Ask the Expert: Skin Texture, CO2 Laser + More [Q&A]

Dr. Angela Sturm shares her insight on frequently asked questions about different treatments for improving the texture of your skin.

Q. I want to refresh my look. My concerns are wrinkles around my eyes and mouth, as well as on my cheeks where I smile. Should I have a facelift or something else?

A. A facelift will lift the muscles of the face creating a smooth, defined jawline, tighter neck and lifted cheeks. However, it doesn’t change the texture of the skin. If this is what you are looking for, you should consider a peel or laser resurfacing.

In the right person, this can make a bigger difference than surgery. In some people, resurfacing is used in combination with lifting, which can produce very nice results! Peels and resurfacing lasers both work to remove the top layers of skin and let your body replace them with fresh new skin. This helps smooth the skin and remove sunspots.

Both peels and resurfacing lasers can range from very light with minimal downtime and subtle results to more intense of a treatment with up to two weeks of downtime (CO2 laser), but natural, yet dramatic results. The right treatment for you can be determined by a dermatologist or plastic surgeon.

Q. I was in the sun as a young adult and am starting to see brown spots on my face. What can I do about this?

A. Options include peels, resurfacing lasers and targeting lasers. Peels chemically remove the upper layers of skin where the sun damage is and allows your body to replace this with fresh skin. Lasers use light to remove sun-damaged skin and promote new skin growth.

The other option is lasers that specifically target the pigment, IPL, KTP, QS YAG, QS Alexandrite or a laser in that family. Depending on the specific laser, these can turn the brown spot slightly darker as the pigment comes to the surface or make a small crust. Then, the darkened area or crust falls off in about a week and the spot is significantly lighter or gone.

Q. Can CO2 be performed on other parts of the body?

A. The CO2 laser produces very dramatic, beautiful results. Unfortunately, the full CO2 laser can only be used on the face. Fractionated CO2—meaning that the laser doesn’t cover 100 percent of the skin, but a smaller fraction—can be used on the body. This reduces downtime and speeds up healing since the other parts of the body don’t heal as fast as the face. You may need a series of fractionated CO2 treatments to achieve the desired results.

Q. What is the recovery like?

A. The laser treatments and peels that will achieve more results will also have more downtime. For example, patients that have the CO2 laser say that they don’t feel pain; they experience some stinging that is described as less than a sunburn for the evening after the laser. Then, they have no discomfort. Since the top layers of skin are being replaced, your skin looks pink and shiny for 10-14 days. After that time, you can apply makeup and resume your normal activities.

Q. If I have a busy work schedule, what are other options?

A. The simplest option is a good skincare regimen that includes Retin-A to encourage skin turnover and a lightening agent, like hydroquinone or kojic acid, if you have brown spots. Also, there is a multitude of resurfacing lasers that fit different needs as far as downtime and resurfacing goals. Lower downtime options include IPL or lunchtime lasers and mid-range include non-ablative fractional lasers, like Fraxel Dual or fractionated CO2, like Fraxel re:pair.

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