Lasers - Skin Rejuvenation

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The laser is used for many medical purposes. The laser light beam is generated from radiation sources so small and safe that it poses no health risks to the patient or medical team. Because the laser beam is so small and precise, it enables surgeons to safely treat tissue without injuring the surrounding area. Lasers may be used to remove growths or cauterize blood vessels.

The ability to precisely control the duration and intensity of laser beams allow for many uses in cosmetic surgery. The relatively painless and accurate removal of birthmarks and tattoos are just two examples of these applications. As with all medical procedures there may be potential complications and possible risks although, when applied by a trained and experienced clinician, Lasers pose minimal risk to patients.

Lasers can be used to rejuvenate skin (e.g. removal of acne, birthmarks, etc.) or to resurface skin (e.g. deep wrinkles, removal of skin layer.)

There are surgical operations that are difficult to perform with the conventional scalpel and a laser beam can be used instead. Initial clinical trials have demonstrated that a finely focused beam from a carbon dioxide gas laser could cut through human tissue easily and neatly.

What are the advantages of using lasers for skin rejuvenation?
By modifying the laser's sole wavelength the laser can also be used for non-surgical applications: a laser can remove wrinkles or other surface changes in the skin without leaving scars. Lasers can also kill cells in the area being treated without burning surrounding tissue.

  1. The light beam is consistent, which means that it gives off the same amount of energy from one second to the next. So as long as the beam is moving along, the incision does not vary in depth; whereas when using a scalpel a surgeon can accidentally make part of the incision too deep.
  2. The hot beam cauterizes, or seals off, the open blood vessels as it moves along. This works well mainly for small vessels, such as those in the skin although the surgeon still has to seal off the larger blood vessels using conventional methods.
  3. Cells in human tissue do not conduct heat very well, so the skin or any other tissue near the laser incision does not get very hot and is not affected by the beam. Lasers are particularly advantageous when a surgeon must operate on a small area that is surrounded by healthy tissue or organs.

How do Lasers Work?
Lasers were first developed in the 1960's in the U.S. and initially were seen as being effective at reducing the colour of tattoos and some brown pigment spots. During the past 50 years laser technology has been greatly developed and now offers advanced options for skin rejuvenation treatment.

Laser equipment

The word 'laser' stands for Light Amplification by the Stimulated Emission of Radiation. Lasers work by producing an intense beam of bright light that travels in one direction and which can cut, seal or vaporize skin tissue and blood vessels. The laser has the unique ability to produce one specific colour (wavelength) of light that can be varied in its intensity and pulse duration.

Ordinary light from non-laser sources is composed of many different colours and appears white. This broad spectrum of light can also be pulsed to a specific duration and varied in intensity as well as the exact range of wavelengths. This allows broad spectrum Intense Pulsed Light (IPL) the ability to specifically treat blood vessels and pigmentation. The wavelength and power output of a particular laser or IPL typically determines its medical application. When the laser or IPL light is directed at skin tissue, its light energy is absorbed by water or pigments found in the skin. Water is found in large amounts in all living cells. Pigments of the skin include haemoglobin, a protein that makes blood red, and melanin, the tan or brown-coloured pigment. All three targets absorb laser light of different colours.

Typically laser treatments for skin rejuvenation do not require anaesthesia although patients may be required to wear protective glasses. Lasers can be used for any area of the body except directly around the eyes.

Laser equipment

Are there different types of lasers?
There are different types of lasers which are distinguished primarily by the length of laser pulse:

  1. Short pulsed laser also referred to as 'Intense Pulsed Light'. Can help: blue/ green/black tattoos, dark circles under the eyes, rosacea, superficial thread veins, active acne, some dark scars, sunspots, some birthmarks than have been clinically proven to be benign and not malignant, and some pigmented lesions. Consultant Plastic Surgeons with Aesthetic Surgery Ireland use the Lumenis One® laser system.
  2. Longer pulsed pigment lasers, including the Nd YAG option can help deeper and darker skin activation including benign moles, some birthmarks and many types of excess hair growth.

Procedures may or may not require a laser to provide optimum outcomes. Even with the sparkle, pure colour, and high-energy beam, the laser is not always the best tool for surgery. The choice of using a laser, and what type of laser, or other surgical alternative is carefully made by the Consultant Plastic Surgeon once a thorough analysis of your skin condition and expectations has been completed.

Generally patients will have to undergo a series of laser treatments to achieve the desired effect. Depending on the particular condition being treated, a typical laser treatment may necessitate 5-6 laser sessions over a 5-6 week period.

How does the Fraxel laser work?
Aesthetic Surgery Ireland uses the Fraxel® laser technology.

Fraxel

Unlike other laser treatments Fraxel® treatment is able to precisely treat thousands of microscopic areas of skin, using pinpoint laser beams that penetrate beneath the skin’s surface to eliminate old, damaged skin cells. Fraxel® treatment stimulates the body’s own natural healing process which replaces damaged skin with fresh, glowing healthy skin.

In addition to skin rejuvenation, Fraxel® treatments may be beneficial in treating acne scars, sun and age spots, wrinkles around the eyes, brown spots, and pigmented lesions.

Clinical studies suggest that for most people, maximum results are realized in just 3 – 5 sessions, which are usually spaced 2 – 6 weeks apart.

What skin conditions can lasers treat?
Lasers can be considered for treating the following skin conditions:

  • Static wrinkles: These wrinkles are visible at all times and do not change in appearance with facial movements, e.g. acne scars, infl uence of gravity.
  • Dynamic wrinkles: These are expression lines that may appear as folds when the skin is not moving, and deepen with facial movements or expressions, e.g. when you smile.
  • Skin Discolouration/Pigmentation: Freckles, sun spots, melasma, or other darkened patches of skin result mainly from sun exposure.
  • Scars: As the result of acne or injury to the skin, scars may be rolling (a wavy appearance to the skin), pitted, discoloured, or have raised borders.
  • Dull looking skin, mild flushing
  • Vascular conditions: Blood vessels visible on the surface of the skin, vascular lesions that appear as tiny blood filled blisters or even a constant flush of facial redness.
  • Thread Veins, Red Birthmarks and Red Faces
  • Loss of skin tone: Weakening of the supportive skin structure (collagen and elastin fibers) that results in a loss of skin firmness, or the development of cellulite.

What types of laser skin treatments are there?
Skin Rejuvenation
Skin rejuvenation includes the treatment of skin discolouration and pigmentation and uses a number of different types of lasers. Determining the duration and energy level of the pulse from the laser is a key factor in achieving optimum outcomes.

The following description outlines the general procedure a patient undergoes for laser rejuvenation treatment. The procedure you may undergo for your specific condition may differ and can be fully explained by a Consultant Plastic Surgeon.

What happens before your skin rejuvenation Treatment?
It is important that your skin is properly prepared for the procedure. This may include application of lighting cream and sunscreen for dark skinned or tanned patients: this is a precaution to ensure that the laser is not absorbed by the tan.

Similarly the Surgeon may decide to apply a water jet to cleanse your skin of any impurities. The use of the JetPeel® water treatment will help to prepare your skin for the laser treatment. The water jet cleanses your skin in preparation for the laser treatment.

What happens during your skin rejuvenation treatment?
Patients are generally required to wear protective goggles which will be supplied by the Surgeon. During the application of the laser the patient may feel a snapping or skin-pricking sensation which provides minimal discomfort. If necessary the Surgeon can apply a topical anaesthetic cream to relieve any discomfort.

Depending on the area being treated the procedure usually can last from 30 minutes (hand) to up to an hour (face).

What happens after your skin rejuvenation treatment?
Soothing face
The Surgeon will cool or sooth your skin immediately after the laser treatment. Depending on your particular condition and the specifics of the laser treatment there may be some darkening of the treated area, redness, crusting or weeping. Generally any such effect is very temporary and will disappear after 3-4 days. Patients can return to work immediately although some patients may decide to apply some form of make-up to hide any temporary discolouration.

The surgeon shall provide you with non-stick dressing and anti-biotic creams to be used for up to a week after your treatment.

What are some of the Potential Complications?
Laser, or light, treatments can leave skin blisters or burns. While this is rare, it may lead to mild scarring and changes in skin colour or pigment. If you have laser treatment around your eyes, you may experience temporary eyelid swelling.

Some types of laser rejuvenation treatments are not advised for darker skin tones. If you have a dark complexion, your Consultant Plastic Surgeon can recommend the optimum laser treatment for you.

Protective goggles must be worn during laser treatment

Laser treatments are not for everyone. Your Consultant Plastic Surgeon may advise you against laser treatment if you're prone to scarring or have a history of light sensitivity that causes a rash or other reaction. And laser therapy is not recommended if you have cold sores or other skin infections at the site of the planned treatment.




Frequently Asked Questions

What is Laser Skin Rejuvenation?
Laser Skin Rejuvenation therapy helps stimulate your skin's collagen production by deconstructing underlying blood vessels using lasers, helping to 'plump up' the skin and minimise the appearance of fine lines. Skin rejuvenation therapy is considered a non-ablative treatment, which means that the surface of your skin shouldn't be damaged by the process.

What is Intense Pulsed Light (IPL) treatment?
Also called the heat lamp method, IPL works by heating the skin below the surface to stimulate the cells. Intense Pulsed Light revitalises dull-looking skin, reduces the appearance of flushed skin and sun discolouration, minimises thread veins, and reduces fine lines. It is most effective for people with fair to medium skin tone. Intense Pulsed Light helps stimulate new collagen development when it's absorbed by the skin. The heating of the skin is also thought to stimulate collagen production.

What is Blood Vessel Pulsed Dye Laser treatment?
Blood Vessel Pulsed Dye Laser also can revitalise skin by breaking up cells under the skin. It uses a different laser than IPL and was originally developed to treat port-wine birthmarks and thread veins. Treatment helps correct discolouration; reduces fine lines, mild eyelid sagging, and wrinkles; and minimises thread veins and facial redness. It is most effective for those with fair to medium skin. The general belief is that this treatment works by causing slight damage to the blood vessels in the skin: the healing process facilitates the production of new collagen.

What skin problems do lasers treat?
In general, lasers and light systems used in rejuvenation therapy can reduce the appearance of uneven pigment and small thread veins on the face. There is also some evidence that these devices can improve the appearance of wrinkles, mild scarring, and large pores.

How often would I require treatment?
Initial treatment may require four or five courses over a few weeks to achieve the level of improvement you desire. Afterwards, you can get treated every six months for maintenance, as required.

Are there any reactions to treatments?
Laser, or light, rejuvenation treatment can leave skin blisters or burns. While this is rare, it may lead to mild scarring and changes in skin colour or pigment. If you have laser treatment around your eyes, you may experience temporary eyelid swelling.Some types of laser rejuvenation therapy aren't advised for darker skin tones. If you have a dark complexion, your Consultant Plastic Surgeon can recommend the best laser treatment for you.

Are laser treatments painful?
Depending on the type of device used and the brand, you may experience mild stinging or burning during the procedure. The area treated may also feel hot for about 15 minutes or so after treatment. Laser resurfacing is a very controlled burning procedure during which a laser vaporizes superficial layers of facial skin, removing not only wrinkles and lines caused by sun damage and facial expressions, but also acne scars, some folds and creases around the nose and mouth, and even precancerous and benign superficial growths. In a sense, the laser procedure creates a fresh surface over which helps to facilitate the growth of new skin. Laser rejuvenation treatments assist the stimulation of your skin's collagen production, helping to 'plump up' your skin and minimise the appearance of fine lines.

After laser treatment, can you go out into the sun again?
You can still go out in the sun, but you should protect yourself by using a high-factor sunscreen (minimum 30+ SPF), regardless of what season it is. Wearing an appropriate sunscreen is always recommended for everyone for summer months when you spend the most time outdoors.

Will I have noticeable facial redness for months after laser treatment?
In most cases your skin will be very slightly pink for one or two days. As long as you are treated by an experienced consultant using the correct energy settings, any skin discolouration should last only a few days.

Does this procedure carry a high risk of skin infection?
Laser therapy does not carry a high risk of infection as the skin surface is not broken during the treatments.

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