A. You should look into fractional CO2. This is an excellent option for scar improvement. The area will need to be covered for a week, and ointments used to speed healing, but otherwise, normal activities can be continued. You might want to also consider getting a full face treatment. Fractional CO2 will ablate the sun damaged skin and actually reduce your risk for future skin cancers. Be sure to use sunscreen everyday!
Q. I am considering dermabrasion. I have also heard of CO2 resurfacing. Are they similar in results?
A. Well, there are varying opinions regarding this question. I feel qualified to give you my opinion since I have performed dermabrasion since 1983 and CO2 resurfacing since 1995. I would say both are effective tools to improve skin quality and appearance, especially for scars, and each has relative strengths and weaknesses compared to the other. Patients with colored skin should try dermabrasion. It will never lighten your skin. Temporary darkening is the greatest risk, but this can be reversed. CO2, on the other hand, has about a 20% incidence of permanent skin lightening. This risk is decreased with fractional CO2 resurfacing, but it still is possible. Dermabrasion, however, is not as good to tighten the skin. I think the heat component causes more tissue contraction with the laser. Dermabrasion is also very bloody and now more difficult to perform since refrigerant anesthetics (used to diminish neural sensitivity to pain by hardening the skin surface to near-freezing temperature) are hard if not impossible to find anymore. Remember, the greatest risk after the procedure is infection, so anti-viral therapy is required and good hygiene and hand washing before dressing change is absolutely necessary. Both have downtime of about one week and redness that can persist (but can be covered with make-up) for several weeks after healing.
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