The main cause of wrinkling is the ageing process with a strong influence produced by our particular genetic inheritance. Nicotine and sunlight can markedly accelerate the deterioration of the skin quality. Over time, wrinkling is usually accompanied by the development of fine blood vessels and pigmentation.
Sometimes a person presents asking for laser skin resurfacing when, for them, it is an inappropriate treatment.
For instance, a young person in the under-30 age group might need improvement in skin quality that is very adequately managed with suitable (and not necessarily expensive) topical skin applications. Such a young person might have some fine crinkling of the skin under the eyes but no wrinkling elsewhere. In such a person gentle laser resurfacing restricted to this area can improve its appearance (the rest of the face being treated with good quality topicals).
With the effects of ageing, fine wrinkles develop in the skin, but again these might respond to topical applications. As the depth of the wrinkles increases, it is reasonable to consider laser skin resurfacing. The most affected regions of the face are usually around the mouth (‘peri-oral’) and around the eyes (peri-ocular). Regional resurfacing can be done restricted to these areas or the full face can be done.
When the wrinkles are deep, as from ‘middle-age’ onwards, it is possible to render them much less deep, and to make some go entirely. That is, a significant cosmetic improvement is achieved.
A laser is a light source consisting of one wavelength of light only and in a very ‘pure’ form. There are many types of lasers that produce good results and even non-laser sources of strong light such as IPL (Intense Pulsed Light) that have a place in improving skin quality and appearance.
Resurfacing lasers are further divided into those that actually remove the top layer of skin, which is replaced by new skin usually within a week (‘oblative lasers’), and ones that produce heat deep in the skin, inducing it to repair itself (‘non-oblative lasers) .
The original laser for oblative skin resurfacing, the carbon dioxide laser (CO2), is still considered the ‘gold standard’ against which all subsequent ones are compared and judged.