Advanced Laser Resurfacing

Dr Halfhide has used ablative lasers like Carbon Dioxide and Erbium YAG since 2016. These target mainly the top layers of skin (epidermis) but also affect the lower layers of skin (dermis). They remove the upper layers of skin in a very precisely controlled manner.

Acne Scarring - Advanced Laser Resurfacing

Overview

Over the last 30-40 years, there have been major advances in lasers: it is now possible to significantly reduce acne and other facial scars, to remove blemishes, lumps and bumps (e.g. moles, *see separate section on mole removal), frequently with minimal disruption and minimal downtime.

The results of non-ablative laser resurfacing like Fraxel Dual are not as impressive as ablative laser resurfacing in scarring nor can they remove lumps and bumps, but the excellent safety profile and rapid recovery post-treatment have made non-ablative lasers like the Fraxel Dual popular. Dr Halfhide has been using Fraxel Dual Laser regularly since 2006, and continues to be impressed with the device and and its effectiveness particularly in rejuvenation (*see separate section on rejuvenation).

Frequently asked questions

Which laser is best for me?

This is best determined in a consultation with the doctor: a) for full assessment of the individual’s concerns and b) to discuss the desired outcomes, as well as pros and cons of each laser.

Those with deeper scars pictured below, or with facial wrinkles and sun-damaged skin, lumps or bumps, would get best results with ablative lasers. Acne scars and facial scars from surgery or trauma may be reduced but very deep scars cannot be completely removed. Many benign unwanted moles or skin growths and scaly patches on the face and elsewhere can be easily removed (see separate section on moles and blemishses).

Those with milder scarring as below, and darker skin types, will be better suited to non-ablative lasers (darker skin types are more at risk of pigmentary change with ablative lasers). Sun block for several months after treatment is important. Also the shorter recovery time of Fraxel Dual of 0-3 days appeals to some though it must be appreciated that non-ablative lasers are not as effective as ablative ones.

Is Pain relief necessary?

Yes it is: for non-ablative Fraxel anaesthetic gel is applied for 1 hour before the procedure; for ablative lasers injection anaesthetic is typically used in addition. One of the attractions of the non-ablative Fraxel Dual is the short down time of 0-3 days though it must be remembered it does not provide as good results as the ablative lasers.

Do I have to take time off work?

Ablative lasers have a down time of 7-10 days; after all crusting of skin has subsided there is often some residual redness (healing with new collagen formation) which can be covered with ordinary over the counter make up. In the initial 7-10 days there will be swelling, redness, exudation and crusting of the treated area. An occlusive healing ointment is important in the initial 7-10 days, it will improve growth of new skin. Dr Halfhide typically treats patients on a Wednesday or a Thursday, patients then take the next day (Friday) off work as well as the following week. Sunscreens are very important in the first months after resurfacing to prevent natural uv light from slowing production of new skin and collagen.

For non-ablative lasers like Fraxel Dual the down time is anything from 0-3 days only. When Dr Halfhide underwent this procedure himself he worked from home the next day, a Friday. He was sufficiently relaxed that for session number 2 (3 sessions is typical) he did not schedule any time off at all. At work the day after session 2, only one of his long standing NHS colleagues seemed to notice anything and said, knowing how careful he is with sun avoidance, ‘Naughty boy, you got sunburnt yesterday’.

How much improvement will I see?

Carbon Dioxide and Erbium YAG ablative lasers give the best achievable results and are rightly considered around the world as the gold standard against which all other acne scarring techniques are judged. Although non-ablative Fraxel Dual does not provide as impressive results its low risk and rapid recovery make it an attractive option for some.

Rejuvenation - Advanced Laser Resurfacing

Overview

Non-ablative lasers like Fraxel Dual have been used by Dr Halfhide since 2006. Fraxel Dual is capable of targeting the epidermis alone, the dermis alone, or both. Non-ablative lasers provide excellent results in sun damaged skin by reducing mottled pigmentation like sun spots and increasing collagen with tightening, thereby producing a more youthful appearance.

Frequently asked questions

What does non-ablative mean?

Ablative lasers remove a proportion of the top layer of the skin (epidermis). Non-ablative lasers do not; tiny pixels of laser light penetrate the skin without removing a layer entirely. The excellent safety profile and rapid recovery post-treatment have made non-ablative lasers very popular.

With ablative lasers (like Carbon dioxide or Erbium YAG) all wrinkles are reduced, but those caused by the sun, especially those around the eyes and lips respond best. It is never too late - or too early - to treat wrinkles once they are established.

Will I need anaesthetic injection?

For non-ablative laser no injection is required, topical anaesthetic gel is used and applied one hour before the start of the procedure. Injection anaesthetic is required for ablative lasers.

Which is best, face lift or laser?

They are not interchangeable treatments and they meet different objectives. A face lift attends to more advanced sagging of aging skin. Lasers do provide a general ‘lift’ to the face, but not as much lift as a plastic surgical facelift. Unlike plastic surgery, however, lasers are better at reducing wrinkles around the lips and around the eyes, and lasers stimulate new collagen formation giving a younger healthier looking tone and lustre to the skin. As lasers and facelifts result in different outcomes, sometimes both procedures are necessary to achieve the optimal results. Dr Halfhide is not a Plastic Surgeon but he will be pleased to guide patients in a straightforward way, providing a clear pathway forward in a consultation, and explaining the relative benefits of plastic surgery versus lasers in each individual case.

Do I need to take time off work?

For non-ablative lasers like Fraxel Dual the down time is anything from 0-3 days only. When Dr Halfhide underwent this procedure himself he worked from home the next day, a Friday, and noted only a little redness. He was sufficiently relaxed after his first session that for session number 2 (3 sessions is typical) he did not schedule any time off at all. At work the day after session 2, only one of his long standing NHS colleagues seemed to notice anything and said, knowing how careful he is with sun avoidance, ‘Naughty boy, you got sunburnt yesterday’. That was it, no one else commented that day.

Sun protection

This is very important after the procedure and Dr Halfhide will talk to you about it during the consultation.