Skin resurfacing employs a variety of techniques to change the surface
texture and appearance of the skin.
Common skin resurfacing techniques
include chemical peels, dermabrasion, and laser resurfacing.
Antiviral medications should be started several days before the procedure.
Laser resurfacing is performed under local anesthesia. An oral sedative may
also be taken.
The patient's eyes must be shielded, and the area surrounding
the face should be shielded with wet drapes
or crumpled foil to catch stray
beams of laser light. The physician will mark the areas to be treated
before beginning the procedure.
The skin should be kept moist following laser resurfacing.
This promotes more
rapid healing and reduces the risk of infection. The face is washed with
plain water and an ointment is reapplied.
Healing will take approximately
two weeks. Pain medications and a steroid to reduce swelling may also be taken.
Chemical peels employ a variety of caustic chemicals to selectively
layers of skin. The peeling solutions are "painted on,"
area-by-area, to ensure that the entire face is treated.
After the skin heals, discoloration, wrinkles, and other surface irregularities
are often eliminated.
Chemical peels are divided into three types:
superficial, medium-depth, and deep.
The type of peel depends on the strength
of the chemical used, and on how deeply it penetrates.
Superficial peels are used
for fine wrinkles, sun damage, acne, and rosacea.
The medium-depth peel is used
for more obvious wrinkles and sun damage. Deep peels are used for the most
severe wrinkling and sun damage.
Preparation for the chemical peel begins several weeks before
the actual procedure.
To promote turnover of skin cells, patients use
a mild glycolic acid lotion or cream in the morning,
and the acne cream tretinoin
in the evening. They also use hydroquinone cream, a bleaching product that
prevent later discoloration. To prevent reappearance of a herpes simplex
virus infection, antiviral medicine
is started a few days before the procedure
and continues until the skin has healed.
Patients arrive for the procedure wearing no makeup.
The physician "degreases" the patient's face using alcohol or another cleanser.
Some degree of pain accompanies all types of peels. For a superficial peel, use of a hand
held fan to cool the face during the procedure is often sufficient.
For medium-depth peels, the patient may take a sedative or aspirin.
During the procedure, cold compresses and a hand-held fan can also reduce pain.
Deep peels can be extremely painful. Some physicians prefer general anesthesia,
but local anesthetics combined with intravenous sedatives are frequently sufficient to control pain.
Within a day or so following a superficial peel, the skin will turn faint pink or brown.
Over the next few days, dead skin will peel away. Patients will be instructed to wash their skin
frequently with a mild cleanser and cool water, then apply an ointment to the skin to keep it moist.
After a medium-depth peel, the skin turns deep red or brown, and crusts may form.
Care is similar to that following a superficial peel. Redness may persist for a week or more.
Deep-peeled skin will turn brown and crusty. There may also be swelling and some oozing of fluid.
Frequent washing and ointments are favored over dressings.
The skin typically heals in about two weeks, but redness may persist.