L
laser skin resurfacing A method for smoothing
scars, ACNEpitting, WRINKLES, and other blemishes
from the SKIN, primarily on the face, using a heat
(usually carbon dioxide) laser. The laser focuses a
high-intensity beam of light that the dermatologist
moves across the surface of the skin, precisely tar-
geting the depth and skin areas for resurfacing.
This precision control allows the dermatologist to
target some areas more deeply than others,
accommodating such variations in the skin as fine
wrinkles to moderate scars. Like CHEMICAL PEELand
DERMABRASION, laser skin resurfacing achieves skin
smoothing by destroying layers of cells. The new
skin that grows to replace the destroyed skin is
tight and smooth.
The dermatologist performs laser skin resurfac-
ing as an AMBULATORY SURGERYprocedure in a clinic,
office facility, or an ambulatory surgery facility, typ-
ically using local anesthetic to numb the skin and a
sedative medication for relaxation and improved
comfort. The length of time the procedure requires
depends on what kinds of blemishes the dermatol-
ogist is treating. The dermatologist may cover the
treated surfaces with an ointment and bandages,
which remain in place for one or two days.
After the procedure the treated skin surfaces
are red, swollen, and tender or painful. After a
day or two the skin scabs or crusts, a normal stage
in the HEALINGprocess. The dermatologist removes
any bandages at this time. As the skin heals the
scabs fall away, typically in 10 to 14 days. The new
skin is red and shiny, transitioning to normal pig-
mentation and texture over the following six to
eight weeks (though most of the redness subsides
in about three weeks). Full HEALINGand noticeable
improvement take about six months.
The risks of laser skin resurfacing are slight and
include excessive bleeding, INFECTION, and pigmen-
tation changes. As with all cosmetic procedures, it
is important to fully understand what laser skin
resurfacing can and cannot accomplish. Most peo-
ple who receive treatment from a qualified derma-
tologist or plastic surgeon are satisfied with the
results. Some people may find that the new skin is
sensitive to soaps, cleansers, and makeup used
before the procedure.
The new skin is very vulnerable to damage
from the sun during as well as after healing,
requiring protective clothing, such as a wide-
brimmed hat or scarf, and high sun protection fac-
tor (SPF) sunscreen whenever sun exposure is
necessary. The effects of laser skin resurfacing typ-
ically last several years, with wrinkles gradually
returning as a normal function of the aging
process. Alterations such as SCAR revision or
removal are permanent.
See also AGING, INTEGUMENTARY CHANGES THAT
OCCUR WITH; BOTULINUM THERAPY; LASER SURGERY; SUN
PROTECTION; SURGERY BENEFIT AND RISK ASSESSMENT.lentigines Dark spots of varying size on the SKIN,
also called freckles, liver spots, or age spots.
Lentigines develop as a result of continued sun
exposure and indicate damage to the skin. A sin-
gle spot is a lentigo. Lentigines are often wide-
spread on areas of skin that receive high sun
exposure, such as the face and arms, sometimes
covering the entire surface of exposed skin. It is
important to examine the skin in areas of heavy
sun damage, such as those with many lentigines,
for signs of SKIN CANCERas most skin cancer arises
from such damage.
Cosmetic products such as creams and lotions
containing alphahydroxy acid, lactic acid, or other
mild fruit acids can lighten lentigines, functioning
as a mild CHEMICAL PEEL. These products have a172