Laser Skin Resurfacing: What It Is, How It Works, Side Effects & Cost

• Laser skin resurfacing smooths and tightens the skin, reducing the appearance of wrinkles, crow’s feet and age spots.
• Ablative lasers remove the thin outer layers of skin and promote collagen. production, but can involve a painful recovery process.
• Nonablative lasers promote collagen production and don’t require any downtime.

Wrinkles, fine lines, loose or sagging skin, uneven skin tone and crow’s feet are a natural part of the aging process that many people choose to address through cosmetic surgery. Cosmetic surgical procedures that promote skin tightening and collagen production can help firm and smooth skin for years to come. 

There are a variety of procedures that promote skin rejuvenation, including laser skin resurfacing. Certain types of laser resurfacing are mildly invasive and require some downtime for recovery.  

What Is Laser Skin Resurfacing?

Laser skin resurfacing is a type of facial cosmetic surgery that uses a laser to smooth and firm the skin. 

There are two types of lasers dermatologists use to perform laser skin resurfacing: ablative and nonablative. A third type of laser, called Fraxel (fractional photothermolysis) may be used and it’s available as both a nonablative and ablative treatment.

Both ablative and nonablative lasers use heat during the procedure to stimulate collagen production in the lower layer of skin. Collagen encourages the skin to tighten and firm, helping it appear more toned. 

Ablative laser skin resurfacing

Ablative laser skin rejuvenation, also known as a laser peel, removes surface layers of skin, or dermis. These types of lasers include Erbium and carbon dioxide (CO₂) lasers. Erbium lasers address surface-level issues such as fine lines; CO₂ laser skin rejuvenation targets deeper wrinkles, scars and warts. 

Ablative laser skin treatments use heat to remove damaged skin with precise, pulsating light over the treatment area. The heat destroys and removes damaged skin cells and encourages new skin cells to grow. 

Nonablative laser skin resurfacing 

In contrast to ablative laser skin resurfacing treatments, nonablative skin resurfacing doesn’t remove layers of skin. These lasers include fractional lasers, pulsed-dye lasers and intense pulsed light devices. 

Nonablative lasers heat the skin to promote new collagen production and tighten the skin without damaging or removing surface skin cells. People with acne, rosacea, sun damage, minor scarring and spider veins may benefit from nonablative laser resurfacing. 

Benefits of Laser Skin Resurfacing

Laser skin resurfacing helps skin look smoother and firmer. It helps to reduce or eliminate minor blemishes, even out skin tone and combat the signs of aging. 

Skin resurfacing is often used to address issues such as: 

• Inconsistent skin tone
• Wrinkles and fine lines
• Crow’s feet
• Sagging or loose skin
• Scars 
• Liver spots
• Warts
• Birthmarks

Acne and acne scars

Cosmetic surgeons can treat small areas of concern, such as acne or chickenpox scars, using laser skin resurfacing. Use of laser treatment reduces the risk of hypopigmentation, or skin lightening, after the scar has been removed.

Festoons

Festoons, or bags under the lower eyelids, can be treated with ablative laser skin resurfacing to encourage healthier-looking skin to regrow. Once healed, this minimizes the appearance of bags under the eyes. Laser resurfacing is sometimes used alongside other cosmetic eyelid procedures such as blepharoplasty. 

Legs and other parts of the body

Laser skin resurfacing treatments address minor issues and can tighten skin on other parts of the body, including the legs and chest. Nonablative laser therapy has been shown to be effective against stretch marks.

Ideal candidates for laser skin resurfacing

People with lighter skin tend to be the best candidates for laser skin resurfacing because a possible side effect of the procedures is a change in skin color. Certain forms of laser therapy, such as Erbium, may work best for people with a darker skin tone. 

However, certain individuals are not ideal candidates for laser skin rejuvenation. These include people who have: 

• A very dark skin tone, as laser resurfacing could lighten skin color in treated areas
• An active acne breakout
• Excess sagging skin or deep, pronounced wrinkles, which may require an alternative cosmetic surgery procedure
• A tendency to scar easily, since ablative laser resurfacing temporarily wounds the dermis
• Medical conditions that could be aggravated by the procedure
• An autoimmune condition or compromised immune system
• Taken prescription isotretinoin for acne in the past 12 months

The Procedure

Before you schedule your laser skin resurfacing procedure, it’s important to see your doctor for a physical exam. Discuss your medical history and whether you’re a good candidate for a skin rejuvenation procedure. Be prepared to have more than one laser skin resurfacing procedure.

Once you’re cleared for laser treatment, your cosmetic surgeon will likely want you to prepare. They may recommend a six-week skin care regimen tailored to your skin type. 

You may receive a prescription for antiviral medication if you have had cold sores in the past, since skin resurfacing can trigger a flare. Your cosmetic surgeon might also prescribe an antibiotic to prevent infection.

Be sure to follow your surgeon’s instructions carefully for best results and to reduce the risk of complications.

They day of the procedure

When you arrive for your procedure, your cosmetic surgeon will clean your skin thoroughly. You will be given protective eyewear as the laser could damage your eyes.

Next, your surgeon may numb your skin with local anesthetic, depending on your procedure. If needed, for example during an ablative laser skin resurfacing procedure, you’ll also be given a sedative. It’s possible you may need general anesthesia if you’re having an extensive treatment or other procedures done at the same time. 

During the procedure, your surgeon will slowly move the laser over the treatment area. Be sure to remain still and keep your eyes protected throughout the treatment. Laser skin resurfacing averages 30 minutes to two hours, depending on the number of areas treated.

When your skin resurfacing is finished, your surgeon will apply topical ointment and dressing to the treated skin. You’ll probably also receive a prescription for pain medication. 

Most of the time, laser skin resurfacing treatments are outpatient procedures, so you’ll be able to go home the same day. Be sure you have someone to drive you home from the procedure, especially if you’ve been sedated.

Recovery and aftercare

Your surgeon may recommend further dressing changes and topical medication to speed healing and avoid possible complications. They may also ask you to cleanse your skin with diluted vinegar or a saline solution during the first few weeks. 

If you’ve had ablative laser skin resurfacing, you’ll likely be sore and uncomfortable. Recovery times vary, usually from one week (Erbium) to two weeks (CO₂).  

For optimal recovery from an ablative resurfacing procedure, ice the area for a few days, sleep in an elevated position and avoid smoking. During this time, you’ll need to avoid excessive sun exposure because your newly resurfaced skin will be more susceptible to sun damage. Your skin will appear pink for a period of weeks to months after the procedure.

Once your wounds have healed after an ablative procedure (nonablative procedures do not cause wounding), you may conceal the pink skin with green-based makeup. 

After nonablative laser skin resurfacing, you can go back to your normal routine right away and use makeup to cover pink skin. Your results will appear more gradually than ablative therapy. 

Avoid unprotected overexposure to the sun in the months after skin rejuvenation therapy. Be sure to apply sunscreen daily to protect the new skin. Silicone gel may help prevent redness and hyperpigmentation. It forms a film when it dries, allowing you to apply sunscreen or makeup over it.

Laser Skin Resurfacing Before and Afters

Laser Skin Resurfacing Side Effects

Like many other cosmetic surgeries, laser skin resurfacing carries side effects and risks. The side effects of laser skin rejuvenation include redness, swelling, itching, stinging and peeling. After the procedure, your skin may be red and feel sunburned. It’s also possible that your skin may blister or ooze. 

Applying moisturizing, protective products for postoperative skin care can help reduce discomfort. Use a gentle cleanser on your skin as recommended; you can also apply petroleum jelly or over-the-counter antibiotic ointment to control itching and dryness.

Risks include:

• Hyperpigmentation (darkening or discoloration of the skin)
• Hypopigmentation (lightening of the skin)
• Acne flares; your cosmetic surgeon will recommend a post-treatment regimen to help prevent breakouts
• Bacterial infection, which may be prevented by a pre- or post-op round of antibiotics 
• Cold sore flare-ups, if you have a laser resurfacing procedure done around your mouth; these can be prevented by taking antiviral medicine before and after treatment
• Milia, or small white bumps
• Redness that lasts beyond the first few months after treatment
• Scarring
• Swelling, particularly if you’re getting treatment under your eyes
• Turning out of the lower eyelid, caused by ablative laser treatment under the eyes (requires a surgical procedure to correct)

Cost

Ablative procedures are more expensive than nonablative. Laser skin resurfacing costs between $1,100 and $3,000 depending on such factors as:

• Size of the treatment area
• Pre- and post-op expenses (such as pain medication)
• Facility fees (for example, a hospital is more expensive than an in-office procedure)
• Surgeon’s fees
• Anesthesia
• Your cosmetic surgeon’s qualifications
• Your location

Keep in mind that most cosmetic surgery is considered elective; that means insurance probably won’t cover your costs. Call your insurance provider to find out more about what procedures your plan may cover. 

Laser Skin Resurfacing at Home

Nonablative laser devices are available for home treatment. However, these lasers are significantly weaker than the ones a surgeon would use and results are not comparable. The wand-like devices often come with skin creams, gels or serums that promote collagen production. 

Takeaway

Laser skin resurfacing is a cosmetic procedure that firms and tightens skin and helps to reduce a wide range of skin concerns.

Ablative laser skin resurfacing uses a laser to remove thin layers of skin to encourage new skin growth and collagen production while minimizing the appearance of skin concerns such as acne scars, fine lines, wrinkles and liver spots. Nonablative laser skin resurfacing uses a laser to gently heat the skin and encourage tightening and new collagen formation.

For optimal results, choose a cosmetic surgeon who is qualified and trained in facial cosmetic surgery and has a successful track record with laser skin resurfacing procedures.  

Talk to your cosmetic surgeon about whether laser skin resurfacing is appropriate for your skin type. They will be able to help you choose the best procedure for your needs.