Our skin undergoes changes with the aging process and loses its healthy, young and aesthetic appearance. Aging is not a factor alone; external factors such as sun, accidents and injuries, and skin diseases such as acne and smallpox can also damage the appearance of the skin.
Conditions that occur due to both aging and skin diseases. Medical procedures performed to treat (correct) can be grouped under the heading of skin renewal and skin rejuvenation. For medical skin rejuvenation, chemical peelings, botulinum toxin applications, PRP (platelet-rich plasma), mesotherapy, and face suspension methods with threads are used.
For skin rejuvenation, patients at advanced ages or serious (stage 4) are used. -5) Surgical procedures such as face and neck lifting are performed in those with sagging.
Laser methods have become more preferred in recent years with their effectiveness in skin renewal and rejuvenation, clinical success and safe application conditions.
For this purpose, CO2 (carbon dioxide) lasers were used for the first time in the 1980s and are still the gold standard of skin rejuvenation today.
Over time, other laser systems began to be developed along with the CO2 laser and are used effectively today.
Laser systems used for skin resurfacing are ablative lasers according to their ability to cause damage to skin integrity (ablation). and non-ablative lasers.
1. Non-ablative lasers (those that do not cause skin damage or peeling); Alexandrite Laser, PDL, IPL and Nd:YAG laser.
2. Ablative lasers (those that cause skin damage and peeling) are Erbium and CO2 lasers.
1-Ablative lasers:
Ablative Skin resurfacing lasers are lasers that provide controlled tissue damage by eliminating the entire epidermis (upper layer of skin) and part of the dermis (lower layer of skin) at the desired depth of the skin with laser-heat damage. These lasers create an increase in temperature around the tissues removed, and this heat is transmitted to the surrounding tissues, ensuring the reproduction and restructuring of collagen. Thus, with the renewal of the skin and the increase in support tissues in the deep tissues, the skin becomes younger, fuller and more vibrant. An appearance is achieved.
With these features, ablative lasers are used especially on aged skin with sun damage.
These lasers;
Spots and color changes on the skin surface,
Wrinkles,
Vascular structure increases,
Sun-induced skin tumors,
In areas where other skin renewal methods are not very successful, such as around the eyes and mouth. skin resurfacing,
It is used in the treatment of acne, trauma and bad scars after surgery.
On the other hand, ablative lasers are used in some skin diseases. It can also be used like a knife. For example, they can be used for this purpose in rosacea (rosacea), rhinophyma (nose growth), xanthelasma (yellow spot on the eyelids), warts and skin tumors.
Is the skin color of people who will have ablative laser important? ?
Ablative lasers are not preferred for people with very dark skin.
Where can ablative lasers be applied?
Face, neck, décolleté and back of hands are among the most common application areas.
Can anyone have ablative laser?
After ablative lasers, the skin regeneration process begins in the skin appendages such as hair and fat cells. Patients should not have problems with skin patches. For example, for these reasons, they are not preferred in patients with scleroderma and radiotherapy. One year must pass after the use of drugs such as isotretin (roaccutane, zoretanin, aknetrent) used in the treatment of acne.
Extra caution in patients with structural keloids (hard and swollen healing of damaged tissue from the skin).
Is there pain during the procedure?
The application is performed under local anesthesia, regional anesthesia or general anesthesia in suitable patients.
What should be taken into consideration before and after the procedure?
Preventive antiviral, antimicrobial and antifungal treatments can be started before the application. Retinoids, especially tretionins (vitamin derivative drugs), can be used on the skin due to their effect during the post-laser healing process. After the procedure a few It is necessary to be well protected from the sun with creams with a high protection factor for a period of months.
After the laser, edema will develop at the application site and there will be fluid discharge from the tissues. For this reason, proper care and dressing of the application site is extremely important.
After the application, redness-erythema may remain for a few months. It is important to be protected from all kinds of light sources to prevent this redness from turning into a blemish.
Fractional definition has started to be used in ablative laser applications since 2004. This definition means that the laser causes ablation (i.e. tissue damage) of certain parts of the skin while the areas in between remain intact (like a sieve). The aim here is to shorten the long recovery time and reduce side effects by reducing the damage to the entire tissue in ablative lasers.
2-Non-ablative lasers:
Traditional (ablative) or fractional lasers are still the gold standard in skin rejuvenation and face lift applications today, but new skin rejuvenation systems are being developed because these methods have long recovery times after application and restrict the patient's social life. When using new laser systems, patient compliance is higher (more comfortable) and the recovery period after application is almost non-existent. These new systems are defined as "Non-ablative skin rejuvenation". During the application, the epidermis, which is the superficial layer of the skin, is protected, and the skin is restructured (collagen production) by providing high heat (with photothermal effect) in the dermis, which is the deep tissues of the skin, without causing minimal (little) or no damage to the epidermis. It aims to trigger the production of new collagen, elastin and intermediate support products and to increase the volume of the dermis with the photothermal effect. Thus, the skin is rejuvenated.
What are other skin rejuvenation methods?
Chemical peelings for skin rejuvenation and skin renewal, dermabrasion, dermaroller (micro-needling), botulium toxin (botox), fillers (hyaluronic acid and others), face lift-rejuvenation with PRP (platelet-rich plasma) threads, There are many methods such as carbon peeling.
What are the differences between CO2 laser and Nd-Yag lasers?
The main factor determining the superiority of carbon dioxide (CO2) laser is wavelength. Other lasers have shorter wavelengths and their effectiveness is limited to remaining on the surface of the skin, and they require repeated sessions for a good result. CO2 laser has a wavelength of 10,650 nm and its results are more effective because it reaches the middle layer of the skin - the dermis. With CO2 lasers, the depth affected by the application on the skin is not determined based on eye judgment or experience, as in chemical peeling or dermabrasion, the desired depth with the laser is known precisely. The introduction of fractional mode in CO 2 lasers in the last 5 years has brought this laser to higher levels. It has become the gold standard that can be used today in skin tightening, renewal and rejuvenation.
The main factor determining the superiority of the Nd: YAG laser is again is the wavelength. Nd YAG laser has a wavelength of 1060 nm. With this wavelength, it reaches the deeper layers of the skin in a way that protects the epidermis (it is defined as nonablative because it does not damage or peel the epidermis). It provides restructuring in the dermis, that is, rejuvenation of the skin. It is an extremely safe method for skin rejuvenation, renewal and skin tightening that can be applied to any skin type and any desired area of the body, including the face. Its advantage over CO2 lasers is that it is not noticeable from the outside as it does not damage the upper layers of the skin, and its disadvantage is the need for repeated sessions.
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