Laser Resurfacing for Skin Rejuvenation - Quick Reference Sheet
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Laser Resurfacing for Skin Rejuvenation

Created on 09/11/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 5 – Audit

Controlled light injury makes skin rebuild itself. Strongest gains: smoother, less wrinkled skin, improved depressed acne scars, clearance of rough sun-damaged patches. Brown-spot fading is weaker and reverses soonest. Gains hold a year or two, not permanently. In older people, treated sun-damaged skin developed fewer new skin cancers. Costs are mostly pigment change, pain, redness, herpes flare-ups and occasional scarring. (Full Review)

Protocol

Fully ablative resurfacing
Single session, high fluence
Full-field CO₂ or erbium:YAG; 7–14 days of open wound care, months of redness
Ablative fractional resurfacing
1–3 sessions, 4–8 weeks apart
Fractional CO₂ or erbium:YAG; 5–7 days of visible healing. 10–30 mJ per microbeam, 5–20% coverage for facial sun damage
Non-ablative fractional resurfacing
3–6 sessions, 2–4 week intervals
1,550 nm erbium-glass or 1,927 nm thulium; 2–3 days of redness. Thulium 10–15 mJ, 15–40% coverage, 4–6 passes
Time to effect
Wrinkle and texture gains
3 months
Appear as collagen remodels; fractional CO₂ gains stable at 24 months
Final result
6 months
Judged at six months, once collagen remodelling has run its course
Pigment gains
1 month
Least durable; drift back toward baseline within three months without strict photoprotection

Benefits

Contraindications
  • Active herpes simplex outbreak, impetigo or any untreated infection in the field
  • Prior parenteral gold therapy at any point in life
  • Documented keloid tendency, or hypertrophic scarring after previous resurfacing
  • Active scleroderma, dermatomyositis or other connective-tissue disease of the skin
  • Unstable vitiligo or active psoriasis in the field
  • Uncontrolled diabetes (glycated haemoglobin above 8%) or non-healing skin ulceration
  • Prior radiotherapy to the treatment field
  • Pregnancy or breastfeeding
  • Fully ablative treatment in Fitzpatrick phototypes V–VI
  • Lower-eyelid treatment with pre-existing lid laxity, prior eyelid surgery or a positive snap-back test
  • Active smoking within four weeks before and after treatment
  • Sunburn or recent intensive ultraviolet exposure in the field within four weeks
    •
Key Interactions
  • Isotretinoin (prescription retinoid; caution persists for fully ablative treatment)
  • Anticoagulants and antiplatelet drugs (warfarin, apixaban, clopidogrel, low-dose aspirin)
  • Photosensitising prescription drugs (doxycycline, hydrochlorothiazide, amiodarone, voriconazole)
  • Systemic immunosuppressants and corticosteroids (prednisone, tacrolimus, mycophenolate; absolute contraindication at high doses)
  • Over-the-counter analgesics and supplements affecting clotting (ibuprofen, naproxen, aspirin, fish oil, vitamin E, ginkgo, garlic, ginger, high-dose curcumin; stopped 7–10 days before)
  • Over-the-counter topical actives (retinoids, alpha-hydroxy and beta-hydroxy acids, benzoyl peroxide, physical scrubs; stopped 5–7 days before)
  • St John's wort (over-the-counter herbal; stopped at least two weeks before)
  • Supplements with additive effects on the same targets (vitamin C, zinc, collagen peptides, arnica, bromelain)
  • Other interventions (chemical peels, microneedling, radiofrequency, photodynamic therapy, dermal fillers, neuromodulators, facelift; caution when stacked)

Risk & Side Effects

  • High: Post-inflammatory hyperpigmentation; prolonged erythema, edema and crusting; procedural pain; herpes simplex virus reactivation; delayed hypopigmentation; hypertrophic or atrophic scarring
  • Medium: Bacterial and atypical mycobacterial infection; acneiform eruption and milia
  • Low: Contact dermatitis to post-procedure topicals; ectropion and eyelid malposition
  • Speculative: Occupational exposure to laser plume
    •

Monitoring

Marker Target Why
Glycated haemoglobin (HbA1c) 4.8–5.4% High glucose slows surface regrowth and raises infection risk
25-hydroxyvitamin D 40–60 ng/mL (100–150 nmol/L) Supports keratinocyte proliferation and barrier restoration
High-sensitivity C-reactive protein (hs-CRP) Below 0.5 mg/L Baseline inflammation predicts prolonged post-procedure redness
Serum ferritin 50–125 ng/mL (women), 50–150 ng/mL (men) Iron is a cofactor for collagen cross-linking; low stores slow closure
Serum zinc 90–120 µg/dL Zinc deficiency delays wound contraction and cell migration
Serum albumin 4.2–5.0 g/dL Indicates protein availability for new collagen deposition
Haemoglobin 13.5–15.0 g/dL (women), 14.0–16.0 g/dL (men) Low values reduce oxygen delivery to healing tissue
Herpes simplex virus type 1 antibody (HSV-1 IgG) No established target; positive or negative Identifies who carries the latent virus that thermal injury reactivates

Cadence: Wound check at days 3–7, closure confirmation at two weeks, pigment assessment at 4–6 weeks, outcome photography at three and six months. Metabolic markers rechecked only before any subsequent session; actinic keratosis counts every 6–12 months where prevention is the aim.

Qualitative Assessment

  • Day on which crusting separates completely and the surface is closed
  • Duration of visible redness, and whether it is fading or static at four weeks
  • Any focal area that stays red or firm beyond four weeks, the earliest scarring signal
  • Subjective skin texture and make-up application at three and six months
  • Recurrence of herpes simplex, acne or milia in the treated field
  • Self-rated satisfaction against the baseline photographs rather than against memory
Not medical advice. Educational distillation of a single evidence review. Confirm any decision with a qualified clinician, especially in the presence of prescription drugs or chronic conditions.