Correct skin texture, tone, and sun damage.
Laser resurfacing treats sun damage, fine lines, acne scars, and rough texture by renewing the skin surface. This treatment is highly effective for reducing fine lines, acne scars, and hyperpigmentation, revealing smoother, younger-looking skin.
InquireAblative laser resurfacing at our practice uses fractional CO2 (carbon dioxide) or Erbium YAG laser systems, selected based on the patient's skin type, concerns, and desired recovery period. Topical anesthetic is applied thirty to sixty minutes prior; oral sedation is offered for full-face ablative treatments. The laser is passed in systematic overlapping vectors across the treatment zone using parameters (pulse energy, density, and stack passes) calibrated to the desired depth of penetration. Fractional delivery treats a column of tissue while sparing intervening skin, accelerating healing compared to fully ablative treatments. The endpoint is a uniform tissue response - graying of the epidermis with fractional treatments, or full vaporization to the papillary dermis with fully ablative approaches.
Laser resurfacing is a good fit for lighter skin types with sun damage, fine lines, acne scars, or uneven texture when a stronger treatment is worth the downtime. Patients must complete pretreatment skin conditioning with tretinoin and hydroquinone and must not be on isotretinoin within twelve months of treatment. Active skin infection, uncontrolled medical conditions, or unclear expectations are contraindications.
Following ablative laser resurfacing, the skin enters a structured healing sequence. During the first forty-eight hours, the treated area appears edematous and raw. Crusting and serous exudate are managed with occlusive petrolatum-based dressings and gentle saline cleansing. Active skin shedding occurs over days three through seven. New epithelium emerges between days five and ten and appears bright pink, gradually fading to normal skin tone over four to six weeks. Strict broad-spectrum sunscreen use is mandatory for six months to prevent post-inflammatory hyperpigmentation.
Edema and exudate managed with occlusive dressings. Avoid sun exposure completely. Topical antivirals and antibiotics as prescribed.
Active skin shedding. Do not pick or remove peeling skin. New epithelium begins emerging. Strict occlusive moisturizing regimen.
New pink skin normalizes. SPF 50+ mandatory. Makeup may be resumed once fully re-epithelialized. Collagen remodeling continues for months.
The primary risks of laser resurfacing include post-inflammatory hyperpigmentation, especially in Fitzpatrick types IV and above, which is mitigated by pretreatment conditioning and sun avoidance. Herpes simplex reactivation is prevented with prophylactic antiviral therapy beginning two days before treatment. Scarring is rare when appropriate laser settings and patient selection criteria are observed. Prolonged erythema lasting three to six months can occur with deeper ablative treatments.
Chemical peels provide a non-laser alternative for skin renewal using chemical exfoliation; medium and deep peels can achieve comparable improvement to ablative laser resurfacing. Non-ablative fractional lasers offer improvement with less downtime but produce more modest results than ablative treatments. Microneedling with radiofrequency addresses textural concerns and mild laxity with minimal downtime. For patients who cannot tolerate downtime, a series of lighter treatments may be a reasonable alternative.
Performed by Dr. Ruben Castro in Newport Beach, California