Laser Resurfacing

The Recovery Period
For 2 to 3 days, you are left in the occlusive dressing, which provides a bacterial barrier as well as comfort. There is a normal response to removal of the outer layer of skin that involves the outpouring of fluid from the skin as it heals from the deeper structures such as the hair follicles. This fluid has high protein content and can coagulate on the skin, creating crusting. Crusts tend to slow down the re-epithelialization process, can get infected, and can result in deeper degrees of injury than intended; in general, it is best to avoid crusting to the extent possible. Frequent cleansing of the face and application of a hypoallergenic ointment do this until the skin forms a protective new layer of epidermis. IT IS IMPORTANT THAT YOU NOT PICK AT ANY CRUSTS THAT DO FORM. THIS CAN LEAD TO PERMANENT SCARRING.

You are seen on a frequent basis by Dr. Parson to monitor your healing progress. This period of the recovery is often quite disturbing, because there is a significant degree of distortion of the face due to swelling, weeping, crusting, and minute amounts of bleeding. Patients report a much higher degree of anxiety during this period than during a comparable period of surgical healing (following a facelift, for example), but within a week or so much of the healing has occurred and the swelling has nearly subsided. It generally takes about 10 days to 2 weeks to begin to see the benefits from the procedure, as they occur with the resurfacing, which your body needs time to do. The laser creates the injury; the benefit comes with the healing of that injury.

Healing by re-epithelialization is an inflammatory process. The skin is stimulated to form new blood vessels, and blood flow to the skin is increased; thus, the face turns red. The intensity of this redness varies between patients, as does the length of time it takes for it to subside. At a minimum, the redness lasts 2 weeks, but it can last 3 or more months in some patients and require camouflage makeup to conceal it. This can appear like a sunburn, or even a deeper shade of red or even maroon color, though this is unusual. Steroid lotion is used during this intense period of redness to suppress the inflammation, as is sunscreen. Sun exposure during this period can lead to deep sunburns and skin damage, and is to be avoided at least until the skin has returned to its normal color.

Transient hyperpigmentation (skin darkening), as mentioned in the section above on risks, can occur but almost always resolves itself over time. Hypopigmentation (skin lightening) on the other hand is universal to one degree or another. It may take months to appreciate how much lighter the skin is, because of the redness during the early recovery period. Dr. Parson advises you initiate or return to a maintenance skin care program approximately 6 weeks following your resurfacing procedure. It is extremely important that you adopt an aversion to the sun; after all, it is the effects of ultraviolet light that create the wrinkles in the first place! SPF 15 sunscreen is recommended 365 days a year for life.

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