Resurfacing

Skin resurfacing is a minor procedure to improve the appearance of fine wrinkles. The principle behind all resurfacing is to damage the deeper layer of the skin, the dermis, which then heals with new, refreshed and more orderly arranged collagen fibres. This new dermis has a rejuvenated and smoother appearance. Resurfacing is sometimes an option for fine crepe lines which occur around the mouth and eyes.

A number of different techniques can be used for resurfacing. These include laser, dermabrasion, chemical peel and needle abrasion. I do not perform laser resurfacing as I believe that the same results can be achieved more cost effectively and with a simpler procedure. In addition, prolonged redness has been reported in a significant number of patients undergoing laser resurfacing. Some patients have also had severe burns as a result of over-zealous laser treatment.

Chemical peel involves the application of chemicals on to the skin, usually trichloracetic acid (TCA). A TCA peel can be performed in the rooms with minimal or no anaesthesia. Since I do not like to destroy or damage the skin surface, I reserve peels for only the occasional case. Following the peel the area will go white or frost for a few minutes, then go red and peel similar to a sunburn after which you will be left with a smoother, better quality skin.

Dermabrasion can be done to flatten acne scars. I do not perform dermabrasion because of the risk of blood contamination from the aerosolized particles.

Needle abrasion is a relatively new technique. Multiple needle punctures are made in the skin which damages the dermis and causes collagen induction. Needle abrasion is painful and requires a good anaesthesia which increases costs.

Overall, I am not a huge fan of resurfacing techniques and tend to reserve them as an adjunct to my facial rejuvenations where I might do a light peel around the mouth or of the lower lid. All patients should ensure that they are receiving optimal skin care before and after resurfacing. Products used should contain vitamins A, C and E and anti-oxidants, etc. Patients prone to fever blisters should take prophylaxis prior to resurfacing.

Article written 25 October 2010.