As one ages, the texture of the facial skin changes in many unfavorable ways. Wrinkles develop, skin texture becomes more irregular, brown discolorations may appear, and in some areas the skin actually thins as well. Many skin rejuvenation methods exist but none have been more effective than that of laser skin resurfacing technology. Injuring the outer skin layers by laser light, burning it if you will, allows new collagen to form underneath and new epithelial growth on the outside.
Once healed after laser treatments, the skin's texture and appearance is improved. The recovery time and how much improvement of the skin is seen depends on how deep the skin injury was. Deeper treatments remove more epithelium and stimulate the collagen layers better....but recovery time is also linked to depth of treatment.
In days gone past, deep laser resurfacing was an operating room experience due to the depth of injury. While the skin results were often spectacular, so was the pain and recovery time. Patients no longer want that experience and the concept of less invasive skin treatments done as a series over time have become a better lifestyle choice. This has been coined Microlaser Peeling (MLP) and looks at a series of 4 to 6 treatments done months apart to get the final result....with recovery time of days rather than weeks. MLP burns off top layers of skin whose depth is controlled by the operator based on what the patient can tolerate with a topical anesthetic and how much recovery time the patient finds acceptable.
A newer approach to laser skin rejuvenation has been the modification known as fractional treatments or Fraxel. (the first company that introduced this technology) In this laser skin approach, the entire surface of skin is not burned off. Rather a portion or 'fraction' of the skin area is treated rather than 100% of it. This fraction is usually about 11% to 16% of the skin in the path of the laser beam. But the depth of each hole that is burned into the skin is deeper, reaching deeper skin areas with the theoretical potential of greater collagen production. (skin thickening effect) So less skin surface injured results in less of a burn injury and less recovery. Fractional laser treatments also require a series of treatments to get the full effect.
The question is...is MLP or Fractional laser treatment better? The question is a good one as the recovery from either one is a little different but so is the skin injury as well. In reality, despite marketing claims, no real scientific studies have been done to compare the two. Both produce results but whether one is really a significant improvement over the other (gets better skin rejuvenation) is more anectodal than proven fact. To those doctors who have taken on the great expense of the Fraxel, they no doubt are great believers.
Most importantly, either laser technology is an improvement over not being used. But the most important issue, in my opinion, is that any laser skin rejuvenation treatment(s) should be part of an overall skin care approach. Used with the laser could be intense pulsed light therapy as well as time-proven maintenance techniques such as microdermabrasion and chemical peels. Skin care and improvement is like your lawn...one cutting will only look good for a very short period of time. Rather than just signing up for a laser series, go to a place where they will sit down with you, make a diagnosis with computerized imaging, and lay out a long-term comprehensive skin treatment plan. Your skin didn't get to look this way overnight and it won't get better overnight either...unless you opt for a deep laser peel.
Dr Barry Eppley is a board-certified plastic surgeon in private practice in Indianapolis, Indiana at Clarian Health Systems. (eppleyplasticsurgery.com eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at exploreplasticsurgery.com exploreplasticsurgery.com
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