What Is Skin Resurfacing?

Despite its higher cost, laser resurfacing is rapidly becoming the most popular method of medium resurfacing since it is easier for the doctor to perform than a chemical peel or dermabrasion. The doctor doesn't have to handle messy acids or bloody abrasives. Some doctors also believe that the laser produces contraction of collagen in the dermis, giving a better result than a chemical peel or dermabrasion of the same penetration. Since lasers are very expensive, you may find that your doctor uses a laser at a medical center, rather than owning it. The cost of laser resurfacing may come down in the future as medical lasers become more common. If you can't afford medium laser resurfacing now, you should consider some of the other lower-cost skin treatment options mentioned in this FAQ and save your money for a future procedure. (You should also consider that the current cost of one medium laser resurfacing procedure will buy a lifetime supply of tretinoin
and AHA treatment.)

It should be mentioned that there are also "nonablative" or "cool" lasers being used by some doctors which are designed to stimulate collagen production in the dermis like medium resurfacing without burning away the epidermis. The advantage is that there is less risk of scarring and little or no healing period or skin redness. If you can't afford to take time off from work and don't want temporary reddish skin, this may be a good choice. If may also be good for those with large pores and oily skin who could have epidermal healing problems. However, the procedure must be repeated multiple times to produce a significant effect, and final results usually aren't noticeable for months. Currently, the results from nonablative lasers are not nearly as dramatic as with C02 or erbium YAG lasers, but new types are being developed that may produce comparable results.

Your Dermatologist 

Due to the risks of medium resurfacing, it is important to select a board-certified dermatologist or plastic surgeon. See www.abms.org or the American Board of Medical Specialties (ABMS) directory at your library. (The ABMS directory may also list details about the doctor's education and training.) These doctors have passed rigorous exams in their specialty beyond what is required for state licensure. Some doctors who were originally trained or certified in other specialties also do resurfacing because it can be very lucrative in large cities. There are a few other competing medical boards that will certify doctors to practice in areas out of their specialty training. These doctors may in fact be highly skilled, but it is safer to go to an ABMS-certified dermatologist or plastic surgeon for skincare since they have extensive training in skin anatomy and healing processes. Establishing a relationship with a dermatologist or plastic surgeon is also good if you or your family need to consult them in the future for other more serious medical problems. If you are over age 50 and have creases, folds, or sagging skin, you should probably consult at least a couple of plastic surgeons first since they may recommend other procedures which will give greater improvement than resurfacing alone. (If you are considering plastic surgery, you should also do a lot of research about the procedures, risks, and cost involved.)

Once you have identified the ABMS-certified dermatologists and plastic surgeons in your area, you can refine your list. Ask friends and other doctors and dentists you see who they would recommend. Check the doctors' yellow pages ads under "Physicians - Dermatology" and "Physicians - Surgery, Plastic and Reconstructive." See if the ad lists a website you can visit. Use a search engine to do an Internet search on the doctor's name and medical specialty. You may find titles of books or papers he or she has written. You can search the Internet medical index Medline with their last name and initials to see if they have written any medical journal articles. Your county may have a medical society that publishes a brochure listing all the local doctors and their qualifications. Ask the reference librarian at your local library what information they have on selecting doctors. They may have reference publications listing the best doctors in various fields. If you live a in a large city, a local magazine may also have an annual "best doctors" issue. Check with your state medical licensing department to see if the doctors you find have had any disciplinary actions. You can also check with the state or local court clerk if any malpractice lawsuits have been filed against these doctors in your state. (Note that some suits filed against doctors are frivolous, so you can ask to read the court files if there are only one or two cases.) All of this will probably narrow your list down to a few doctors, so you can make appointments for consultations. Be aware that some of the older, prominent doctors on your list are probably going to charge more than younger doctors who have only recently obtained their board certification. These younger doctors may actually be better trained in the latest resurfacing techniques. Obviously, not everyone will do all this work. However, the more research you do in selecting a qualified doctor, the less risk you will be taking.

If you live near the doctor's offices, you can simply stop by before making and appointment and ask the office staff what type of facial resurfacing procedures they do - chemical peels, dermabrasion or laser. See if they have a brochure they can give you or a website you can visit. Depending on the type of reception you get, you can decide whether to make an appointment for a consultation. When you meet the doctors and their medical staffs, it will be easy to tell if you like their personalities. This is important in case there are any complications later. Regardless of personality, you also want to choose a doctor who will explain everything to you personally and is cautious about infection and scarring. The doctor should take time to examine your face carefully for a few minutes and then discuss recommendations and answer your questions. Some doctors will have a nurse or physician-assistant talk to you first to give you basic information about the procedure and take a medical history. If a doctor just has you watch a video and gives you a five-minute sales pitch, you should choose another doctor. Ask how many resurfacing procedures of the type you are considering the doctor has done. Ask if the doctor is willing to do a small test area first to see how your skin responds. (You may have to pay a small charge for the test area to be done, because it requires set-up of the resurfacing equipment.) The doctor should offer to show you some before-and-after pictures of other patients he or she has treated - not just printed sample pictures of someone else's patients in a
pamphlet or book. If a doctor seems insulted when you ask about experience and qualifications, you should choose another doctor.