Fractional Skin Resurfacing

Skin resurfacing is a means of revitalizing the damaged upper layers of skin. After skin resurfacing, the lower layers of skin regenerate the surface. Skin resurfacing essentially reboots the skin to eliminate wrinkles, dark spots and surface plaques. Sun exposure, natural aging, heredity, nutrition, smoking, and other things contribute to wrinkle formation and loss of the natural elasticity of skin. Prior acne may produce uneven skin, pits, and scars. Medications such as birth control pills, aging, and sun exposure may also produce blotchiness and brown spots. All of these conditions may be improved by skin resurfacing.

Skin resurfacing benefits have been understood since ancient times when the Egyptians used weak acid solutions to peel the upper layers of facial skin for rejuvenation. Modern techniques of chemical peeling and dermabrasion are more refined and yield very predictable and safe skin rejuvenation. The depth of skin resurfacing can now be very accurately controlled. The deeper the skin resurfacing is taken, the more dramatic the improvement results. Unfortunately, traditional deep level resurfacing has been associated with increased risk of complications including scarring and white patches resulting from reduced skin pigment. Long recovery periods are another disadvantage of traditional deep skin resurfacing measures.

Ablative CO2 laser skin resurfacing was introduced in the late 1980s. The CO2 laser offered the benefit of deep skin tightening with shallower damage zone yielding similar results to dermabrasion and deep chemical peels while limiting the risks and recovery time; however, persistent redness that could last for months and still relatively long recovery times remained a disadvantage.

The newest innovation in skin resurfacing is the fractional CO2 laser which was introduced in 2004. The fractional CO2 laser fires multiple, separated pinpoints of laser light into the skin like pixels on a computer screen. This leaves intact bridges of skin between the pinpoints. Thermal energy imparted to the points initiates skin tightening and improvement in wrinkles. Separation of the points allows rapid healing while still yielding the benefits of deep skin resurfacing.

Downtime after fractional CO2 laser may be limited to 1-3 days as compared to 1-4 weeks with traditional skin resurfacing techniques. Another advantage of the fractional CO2 laser is that color-producing cells are largely spared; thus after treatment, skin maintains its color. This maintenance of skin coloration allows better treatment of regional areas such as the areas around the mouth and around the eye without creating visible lines of demarcation.

Fractional CO2 laser treatment decreases downtime while maintaining effectiveness and increasing safety in skin rejuvenation. It can even be used in darker skin which was previously a contraindication to skin resurfacing. In addition to skin rejuvenation, the fractional CO2 laser is very effective in treating burn scars and other scars.

The eCO2 fractional CO2 laser rejuvenates the skin with a single treatment under topical anesthesia. Numbing cream is used to anesthetize the face. The laser treatment is completed comfortably in 30 minutes. Patients may often return to using makeup after 3 days.

In our office, we utilize the Lutronic eCO2 laser, the premium upper eschelon fractional CO2 laser developed in 2008 by Lutronic. The eCO2 allows maximal tailoring of settings to adjust for patient’s individual needs. We also use the Lutronic Accusculpt precision facial contouring laser introduced in 2009 for fat sculpting.