26 January 2015
Non-Surgical Facial Rejuvenation – Carbon Dioxide Laser Resurfacing
Long-term sun-exposure, both from work and leisure, is a hazard of life in Australia.
Solar (sun) damage affects both the epidermis (the very thin superficial layer) and the dermis (the thicker, deeper layer) of skin.
Solar damage to the epidermis results in scaly, dry skin, with red and brown blotches all over.
The base of the epidermis is called the basement membrane and is made up of mainly basal cells which are the template cells for formation of new skin cells. Though these cells are replaced every 30 days, the template cells, once damaged, can only produce new cells with the existing damage in them.
Solar damage to the dermis results in thinning of this layer, including the collagen and elastin in the dermis, which give form and tone to the skin.
Solar damage to facial skin is compounded by aging changes, causing facial skin to be droopy, thin and lined.
The reversal of solar damage and aging of facial skin
This requires repair or replacement of the basal cells of the epidermal basement membrane to rejuvenate the epidermis, and production of new collagen and elastin in the dermis to restore the tone of the dermis.
Repair (Healing) is the easier of the two and lasers and intense pulsed light (which has a similar action to Laser) have the ability to convert light into heat, which has a healing effect on the damaged template cells
Replacement (regeneration) of the epidermis and new collagen formation in the dermis is obviously the better outcome and the carbon dioxide laser is the laser of choice for this.
The Carbon Dioxide (CO2 ) Laser – how does it work its magic?
“ Scarless Surgery” has been the holy grail in the use of lasers. For many years, while various lasers had been developed, there were many problems caused by the heat generated, resulting in burn injuries.
The carbon dioxide laser causes its desirable effects by ” PhotoThermolysis” (photo= light / thermo= heat / lysis= destruction),ie., the CO2 produces light, which becomes heat, which then destroys the target cells (the basal cell of the epidermis), which is then replaced from basal cells stored in the dermis (please see technical note at the end).
The CO2 laser also stimulates the dermis to produce new collagen and elastin, thus improving both the epidermis and dermis – the effects are dramatic when seen!
( Technical note for those need to know !)
1 The epidermis is a very thin layer draped over the dermis and gains traction and adhesion to the dermis with spike like projections into the dermis, and it is these basal cells that migrate to the surface after epidermal damage caused by the CO2 laser.
2 the carbon dioxide laser produces its effect by damaging spots of epidermis and leaving normal epidermis between these damaged or burnt spots. Usually heat spreads like ripples in a pool and the spots of heat coalese and cause burn injury. The beauty of the modern carbon dioxide laser is the ultrashort dwell time ( laser – skin contact time), and the rapid thermal relaxation time (very short heat diffusion time), which prevent burn injuries.
3 A further improvement is the development of software, permitting fractional CO2 laser treatment. In fractional treatment, less skin is damaged and treatment is therefore appropriate for younger people with less damaged skin.
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