Laser skin resurfacing

A unique service in the Border region.

Dedicated skin laser unit

A dedicated laser skin unit was established at East London Private Hospital in 1999, with a modern theatre where plastic and reconstructive surgeons perform laser skin resurfacing, and an overnight ward for the post-treatment care of these patients. Please click here for more details on East London Private Hospital. East London Private Hospital is a member of Life Healthcare, a group that is widely respected for its commitment to quality, cost-effective healthcare. The hospital's management and staff regard their patients' well being as of the utmost importance, and the quality of their care has earned the hospital a proud reputation for consistently high service standards.

Latest technology for skin rejuvenation

Until recently the plastic surgeon's knife was the only option open to persons suffering from certain skin conditions, or those wishing to minimise the ravages of time. However, modern technology - in the form of medical laser equipment - has made it possible for specialists to treat these skin conditions effectively in a safer and more affordable way.

The super-pulsed CO2 laser treatment is used for skin resurfacing - removing the top layers of the skin in a precise computer-controlled technique enables rejuvenated new skin to develop. Because CO2 laser treatment stimulates the formation of collagen and enhances elasticity of the new skin, it is especially effective in the treatment of deeper-rooted skin conditions such as acne scarring and deep lines and wrinkles (e.g. around the mouth area and on the forehead).

Laser skin resurfacing is used for the treatment of the following conditions:

• Aging skin with wrinkles of the mouth, forehead, cheeks and chin.
• Acne scarring and pitting.
• Solar keratoses, i.e. sun-induced rough areas and pigmented patches (lentigos).
• Seborrhoeic keratoses, skin cancers and other small skin lesions.
• Some types of scars.
• Warts, and more particularly resistant plantar warts on the soles of the feet.

Skin laser technology has been refined considerably since its introduction into South Africa in 1995. Dependent on their basic skin type and individual history of skin care, patients can expect an average 60% improvement in skin texture.

Pre-operative treatment

It is essential that the skin be treated for one to two weeks prior to the laser skin resurfacing procedure. Following your preliminary consultation with one of the plastic surgeons, you will be advised on a treatment regime, which will probably require the use of a prescribed skin preparation. In certain cases, medication may be required as well - especially in those with a history of acne or herpes zoster (fever blisters). The specialist should be informed of existing medical conditions so that the necessary treatment can be given to prevent possible flair-ups of these problems after the procedure.

The Procedure

The procedure is carried out in theatre at East London Private Hospital. It usually takes between fifteen minutes and two hours to resurface the skin by means of the CO2 laser, depending on the severity of the condition and the size of the area to be treated. For the treatment of smaller areas, a local anaesthetic is injected to ensure that patients do not experience pain during the procedure. If a large area has to be treated, intravenous sedation is used to make the procedure as comfortable as possible. In some cases a general anaesthetic is administered. The type of sedation used is discussed with the patient beforehand. Patients with a history of allergy for local anaesthetic, adrenalin or general anaesthetic should inform the specialist beforehand.

CO2 laser beams can harm the eyes if they are not protected, and the patient's eyes are therefore shielded during the procedure.

Post-operative Care

Patients may remain in hospital overnight and are usually discharged the following day. After the procedure, the skin will be red and weeping and this condition can persist for five to seven days. It is important for patients to drink a lot of fluids to replace the fluid lost through the skin during this time.

In addition, the skin may feel tight and swollen, especially during the first 48 hours and the patient may experience a degree of burning pain or discomfort particularly in the first few days. In such cases an analgesic will be prescribed to relieve pain.

To ease the swelling, it is recommended that, if possible, patients sleep with the top end of the bed elevated for the first week, or alternatively to use three to four pillows to elevate the head. The skin usually heals within seven to ten days, during which time exposure of the skin to the sun should be totally avoided.

Patients need to make an appointment for the first post-operative consultation with the specialist. This consultation should be arranged for two days after discharge from the hospital. The specialist will discuss further follow-up visits at that time. However it is important that a patient contact the specialist immediately if any problems are experienced.

Skin treatment - 48 hours

It is important that patients wash their hands with an antiseptic soap or solution (e.g. Savlon or Gill soap) before touching the treated skin. The face or area treated should be cleaned at least three times daily, or more frequently if necessary - if this increases comfort. This is done by gently wiping the skin with cotton wool that has been soaked in lukewarm water, where after Diprogenta cream should be applied. If the skin feels dry or starts flaking, Vaseline should be applied before the Diprogenta cream. Take care not to apply the cream too close to the eyes. The actual methods of treatment of the lasered areas may have to be reassessed as you go - some methods work better for some people than others. Your surgeon will always be available to discuss your particular post-operative management and will make recommendations according to your specific needs.

Skin treatment - third day onwards

Patients should continue with the skin care routine mentioned above, unless the specialist gives new instructions. It may become more beneficial to use additional Vaseline to alleviate any discomfort. Once the skin is healed (from seven to ten days), patients should start using a good quality moisturiser. A cosmetic base, such as Clinique's green base can be used from this time onwards - serving to disguise the redness of the area treated.

After the initial healing period, the skin is still very sun-sensitive and prone to sunburn. It is therefore very important to protect the skin from the sun by using a sun block cream with a protection factor of at least a factor 15.

After approximately two to three weeks an alphahydroxy acid treatment regime should be used as this will further stimulate the skin to recover. A good product to use is available from your surgeon.

The post-operative skin care programme should be maintained for some six weeks following the procedure.

Possible long-term complications

• Redness of the skin can persist from four weeks up to twelve weeks, and sometimes even longer. Once the skin is healed after seven to ten days, Clinique's green base can be used to disguise the redness of the skin.
• Milia, or 'white heads' as they are commonly known, can form on the skin. Using a "Buf-puff" to break the surface can treat this.
• Patients who are prone to acne could experience an acne flair-up, especially if no treatment was given prior to the procedure to prevent this from happening.
• Pigmentation changes in the skin can occur.
• Patients with a history of herpes zoster - i.e. 'fever blisters' - can experience a flair-up, but this can be prevented with pre-operative treatment.