Laser Skin Resurfacing

Laser skin resurfacing is a dermatology procedure that uses focused beams of light to remove damaged outer layers of skin and stimulate the growth of new, healthier skin beneath.

The laser delivers precisely controlled energy to the skin's surface. This either removes the outermost layers entirely — a method called ablative resurfacing — or heats the deeper layers without removing the surface, which is called non-ablative resurfacing. In both cases, the controlled injury triggers the body's natural healing process, encouraging the production of collagen (the protein that keeps skin firm and smooth) and replacing old, uneven skin with new tissue.

Laser skin resurfacing is used when skin concerns have not responded well to creams, peels, or other non-laser treatments, and when a dermatologist (skin specialist) judges that the patient's skin type and overall health are suitable for laser treatment.

• Fine lines and wrinkles, especially around the eyes and mouth
• Acne scars (pitted or uneven skin left after acne heals)
• Surgical or traumatic scars that have flattened but remain discoloured or textured
• Sun damage, including age spots (flat, darkened patches caused by years of sun exposure) and uneven skin tone
• Enlarged pores that make skin look rough
• Mild to moderate skin laxity (loose or sagging skin) on the face
• Sebaceous hyperplasia (enlarged oil glands that appear as small yellowish bumps on the face)
• Precancerous skin lesions (abnormal patches of skin that a doctor has identified as needing removal), in selected cases

Laser skin resurfacing is generally not suitable for everyone. A dermatologist will usually advise against it in situations such as:

• Active acne or open skin infections in the treatment area
• Very dark skin tones, where certain lasers carry a higher risk of pigmentation changes
• A history of keloid scarring (thick, raised scars that grow beyond the original wound)
• Recent use of isotretinoin (an oral medication for severe acne) — doctors usually recommend waiting several months after finishing the course
• Pregnancy or breastfeeding
• Autoimmune conditions or conditions that impair wound healing
• Unrealistic expectations about what the procedure can achieve

Laser skin resurfacing is generally well tolerated, but like any procedure that affects the skin's surface, it carries recognised risks that vary depending on the type of laser used, the depth of treatment, and individual skin characteristics.

• Redness, swelling, and a sensation similar to sunburn — very common in the first few days, more prolonged with ablative lasers
• Temporary skin darkening (post-inflammatory hyperpigmentation) — more likely in people with medium to dark skin tones
• Skin lightening (hypopigmentation) — a permanent loss of pigment in the treated area, seen more often with aggressive ablative treatments
• Prolonged redness (erythema) lasting weeks to months after ablative procedures
• Infection — bacterial, fungal, or viral (including reactivation of the herpes simplex virus, which causes cold sores)
• Acne flare-up in the days following treatment
• Scarring, including raised or pitted scars — uncommon but possible if healing is disrupted
• Eye injury if the treatment is performed near the eyes without proper protective shields
• Incomplete results, requiring more than one treatment session

Preparation for laser skin resurfacing usually begins several weeks before the procedure. The steps below are typical, but your care team will give you instructions tailored to your skin type, the laser being used, and your medical history.

In the weeks before the procedure, doctors commonly recommend: avoiding direct sun exposure and using a broad-spectrum sunscreen every day; stopping any skin-care products that contain retinoids (vitamin A derivatives that thin the outer skin layer), strong acids, or exfoliants; and, if relevant, starting a course of antiviral medication (to prevent cold-sore virus reactivation) or skin-brightening cream (to reduce the risk of post-treatment pigmentation changes). Smoking and alcohol are generally advised against, as both impair skin healing. Blood thinners and certain anti-inflammatory medications may be paused on medical advice.

Before the procedure, the doctor will typically carry out:

• A detailed consultation to review skin concerns, medical history, and any medications being taken
• A skin-type assessment to choose the most appropriate laser and settings
• Possibly a patch test — a small test treatment on an inconspicuous area to see how your skin responds
• Photography of the treatment area for comparison after healing

On the day of the procedure, here is what typically happens:

• 1. The skin is thoroughly cleansed to remove oils, make-up, and sunscreen.
• 2. A topical anaesthetic cream (numbing cream applied to the surface) is applied and left to work for a set time. For deeper ablative treatments, a local anaesthetic injection or sedation may be used instead.
• 3. Protective shields are placed over the eyes.
• 4. The clinician guides the laser handpiece over the treatment area in overlapping passes, following a planned pattern.
• 5. Treated skin is cooled immediately — using a cold air device, damp gauze, or a cooling spray — to reduce heat and discomfort.
• 6. A soothing ointment or dressing is applied to the treated area before you leave.

Recovery after laser skin resurfacing depends greatly on whether an ablative or non-ablative laser was used. Non-ablative treatments typically allow a return to normal activities within a day or two, while ablative treatments involve a more noticeable healing period that can last one to several weeks. Your care team will give you a specific aftercare plan; the points below reflect what is commonly advised.

• Keep the treated area clean and moisturised as directed — the skin will be raw and sensitive, especially after ablative treatment, and may weep or crust before healing
• Avoid touching, rubbing, or picking at the treated skin, as this can cause scarring or infection
• Apply a gentle, fragrance-free moisturiser and, once the skin has healed enough, a broad-spectrum sunscreen every single day — sun protection is critical because new skin is much more vulnerable to pigmentation damage
• Avoid direct sun exposure for several weeks; wear a wide-brimmed hat when outdoors
• Do not use active skin-care ingredients (retinoids, strong acids, or exfoliants) until the doctor confirms the skin has healed
• Avoid swimming pools, hot tubs, saunas, and strenuous exercise until the skin has closed and the doctor gives the go-ahead
• Attend all scheduled follow-up appointments so the doctor can check healing progress and address any signs of infection or abnormal scarring early
• Report any sudden increase in pain, pus, fever, or unexpected blistering to your medical team promptly
• Results continue to improve as new collagen forms over several months — final results are usually assessed at around three to six months