resurfacing, it’s important to realize that it is not the laser itself that makes the difference, but how it is applied to the skin. The fractional technique uses the idea that the entire treatment area should not be damaged, but only a fraction of it. During treatment, the laser beam is divided into smaller “packets” of energy that are selectively delivered to parts of the treatment area, leaving healthy tissues in between. This fractional laser resurfacing idea has been used with ablative and non-ablative devices because it causes less damage, thereby decreasing side effects. The Fraxel laser device was the pioneer in fractional laser skin resurfacing. Now, many companies have developed their own versions, with various additions like suctioning technologies to increase light penetration into the skin, thereby decreasing the amount of energy needed; and specialized filters to better target specific skin problems.

Fractional Laser Resurfacing Side Effects

Although fractional laser skin resurfacing is less effective compared to ablative skin resurfacing, it is becoming a more popular choice because of the lower instance of side effects. However, this does not mean that fractional skin resurfacing is the best skin treatment. Side effects from aggressive treatments with this technique can include swelling, inflammation, hypersensitivity, and even skin peeling and crusting, which could last for up to a week after the procedure. Also, patients with darker skin tones, or those with a history of melasma, are prone to post-inflammatory pigmentation issues. Therefore, it’s important not to fall into the advertising trap for such procedures, which often make the side effects seem less serious, and to understand that fractional laser skin resurfacing has its own set of problems and potential health hazards for patients.


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7 replies
  1. Doris M
    Doris M says:

    Hi, I am interested in a laser treatment but I want minimal downtime, what would be the best option? This article has given me an insight but I am still confused about which one gives the best results with no downtime?

  2. Connie
    Connie says:

    I would say that the best and the most fantastic results you can get with the ablative laser treatment, but I wanted to go lower key. I don’t mind the longer downtime, which is not really that long if you think about it. I stayed at home for one or two days, but by the third date I could already continue with my usual life. And I just love the laser skin resurfacing. It really transforms your skin into what you want it to be. I’m thrilled because skin rejuvenation has been taken to another level, a more practical one, for us women who don’t have a lot of time to spend at the cosmetician, or in surgery. I could feel my skin tightening from both inside and outside, if that makes any sense. It’s not just the feeling, but you could really tell the difference. It’s just revolutionary and perfect for the modern day woman.

  3. Serena
    Serena says:

    To be honest, I’m still very much hyper about this laser skin clinic I went to. They introduced me to the entire world of laser skin treatments, and ladies… I do look fabulous. I’m not an expert in these medical terms, but I am an expert when it comes to my skin. No wrinkle, age spot, or freckle will pass by me untreated. My physician is a professional and beyond, and I do believe that it contributes a lot to how I felt after and what the results were. The results were mild in the beginning, but not so aggressive. I did feel discomfort, but it was worth it. I am surely going for it again, to take the most out of it.

  4. Natalie
    Natalie says:

    Fractional skin resurfacing isn’t that painless and it did take my three days to recover, from a little swelling I was facing. But it’s really not a big deal if you want to look beautiful. I paid the price and I will do it again. The acne scars I had were there for so long, but now I can even see them fade away. It’s an incredible feeling to rely on the procedures like skin resurfacing to make yourself look like you did before all the ageing started getting to you.
    Am I am going to do it for the rest of my life? Probably not, but as long as I do care for my beauty I will. Especially because creams don’t work, and this is after all revolutionary technology, that if done by a professional, gives amazing results. You’ll just be fascinated with how your skin starts rejuvenating, you’ll keep going for more…

  5. Mandy
    Mandy says:

    I can really relate to anyone who had serious acne issue. My skin was horrible… And it still is. I Couldn’t get rid of acne, which were all over my face, no matter what I did. It was so frustrating, not to mention, my self-esteem was so low… I really didn’t like the laser resurfacing because it was too aggressive, and I felt that my skin is too sensitive. But that was a long time ago. I started re-thinking the entire facial rejuvenation thing, when I saw that there are other resurfacing methods available these days that give great results, with a little less pain. The point being, you get a laser treatment, which covers both your upper and lower cells in the face, but without those major burns or pain. This was a different experience, and the positive one, because my scars have started to become less visible, for the first time in my life.

  6. Freckle Girl
    Freckle Girl says:

    As a girl with no severe issues, I chose to go for scar removal and freckle removal. And I have to say I really didn’t have that many, but they were so annoying. I choose the laser fractional treatment just because it was effective enough to treat my skin, and provide me with the results I was looking for, and it wasn’t that harsh on my skin. No, after the first treatment I notice a little improvement, and I didn’t really suffer through any side effects that some people experience with, for example surgical treatments. I just went in, did it, and walked out of there, paid attention to my skin a bit, and that’s it. It looks drastically different now after a couple of times I went…I would recommend it to anyone who wants results in a more natural way, with less discomfort and recovery time.

  7. Julie
    Julie says:

    My daughter has various skin issues since her teenager years. I’ve taken her to every treatment possible out there, I just couldn’t see her suffer like that. Her skin looked like she was a 35-year old woman, and not 15. And the harsh chemical peels or laser techniques even made it worse. I basically had no other option, so I read about the fractional laser resurfacing and all the available options. At first I thought, well, who cares, it’s just another treatment out there, aiming to get your money. But once I talked to a consultant about the skin resurfacing laser and what it does I realised that it worked differently. It simply attacks your skin in fractions and little pop of energy, making it less aggressive and more potent for treatment. I didn’t even care about the fraxel laser cost. I grabbed my daughter’s hand, took her to a couple of treatments, and we are both really happy with the results. They did take some time to manifest, but once they did… I could not put a price on her happiness.


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