Laser Skin Resurfacing - Pros and Cons?

i've considered getting laser skin resurfacing to improve acne scars.  what are the pros and cons? is it good for overall skin care?

Doctor Answers (23)

The pros and cons of laser skin resurfacing Laser...

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The pros and cons of laser skin resurfacing

Laser resurfacing can be tricky because the more aggressive you want to be, the more potential there is for side effects like permanent lightening of the skin (hypopigmentation), darkening of the skin (hyperpigmentation), scarring, or a lot of downtime.

If I told you that we were going to improve some of those lines and that infection and other side effects could happen, you won’t be able to go outside for a couple weeks, and you won’t be able to socialize for a couple weeks, is that something you’re interested in doing?

Originally it was the CO2 laser that was used, now they’re doing some other things that are not quite as dramatic, called Fraxel. They’re not going as deep as the CO2 laser and typically are not as effective as a CO2 laser. So they’ll take you so far, but not as far as a CO2 resurfacing might be. They’re sort of playing on the same theme that people want some results, there are varying degrees of results, there are varying degrees of aggressiveness, and then what do you want as far as downtime?

People want great results and minimum downtime. And we’re trying to balance that, but you get what you pay for as they say, and that’s always a balance of what I’m trying to figure out with a patient.

Initially, I used a lot of the agressive resurfacing lasers, but the downtime was just too much for people. Now I find that we’re doing more lower-dosage lasers. Low-dosage lasers offer some improvement for some of the finer lines.

So its really that combination approach. We’re not going too deep, there’s less chance of infection and side effects, and it’s good for some of those mild to moderate wrinkles, but it’s not going to touch the deeper wrinkles, like some of the more aggressive techniques would be.


Atlantic City Dermatologist
1.0 out of 5 stars 1 review

Pros and Cons Laser Resurfacing for Acne Scars-Non Ablative is Best

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Laser Resurfacing is one of the best modalities for treating acne scars.

It is important to understand the difference between Ablative Laser Resurfacing and Non ablative Laser Resurfacing.

Ablative Resurfacing actually removes skin and causes significant down time for healing. Non ablative does not remove skin and creates only redness for a day so that you do not need to miss work.

Fortunately, in my opinion, Non ablative Laser Resurfacing is best for treating acne scars. This is so because Non ablative resurfacing can go deeper into the skin and build more new collagen to plump the acne scras than can Ablative Resurfacing. In addition, Ablative laser Resurfacing can in some cases remove skin from the depth of the scar and fail to change the appearance of the scar.

Pros of Non-ablative resurfacing for acne scars:

  • Non surgical treatment
  • No recovery time
  • Effective building of new collagen in skin to plump scars
  • No pigment problems-loss of or hyper pigmentation

Cons:

  • I cannot think of any

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 34 reviews

The pros and cons of laser resurfacing for acne scarring

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The pros and cons of laser resurfacing for acne scarring can often depend upon the user of the technology as well as the individual patient.

I've published an article on the improvement of acne scarring with the CO2 laser which you can read but I will summarize some of the key points.

The pros consist of a bimodal degree of improvement where the skin is first sanded down and the heat injury actually confers additional improvement over the course of six months. It is by far in my opinion the best treatment for significant acne scarring of the face since it can safely penetrate the deepest into the middle layer of skin. It can also be repeated in patients with severe acne scarring.

The major cons include a longer period of healing, typically two weeks and it requires wound care by the patient which can sometimes be painful during the healing process. Also, in darker skinned individuals it can result in loss of pigmentation and a line of demarkation at or near the jaw line especially in females; this is less likely to occur in males. Finally, it is not for African or Indian Americans due to the darker skin type and risk of skin lightening.

Finally, if you are of the proper skin type and willing to put up with the down time, there is in my opinion no better treatment for acne scarring.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Guidelines for laser skin resurfacing This really...

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Guidelines for laser skin resurfacing

  • This really depends why one is considering laser resurfacing. You want to make sure that your expectations are realistic and that resurfacing is appropriate for your skin care concern.
  • You want to make sure that you see a board certified dermatologist or plastic surgeon, and you have had an appropriate consultation and you feel comfortable with their recommendations.
  • Additionally, if possible, you want to see before and after pictures of their work. The main thing though, is to make sure that resurfacing is appropriate.

Charles Crutchfield, MD
Minneapolis Dermatologic Surgeon
4.0 out of 5 stars 8 reviews

Laser skin resurfacing for eye wrinkles Laser...

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Laser skin resurfacing for eye wrinkles

Laser resurfacing is a great procedure for improving wrinkles in the lower eyelids. Tiny wrinkles, which appear in the lower eyelids, can be reduced with laser resurfacing or medium depth peels.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Contour laser skin resurfacing The word "laser" is used...

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Contour laser skin resurfacing

The word "laser" is used so loosely that it has practically lost its meaning. To correct wrinkling and pigment problems of the skin, the best laser is the Contour Laser made by the Sciton Corporation.

The Contour Laser can be used in one of two ways:

  1. With low energy settings you get a superficial resurfacing (Micro-Laser peel). That will give you some improvement and a short down time of two or three days.
  2. With higher energy settings, you get a deep resurfacing that will give you dramatic improvement and a down time of 7 or 8 days. With deep resurfacing, you also have to wear makeup afterwards because the lasered skin can remain pink for weeks. But you look fine with makeup after one week.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

When performed in the right hands, acne scars can improve.

+2

The use of resurfacing lasers for acne scars is one of the best options provided your skin does not have too much ethnic color present.  If you have a lot of “color” or pigment irregularity, the risks are increased.  This is why a consultation with a Board Certified Dermatologist and Plastic Surgeon are critical for a thorough evaluation.  Treating acne scars requires a deeper treatment so the risks change.  Use of the eMatrix is also good with acne scars and is a little more pigment friendly than lasers. When performed in the right hands, acne scars can improve.

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
4.0 out of 5 stars 10 reviews

Best laser for Acne scars

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The "Best" laser for deep acne scars is actually combing the ability of the Erbium laser to sand down the ridges of acne scars and deep lines around the eyes, mouth and cheeks with the smoothing, tightening and pigment reduction of Microfractional CO2 laser. The skill of the Surgeon is the most important choice a consumer can make. Make sure that your doctor is a board certified in either Dermatology or Plastic Surgery and has done at least 500 procedures. This is not a treament that nurse or unqualified physicians should perform. I have used all of the CO2 lasers manufactured since 1991 and in my hands they all work equally well in spite of the manufactuers claims to the contrary. A customized skin care program using topical antioxidants, skin exfoliaters, and SPF 60 or higher suncreen are just as important as the laser surgery to provide long term results. No laser wavelength below Erbium's 2640 nanometers is anywhere near as effective in reducing deep scars and long term (more than 10 years) results.

Michael Tomcik, MD
San Ramon Dermatologist
4.0 out of 5 stars 4 reviews

Laser resurfacing is great for cosmetic and medical reasons

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Laser resurfacing are great for cosmetic and medical reasons. If you are interested in improving your wrinkles, pigmentation problems (like sun spots, etc), the size of your pores, your skin texture, etc laser resurfacing can be a great option. It can make a huge difference in your appearance for the better. These are things or areas of improvement that really only resurfacing can do in a significant way. Skin care with cosmeticeuticals can only minimally improve your skin. Some skin care lines at the doctor's office can do a little more than the products that you get at the cosmetic counter.

You might not know this but resurfacing can also improve your skin by reducing the number of cells that are bad as well. So from a medical standpoint, it can be beneficial in reducing your chances of acquiring skin cancer. This is done when you remove your more superficial layers of skin through resurfacing and receive more refreshened cells from deeper within your hair follicles when these cells "resurface" the skin that has been removed. These newer cells typically have much less DNA damage and hence less bad mutations that lead to cancer and this has been proven in scientific studies.

Consulting a Board Certified Facial Plastic Surgeon would be something that I would recommend. We specialize in the face and are highly qualified to help you with this.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 37 reviews

Laser skin resurfacing for acne, etc.

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Laser skin resurfacing, specifically fractional CO2 laser, is a fantastic treatment for uneven skin tone, surface irregularities, and scarring. Care must be taken in patients with more pigmentation -- to avoid issues with changes in the skin color after the treatment. Best of luck moving forward!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.