I’d love to put a smile on your face. But, as a dermatologist , I have to tell you that making you smile too much can cause some wrinkles. But don’t fret…there are new ways to help keep those signs of aging at bay.
In simple terms, here is why you get wrinkles as you age:
- Collagen and the elastic fibers of the skin break down faster than they are replaced as you age.
- The cumulative effect of sun exposure over time makes it worse by activating enzymes in the skin that makes the collagen break down even more.
- Add to that all the smiling, frowning and other facial expressions can deepen lines and wrinkles.
Now the good news! There are several laser treatments available that can resurface the skin and correct imperfections with minimal or short healing time. Two in particular have become popular because they have proven safe and effective:
- Fraxel laser, which is performed in a series of 3-5 treatments, and
- Fractional CO2 laser, done in a single treatment
Fractional CO2 vs Fraxel Laser
Fraxel: Amazing Results with Minimal Downtime
The Fraxel laser, administered in your dermatologist’s office, helps rejuvenate the skin from the inside out by stimulating new collagen and is effective for:
- fine lines and wrinkles,
- sun damage,
- acne scars and other types of scars, and
- pigmentation or age spots.
Prior to your treatment, a numbing cream or topical skin anesthetic is applied one hour before the laser treatment begins. The numbing cream is then removed, and a special gel is applied to the skin to allow your dermatologist to slide the laser hand piece over the skin. The hand piece has a “smart” scanner that allows the laser beams to penetrate the skin while ensuring maximum safety.
Each treatment takes 30-45 minutes. Healing time is quick, about 2-3 days, and easily managed with your normal routine. The results are gradual and natural over the course of 4-5 treatments.
Fractional CO2 Laser Skin Resurfacing: Dramatic results with just one treatment
The Fractional CO2 laser is another option that offers more dramatic results in a single treatment session. The CO2 laser stimulates new collagen and resurfaces the top layer of skin to treat:
- fine and deeper lines,
- age spots,
- acne scars and
- loose skin.
It works best for patients over 55 with more significant aging changes. It is a good option for those wanting more immediate results.
This laser also is done with topical numbing cream in your dermatologist’s office and is an easy, comfortable procedure. The healing time is about 1 week, requiring some time off of work and avoidance of outdoor activities. However, many patients find this downtime to be worth the wait, as this laser delivers fast, dramatic results.
Common Laser Skin Resurfacing Questions
What is the Downtime for Fraxel vs CO2?
- Fraxel laser: After treatment, the skin will be pink or red for 3 days on average. The skin will peel gradually and feel like fine grains of sand to the touch. The peeling skin make your face looked bronzed. Makeup can usually be applied on day 3 or 4 , depending on the depth of treatment. Most patients who are treated on Friday, go back to work wearing makeup on Monday ( 3 days after the procedure). Sun avoidance is recommended for 1 week after the procedure.
- Fractional CO2 laser: This treatment causes a deeper level of peeling or ablation. There is redness on day 1, followed by marked peeling of the skin by day 3. The skin is typically healed with only localized minimal peeling by day 7 or 8. Makeup can be applied on day 7 or 8. Sun avoidance is recommended for 7-10 days after the procedure.
Is laser resurfacing painful?
Both the Fraxel laser and the CO2 laser feel warm and can have a minimal pinprick sensation. To make the procedure comfortable, we follow this procedure:
- Patients arrive 1-1 1/2 hours ahead of treatment time for application of a topical anesthetic or numbing cream. The main ingredient is lidocaine and it works very well.
- In addition we use an injectable pain relieving NSAID (non-steroidal anti-inflammatory) medication in the same family as ibuprofen called Toradol. This works within 20 minutes and lasts for several hours
- During the procedure, we use a special cooling device that delivers cold air to the skin in the area of treatment
- Post procedure, we apply ice packs as well as topical products that we keep refrigerated to cool the skin.
How can I prepare for the procedure?
In our Torrance dermatology practice, we schedule a pre-operative visit 7-10 days before the laser procedure. During this visit, we’ll discuss:
- Medications taken by the patient, and which ones to discontinue. Examples of medications that should not be taken include preventative aspirin (that is not medically necessary) and blood thinning supplements.
- Skin care products used by the patient, and which ones to discontinue. Skin care products that should not be used prior to a laser treatment include topical Tretinoin and Retin-A (which should be stopped 3 days before treatment).
We will also go over post-care instructions during this initial visit, to include:
- specific post care products that we have tested for use after laser treatments.
- having ice packs on hand to minimize swelling (degree of swelling varies from patient to patient)
- stocking up on food and entertainment for the number of days recommended as “downtime”(you can’t go outside during your healing process).
- making sure you have made arrangements for time off work as well as time off of certain parental duties such as carpooling.
What about post-treatment care?
During your pre-op visit, we will review all post-procedure instructions, including:
- Avene Mineral Spring Water to hydrate and reduce inflammation after a Fraxel or CO2 treatment;
- Moisturize to aid in healing. For Fraxel patients, we recommend a hypoallergenic moisturizing like Acene recovery cream be applied often during the day; for Fractional CO2 patients, a heavier cream is recommended, such as Avene Ciclafate or Aquafor, applied every few hours.
- Use a gentle cleanser during recovery, such as Avene Extremely Gentle Cleanser.
All of these recommended skin care products are available in our practice.
How do I maintain my results after treatment?
To maintain post procedural results, you must continue an anti-aging skin regimen at home, including:
- Sunscreen – Fanatic use of #30 or higher sunscreen on a daily basis; this is the most important part of the post procedure skin care routine.
- Anti-Aging Products – Some of my favorites include:
- AM: A Vitamin C serum such as Societe Triple C or a growth factor serum such as Skin Medica TNS. The Vitamin C Serum is an antioxidant that provides an additional layer of sun protection. Growth factor products stimulate new collagen
- PM: use a prescription strength Vitamin A cream such as Renova, Refissa or Tretinoin. If this is too strong for you, try an OTC Retinol or alpha hydroxyl Acid (AHA) product. This step will exfoliate and keep the skin smooth
- Skin Brightener with Hydroquinone – For patients who are treating abnormal pigmentation or brown spots, the post procedure plan always includes a prescription skin brightener with hydroquinone.
How much does laser skin resurfacing cost? What goes into that cost?
Fraxel laser: This laser always requires a series of 4-5 treatment sessions scheduled 4-6 weeks apart. The cost per treatment varies from $700-$1000.
Fractional CO2 laser: The cost varies from $2000-$3000 depending on the practice location. Treatment performed in a medical office by a physician may be more.
Laser skin resurfacing treatments should be performed in a medical practice by a physician or by a licensed medical professional (nurse, nurse practitioner or physicians assistant) with oversight by a physician.
In a medspa, a physician is not always on site and training of the providers may be minimal. The final result depends on the experience of the provider in using the proper settings for your skin type. More importantly, should there be a complication, a physician is best trained to handle it.
Stay away from deep discounts such as Groupon deals. If you have a relationship with a dermatologist or cosmetic surgeon who performs laser procedures, that is your best bet for treatment.
Whether the concern is acne scars, fine lines or abnormal pigmentation, laser resurfacing can improve the skin safely and with minimal downtime.
Dr. Susan Goodlerner?