Laser Skin Resurfacing
Laser skin resurfacing uses light-generated heat to remove damaged layers of the epidermis and upper dermis in a controlled way, while triggering the body's natural wound-healing response to rebuild the skin from the ground up. It is considered the gold standard for treating atrophic (depressed) scars, static wrinkles, sun damage and cumulative skin aging.
At Haute-Derma, we don't use one fixed setting for laser resurfacing. Each treatment is tailored to the depth of damage, the patient's skin type and how much downtime they can take. By combining ablative, non-ablative and fractional technologies as needed, we maximize collagen stimulation while keeping the risk of post-inflammatory hyperpigmentation tightly controlled.
Microthermal Treatment Zones - MTZs
Fractional resurfacing works by creating thousands of microscopic columns of thermal injury, called microthermal treatment zones (MTZs), that reach into the dermis while the tissue around each column is left completely untouched.
- Rapid healing: keratinocytes and fibroblasts from the surrounding healthy tissue migrate quickly into each MTZ and close it within 24–48 hours.
- Collagen remodeling (neocollagenesis): the laser's heat breaks down old, fragmented and denatured collagen fibers and prompts fibroblasts to produce new type I and type III collagen and new elastin fibers over the following 3–6 months.
- Clearing pigment debris (MENDs): as the skin flakes, the microscopic columns push keratinocyte debris and melanin out of the skin as microscopic epidermal necrotic debris.
Comparing Laser Resurfacing Technologies
| Laser Technology | Degree of Ablation | Main Indications |
|---|---|---|
| Fractional CO2 laser, 10,600 nm | Strong fractional ablation | Severe atrophic scars (boxcar, rolling), deep wrinkles, advanced aging |
| Fractional Er:YAG laser, 2,940 nm | Light fractional ablation | Surface rejuvenation, shallow scars, enlarged pores |
| Fractional Er:Glass laser, 1550 nm / 1540 nm | Non-ablative | Recent acne scars, pore refinement, mild to moderate rejuvenation |
| Fractional thulium laser, 1927 nm | Light epidermal ablation | Hyperpigmentation, sun damage, brightening |
Clinical Protocol and Safety Measures at Haute-Derma
- Pre-Treatment Skin Preparation
- For 2–4 weeks before ablative or deep fractional laser, patients must use melanin-inhibiting ingredients (tranexamic acid, niacinamide, arbutin) and moisturizers that strengthen the skin's lipid barrier, to lower the rate of post-inflammatory hyperpigmentation (PIH) in Asian skin (Fitzpatrick IV–V).
- Combination Therapy
- For complex atrophic scars, Haute-Derma combines subcision, TCA CROSS and platelet-rich plasma (PRP) or exosomes applied immediately after fractional laser to fill the scars as much as possible.
- Post-Treatment Care
- We follow the principle of moist wound healing, using products with ceramides, hyaluronic acid and epidermal growth factor (EGF), plus a broad-spectrum mineral sunscreen as soon as the epidermis has closed.
Common Complications and How We Manage Them
- Prolonged erythema: occurs with high energy settings or fully ablative lasers. It is managed with red LED light (633 nm) and creams containing panthenol or madecassoside, or with long-pulsed Nd:YAG laser or IPL if the redness lasts longer than 4 weeks.
- Post-inflammatory hyperpigmentation (PIH): very common in darker skin. The approach is to calmly control inflammation, stop irritating products, and apply hydroquinone 2–4% or tranexamic acid, combined with low-power picosecond laser from week 4 onward.
- Secondary infection (HSV or bacterial): patients with a history of cold sores around the mouth must take prophylactic acyclovir or valacyclovir starting 1 day before the procedure and continuing for 5 days afterward.
