Dr Rita Rakus explains the difference between surgical and non-surgical options.

Lasers may be used in many areas such as removing superficial pigmented sun damage or to remove fine lines and wrinkles caused by sun-induced premature aging of the skin. Whilst these surface effects cannot be removed with a surgical facelift, no laser can treat drooping of facial tissue, (e.g. loose neck and jowls) which have to be restored to their correct anatomical position by a face-lift or neck-lift. In many people, both the effects of gravity and sun damage (often sustained many years earlier through holiday sun bathing), are factors in facial aging, in which case both face lifting and laser resurfacing may be required.

The major purpose of laser resurfacing is to reduce wrinkles and fine lines on the cheeks, around the mouth and eyes by precisely removing skin in micro-layers until all the damaged tissue is gone, thereby stimulating the body’s natural healing response to create new collagen and therefore a fresher, “fuller” skin tone.

If laser resurfacing is sufficiently deep, results may last up to 10 years or longer. However, people who smoke heavily or return to sun baking after resurfacing can expect the skin to age quickly again.

The first laser to be used for skin resurfacing was the Carbon Dioxide (CO2) laser which in many cases produced dramatic improvements in deep wrinkles but one major drawback was the loss of natural skin pigment, often emerging only 12 months or later after treatment. This would appear as patchy white areas or a distinct “tide mark” along the edge of the treated facial area giving a “clown mask” effect. Whilst the loss of wrinkles and the use of makeup still provided a satisfactory result for some older patients, there had to be a better way.

The more efficient and controllable Erbium laser was introduced about 3 years ago providing greater accuracy and absence of heat damage to treated skin.

The Erbium laser has proved particularly effective in treating younger skin for superficial sun damage and removal of unwanted blemishes and has given rise to the concept of the “laser peel”. Erbium laser also works well in darker skin types and is equally effective in the treatment of deep as well as fine lines and wrinkles.

The treatment procedure itself involves the use of some form of anaesthetic to avoid pain. For partial facial areas, a topical anaesthetic cream may be sufficient but for larger areas regional nerve blocks are used (similar to dental treatment) and sometimes some form of sedation.

Following resurfacing, the underlying skin layers are exposed and a new layer of skin is produced from the still-intact skin structures including the pores, sebaceous glands and hair follicles. This natural healing process normally takes 7-10 days with Erbium laser treatment but may be less in the case of very superficial skin rejuvenation peels.

After initial healing, the skin remains red for some time due to inflammation in the skin. This redness is longer lasting following Carbon Dioxide laser treatment as the body needs more time to remove the deeper heat-damaged skin layers.

With Erbium treatment, redness is usually mild and lasts up to 8 weeks whilst with Carbon Dioxide laser treatment the redness is more severe and can last up to six months.

Redness is less obvious when the whole face is treated although Erbium treatment generally blends more naturally with adjacent skin even where smaller areas only are treated. This redness can be disguised easily with camouflage makeup and tinted sunscreens available from the Franklynn Centre.

Treatment costs from about £1000 for single areas such as upper lip and laser “refreshing” and from £1,500 - £3,500 for full face and chin resurfacing including medication.