Laser skin resurfacing: features of the postoperative period

Laser skin resurfacing – a rather traumatic procedure, and, despite the use of the latest techniques and modern lasers, the success of laser therapy largely depends not only on the qualifications of the doctor, but also on how carefully the rules of postoperative skin care were followed. The attentive attitude of the doctor and the patient to the rehabilitation period after laser resurfacing will help to significantly reduce side effects and avoid complications.

Features of the skin condition after laser resurfacing

During the first 24-48 hours, erythema and edema increase. These phenomena can be reduced by prescribing depomedron during the procedure. The area to be treated should be well hydrated with, say, appropriate gels. Repeated application of ice packs may reduce swelling and discomfort during the first stage of treatment.

Careful monitoring is needed during the 1st week to prevent infection, poor wound healing and unexpected inflammation. In most cases, re-epithelialization takes 7-10 days. To mask residual erythema, you can use a green make-up base. Erythema is most intense after 10-14 days and may take several months to resolve.

In the postoperative period, patients are advised to use moisturizers regularly and, if necessary, apply topical hydroquinone to reduce hyperpigmentation. If hypertrophic scars occur, they are immediately treated.

Side effects and complications after laser procedures

Among the most serious complications after laser procedures, herpesvirus infection is called. Reactivation of herpes simplex infection can occur, and very strong. If the patient has a history of recurrent herpes, antiviral prophylaxis is indicated, and most doctors perform it as a routine measure during resurfacing. Other infections may also occur, so the treatment area must be closely monitored during the healing process. Many doctors prescribe prophylactic antibiotics in the postoperative period.

Postoperative erythema occurs in all patients. The erythema is most pronounced 10-14 days after resurfacing, and then it slowly fades, although it may take many months before the skin acquires a normal color. Persistent erythema should be monitored closely as it may indicate the development of hypertrophic scarring. Green make-up base can be used in the postoperative period to mask the color.

Scarring or ectropion may develop after laser procedures. This occurs due to defects in technique, poor postoperative care, or infection, but sometimes also as a result of idiosyncrasy. Scar development usually presents in the first month as persistent erythema. Scarring is treated with topical or intralesional steroids and/or silicone gel sheets. In such cases, early treatment with a 585 nm pulsed dye laser is beneficial.

Temporary hyperpigmentation occurs in about 1/3 of patients and becomes apparent within 3-4 weeks. It usually resolves spontaneously. However, the process can be accelerated by topical hydroquinone twice a day or a light acid peel once every 2 weeks or a month. This treatment should be started at the first sign of any darkening. Patients are asked to take the utmost care to avoid exposure to solar radiation and to take protective measures against it during the post-treatment period.

Hypopigmentation comes later – at the earliest in 6 months – and may not appear until 12 months of age. Unfortunately, this side effect can become permanent, but sometimes improves with peeling of the surrounding skin. There are interesting reports on the use of UV lasers (excimer lasers) to treat this complication.

Sometimes there are other problems such as milia and acne flare-ups.

Thus, one of the disadvantages of laser skin resurfacing is a long postoperative period, which in typical cases stretches for months. However, with the advent of carbon dioxide lasers with shorter pulses, as well as erbium YAG lasers, the duration of this period has decreased to an acceptable level. Careful postoperative care is paramount to the success of laser therapy. But it is especially important that the laser skin resurfacing procedure is carried out by an experienced and skilled doctor.