Fractionated Laser Skin Resurfacing

I am pushing 50 and have worn high SPF 50 on my face everyday since my late teens. However, last year I started taking peptides and visiting tanning salons over the winter holidays in preparation for a Caribbean vacation to build a base tan. I developed a super-dark tan and I loved it. I adored tanning for a few weeks each year in winter and I thought it was helpful for my SAD, Seasonal Affective Disorder. However, I noticed new skin-colored bumps developing on my face, which were sebaceous hyperplasia.

I had a consultation with Dr. Ladner and he was wonderful. He explained how laser skin resurfacing would fully ablate/remove the bumps on the surface of my skin and improve the surface texture, plus the fractionated laser uses deeper wavelengths to stimulate collagen production in the deeper layers on the skin. He said that some people get laser resurfacing done once a year, but if you stay out of the sun and take good care of your skin, you may be able to prolong time between treatments to only needing one moderate to aggressive treatment done once every 3 to 5 years.

I decided to sign up for two moderate treatments instead of 1 aggressive treatment. I have so far only had one moderate treatment on my face only. One month beforehand, I had to start using a prescription compounded brightening treatment every night for at least 30 days before my appointment. This was to minimize the risk of hyperpigmentation. Then I was instructed to stop using the treatment 2 or 3 nights before my appointment. I have also gotten cold sores before, so I got a prescription antiviral that I began taking the night before my appointment and continued taking for 5 days, twice a day.

On the day of the appointment, you show up with clean, dry skin and nothing on your face whatsoever -- no lotions, no sunscreens, etc. They prep and gently clean your skin, then they covered my face with a thick layer of numbing cream and let it sit on my skin for about 45 minutes before beginning the treatment. The treatment itself was "spicy" and unpleasant but nothing I couldn't handle. I have gotten laser tattoo removal on my back, and it's similarly painful to having laser skin resurfacing done on the face. They have an air purifier running in the room during the treatment, and they also give you a hose that blows purified cold air onto your skin, which helps. There is a strong smell of burning hair during the treatment. After the treatment was finished, they apply special healing serums to your skin, and then you get sent home with all your aftercare items.

I was not prepared for the amount of pain I experienced after the treatment ended. They said it would feel like a really bad sunburn, but my face hurt a LOT. I had to wait 10-15 minutes for my Lyft driver to pick me up, and it was intense and I could hardly stand it. My whole face felt like it was burning, and when I got home it was unbearable, so I took some pain medicine and lay down for a nap. When I woke up a couple of hours later, I was still in pain so I had to take a second dose plus 600mg ibuprofen. In my aftercare instructions, they described how long I needed to wait before beginning gentle cleansing and applying healing treatments. I misted my face with hypochlorous acid, used the healing salves, drank a ton of water and electrolytes, and slept as much as I could.

That night, I took an antihistamine (Xyzal) and slept propped up on pillows. In the morning on the 2nd day, I had a slight amount of swelling and then the pinpoint minor bleeding and a little bit of oozing began. By day 2 the pain was gone but I had a LOT of itching. I kept misting my face with hypochlorous acid every 2-3 hours while I was awake and then washing my hands and carefully reapplying the treatment salves/balms over my entire face. On days 2-3 I had some very minor peeling. By day 5 my face was almost totally healed and i was able to start wearing sunscreen again. I am still using 100% fragrance-free everything on my face, being very gentle with the new skin, and keeping my entire face moisturized. I am also using SPF 50 sunscreen all over my whole face and wearing a hat anytime I go outside.

The person doing my treatment was very conservative because she said that she did not know yet how my skin would react. She said that we can always go back and add more laser later, but we can't take it back if she goes too aggressively, so she was very reserved. If I go back for the planned second procedure I expect that she will probably use a slightly more aggressive setting because of how quick and easy my healing went. I am worried about the level of pain, so I will tell the provider at my follow-up visit in a few weeks.