Since the early 1990s, ablative lasers have become the high tech equivalent to deep dermabrasion or chemical peels for skin resurfacing; the removal of the outer layer of the skin to promote new fresh skin growth. There are two main types of ablative laser – carbon dioxide lasers, and erbium:YAG laser systems. Ablative laser skin resurfacing is a process where the upper layers of aged or damaged skin are vaporized by applying a controlled laser beam.

These skin resurfacing lasers briefly direct an intense burst of laser energy onto the skin. This energy heats water within the surface layers of the skin, causing both the water and the tissue to turn to vapor. Every time the laser passes over the skin, some of the outermost layers are removed in a precise and controlled way to the appropriate depth. The skin then heals over a period of time as new layers of collagen are produced. This can significantly reduce the appearance of lines, wrinkles, and pigment changes on the face, neck, and body.

Comprehensive consultations are available by Dr. Robinson. Please call (503)-635-8930 for details.

Laser Skin Resurfacing Background Information

The use of light as a medical treatment has grown considerably over the past few years. There are now many kinds of devices, which deliver various different types of light for an ever-increasing number of potential uses.

The use of light from lasers for medical procedures was developed in the 1960s when they were first used as cutting tools in operations by some surgeons. Laser technology has developed over the last few decades to treat patients with a variety of different skin problems including the effects of sun damage, the removal of body hair and recently the treatment of psoriasis and acne.

Since the early 1990s, ablative lasers have become the high tech equivalent of  deep dermabrasion or deep chemical peels for skin resurfacing (removal of the outer layer of the skin).Figures from the American Society for Aesthetic Plastic Surgery (A.S.A.P.S.) indicate that laser skin resurfacing was the sixth most common cosmetic treatment in the U.S.A. in 2009 with over 512,000 treatments. (Note: the number of treatments quoted by ASAPS included 27.2% carried out with an ablative laser and 72.8% with a non-ablative laser). See Laser/IPL Skin Rejuvenation for details of non-ablative techniques.

What are lasers and how do they work?

A laser is a high-energy beam of light that can be directed into certain areas or tissues within the skin. These beams of light are produced in one wavelength or color at a time, and can vary in terms of their strength and the type of tissue that they can target.

Ablative Lasers

The “ablative” or skin resurfacing lasers briefly direct an intense burst of laser energy onto the surface of the skin. This energy heats water within the surface layers of the skin, causing both the water and the tissue of the skin to turn to vapor. Every time the laser passes over the skin, some of the outermost layers of the skin are removed in a precise and controlled way to the appropriate depth (see diagram below).

The skin then heals over a period of time, as new layers of collagen are produced. The skin can literally resurface itself, causing an improvement in the appearance of sun damaged or acne scarred skin. After the treatment, the skin will look much healthier than it did previously.

This intensive treatment can significantly reduce the appearance of lines, wrinkles, and pigment (or skin color) changes on the face, neck, and other parts of the body. They can be used in sensitive areas, such as lines around the lips, eyes and even eyelids, or over the whole of the face. Acne and other types of scars and certain stretch marks can also be improved.

What happens during a Laser Skin Resurfacing treatment?

Depending on the area of skin to be treated and the type of laser system used, different treatment procedures may be recommended for you by your practitioner. Your first discussion with a practitioner should clearly set out your expectations of the laser treatment and whether your medical practitioner believes that he or she can achieve this for you.

A medical history should be taken at this time to make sure that there are no reasons why you shouldn’t have the treatment. You would normally be asked to read detailed information and sign a consent form which means that you have understood the potential benefits and risks associated with the procedure recommended for you.

Photographs may also be taken by the practitioner for a “before and after” comparison at a later date.

Treatment Procedure for Ablative Laser Skin Resurfacing

• Recommendations a week before the treatment may include stop taking any aspirin or non-steroidal anti-inflammatory drugs (NSAIDS) to reduce bleeding following treatment.
• We may recommend some form of pre-treatment to the skin 2 weeks before the procedure; these can include retinoic acid, or alpha-hydroxy acid based creams, which help to condition the skin and improve healing after the laser treatment.
• The full procedure usually involves the use of local anesthetic on the area to be treated and for larger treatment areas this may be combined with some form of sedation to make you drowsy during the procedure and to lessen any discomfort.
• Before laser resurfacing, the skin surface is treated with an antiseptic and gently cleansed. Surrounding hair is protected with wet gauze, and eye shields should be worn.
• If the eye area itself is to be treated, then intraocular stainless-steel eye shields are used to ensure that your eyes are fully protected from the laser.
• If you are not sedated, be prepared for a loud cracking noise when the laser is being operated as the beams are emitted onto the surface of the skin. Do not be alarmed: this is quite normal!

How long will it take to recover from Laser Skin Resurfacing?

Most people find that they can return to work after 7-10 days.

What are the risks or side effects from Laser Skin Resurfacing treatment?

• Immediately after laser skin resurfacing, you will have a raw, uncomfortable and weeping surface burn in the area treated. This will take 3 – 8 days to heal, depending on the extent and depth of the procedure and your healing capacity.
• Side effects or risks after the procedure can include infection, itching, swelling and pain at the treatment site.

  Skin erythema (redness) will last from several weeks to 6 months following the procedure. In rare cases, this redness can continue for longer.

• Milia (small raised cysts which look like white spots) usually occur during the first 6 – 8 weeks after treatment, and may remain from a few days to many weeks after the treatment.
• Hyper-pigmentation (increased pigmentation or color in the skin) can occur in the area treated, particularly in those with darker skin types.
• Hypo-pigmentation (decreased skin color) can also occur. This is less common and appears to be related to the depth of treatment, but can occasionally be permanent.
• Rarely, scarring of the skin can occur, which in some cases can be permanent.

What should you do after a Laser Skin Resurfacing treatment?

It is very important that you follow the advice of your practitioner carefully after any laser treatment to help the procedure to be successful and to reduce the risk of complications.

Post treatment advice may include:

• use recommended painkillers and sleeping tablets as required;
• follow the recommendation of your practitioner regarding your skin. The most important thing is that the wound is kept moist and clean during the healing process;
• sleep on your back with your head propped up by a few pillows;
• return to your practitioner a couple of days after treatment for an assessment;
• avoid strenuous exercise for a couple of weeks;
• avoid scratching or picking at the skin to reduce the chances of scarring;
• start using a sunscreen about 2 – 4 weeks after the laser treatment and avoiding any direct exposure to the sun for around 6 weeks;
• contact your practitioner immediately if you notice any signs of infection, scarring or pigment changes.

What is the average cost of Laser Skin Resurfacing?

Prices for a private laser skin resurfacing procedure can range from around $800 for a small area to around $3,800 for full face laser skin resurfacing.

Summary of advice for Laser Skin Resurfacing

Traditional ablative laser skin resurfacing has been shown to be very effective in improving deeper lines and wrinkles associated with sun damaged skin.
The downside is the recovery time, cost and potential complications.

As a consequence of this, the development of lasers has focused on so called non – ablative laser and IPL light sources that do not remove the surface of the skin, but still cause visible improvement of lines and wrinkles.

These alternatives do not, as yet, produce such dramatic and long lasting results as ablative lasers, but they are safer and involve virtually no recovery time.

Please see our laser/IPL/LHE skin rejuvenation section for more details.

You will often find that your practitioner recommends the use of botulinum toxin (Botox® or Dysport) at the same time as a laser treatment. This is to reduce creasing of the skin around the eyes or forehead during the healing process.

Obviously, this is only necessary for those who have had treatment in these specific areas. Botox® helps the skin to heal and also reduces the chances of reappearance of crow’s feet or forehead wrinkles after the procedure.

No matter what equipment or techniques is used, laser resurfacing rarely removes or markedly reduces deep wrinkles or facial sag. Another alternative for deep wrinkles, whether related to movement or not, are fillers such as Restylane or JuveDerm. Facelift remains the procedure of choice to correct marked facial sag.

Before and after photographs of Laser Skin Resurfacing

Results vary depending upon both the patient and the skill of the surgeon.

Results with Sciton Erbium & ProFractional Laser. Images provided courtesy of Dr. Lee Robinson.

All before and after photographs are real patients, your results may differ.

Each year, millions of patients with persistent skin problems visit their dermatologist’s office to treat fine lines and wrinkles, Rosacea/persistent red complexions, sun spots, acne scars, large pores, along with aged skin. Photo-rejuvenation, with the use of Sciton’s BBL device, can effectively treat these common conditions with little to no downtime or discomfort. Also FotoFacials™ can be used to treat the face, chest, neck, and hand. Treatments only take 30 to 45 minutes per session and almost everyone is a candidate and will benefit from this procedure. Three to five sessions are recommended for optimal results.

FotoFacial™ BBL Treatments

Safe & Effective Laser Therapy without Down-time

This is a new and unique use of pulsed broadband light technology developed by California Dermatologist Dr. Patrick Bitter Jr. MD and Sciton® Laser Systems. The FotoFacial™ procedure rejuvenates skin with little to no downtime using a series of full-face treatments and specific light parameters to produce a consistent and dramatic improvement in sun damaged, flushing and Rosacea prone skin. “No skin care product, Bio-identical hormone replacement, supplements or vitamins can improve the appearance of aged skin better than just one treatment of Sciton BBL.” Dr. Patrick Bitter MD, 2010.

FotoFacial™ BBL BroadBand Light technology utilizes the power of pulsed light to deliver excellent phototherapy results. By selecting the appropriate wavelength or filter, the physician will be able to treat a broad range of skin conditions caused by skin aging and sun exposure. The light energy delivered by the BBL gently heats the upper layers of the skin. The heat absorbed by the targeted areas stimulates the skin cells to generate new collagen. This process helps restore the skin to its natural stage. In addition, the photothermal energy targets and eliminates many of the fine vessels that cause redness and the unwanted melanin responsible for pigmented lesions.

Prior to your first FotoFacial™ treatment, you will meet with your doctor or laser specialist to discuss your goals and to determine the best way to treat your problem area. A topical anesthetic can be used to ensure your comfort if desired and you will be given dark glasses to protect your eyes from the bright light. A soothing gel will then be applied to the face and a chilled sapphire crystal will be placed on top of the gel. The pulses of light will go through the crystal and treat the desired areas of your skin. There are filters in the handpiece that control the wavelength range allowing for different applications and skin types.

The light passes through the facial tissue where it is then absorbed by either blood or melanin. The injured tissue is then removed by the body’s natural processes and the skin appears fresh and even. The first session of BBL will not be as aggressive in an effort to help minimize aggravation of the skin. You will have treatments every 3 to 4 weeks, and the intensity will increase with time.

As mentioned earlier, there is little downtime with this procedure, so you can resume normal activities immediately. Most clients do not report any discomfort following their sessions. You will need to protect the affected areas from UV rays, including those from tanning beds. Minor swelling may be notice and your skin might be a little pink, but this should disappear within a few hours to a few days. The sun damaged area will temporarily appear darker but then will be sloughed off when washing, usually around 7-10 days after treatment. Make-up may be applied immediately after the procedure.

Since the inception of light based therapies, “this is the closest we have come to the Fountain of Youth for preventing skin aging.” Bitter Jr., 2010. Call us today for your complimentary consultation. 503-635-8930.

As you get older, your skin starts to develop signs of aging that many people don’t want to live with. These days you don’t have to because there are treatments available to help rid you of these problem areas. One of the treatments that is available is Intense Pulse Light Therapy. This treatment will help with many different types of problems.

Knowing what the problems are that this therapy will help with, will make it easier for you to decide if you should have it done. Here are some of the types of problems that this treatment helps many people with.

1. Sun spots, age spots or what is also known as liver spots – These are areas of your skin that are a darker color due to exposure to the sun on certain parts of your body. The most common areas that people develop this problem is the backs of their hands, face, chest and shoulders.

2. Freckling – This is also known as superficial pigmentation and usually happens on the nose and cheeks. To effectively treat this problem, you will need two or three treatments spanning a period of a couple months.

3. Hyperpigmentation – This problem is caused by repeated exposure to the sun and is especially found in people that are fair skinned.

4. Melasma – This can be the hardest type of hyperpigmentation to treat. This problem usually happens secondary to hormonal changes during a woman’s pregnancy or if a woman is using birth control pills. This may require many treatments to help.

These are the most common types of problems that intense pulse light can help you with. It is a good idea, no matter where you live, even in Lake Oswego, Oregon, to set up a consultation with a RN laser technician to decide on the best treatment option for your problem.

Laser resurfacing is something that many people in the world are considering for many different reasons. This treatment is used for treating many different problems with your skin. You need to know who has this treatment and if it is effective, which this article is going to explain to you.

Let’s start with who has the treatment. The truth is that pretty much anyone can have this treatment done if you have a skin problem you need help with. Here are some of the different reasons that people may have this treatment done.

• Sunspots, liver spots and age spots
• Wrinkles
• Acne Scars

These are the main reasons that people all over the world are opting to have this treatment. If you have any of these problems, then it may be a good idea for you to, but you will want to do more research to decide this for sure.

Now, this laser treatment is effective for anyone because the laser penetrates the deep layers of your skin, which means that it can take care of problems on a deeper level than other treatments can. Plus, it doesn’t cause much bleeding, bruising, scarring or discomfort like many other types of treatments can. It is a good idea to know though that it may require two or more treatments for you to achieve the full benefits from it.

It is now time for you to decide if laser resurfacing is right for you or not. Take time to research this subject and to find a place near you that can do the treatment for you. In other words, if you live in Lake Oswego, Oregon, then be sure the treatment is done in this area to make it easier on you and the doctors performing the treatment.