The procedure may be done under either local or general anesthesia, depending on the size of area to be treated. Intraoperatively, the laser is used to vaporize thin layers of skin which are wiped clean. The area is then reevaluated and additional passes are made until rhytids are removed or the endpoint is reached. A semiocclusive dressing or ointment is then applied. Postoperative care requires close follow-up which includes daily patient visits with cleaning of wounds and new dressings as indicated.
Every attempt is made to identify wound healing problems early if they occur.
Once epithelialization has occurred moisturizers protect the new skin and steroid ointments can help diminish inflammation. When skin becomes less sensitive, the patient is restarted on topical retinoids or alpha hydroxy acids and hydroquinone. It should be emphasized that patients use sunscreen to protect the new skin. Complications may include hyperpigmentation, hypopigmentation, delayed healing, and hypertrophic scarring. These complications seem to occur less frequently with laser resurfacing than with peels.