But hold on. Sure, lasers are the newest cosmetic kids on the block–newer than face-lifts, dermabrasion (smoothing with a sandpaperlike wheel), collagen injections and the several types of chemical peels, including the currently popular “light” ones done with alpha-hydroxy acid. (Deeper chemical peels are done with trichloracetic acid–TCA – or phenol, another acid.) Yet when it comes to applying what one patient described as “a fiery pencil point” and another compared to “the snap of a rubber band” to the only face you’ve got, newness isn’t necessarily nifty. More than 30,000 laser peels have been performed since 1992. But “it is still an evolving technology,” says Dr. Jack Kerth, chief of facial plastic surgery at Northwestern University Medical School. “I think it’s a little early to say that it’s the ultimate.” In fact laser peels may even pose potential hazards.
Dermatologists began using lasers to remove port-wine stains in the 1970s, but about three years ago a new generation of equipment came along. Using short bursts of invisible, high-energy light, these lasers annihilate wrinkles and lines, brown “age spots” and under-eye circles. For some patients, the laser has lived up to its promise. Olga Goerg, a retired but vigorous woman in her 70s from Orlando, Fla., wanted to look as young as she feels. She had the procedure on the vertical lines above her upper lip, and now, she says, her lipstick no longer “sneaks into the crevices.” In an experiment, she also got a laser peel on the right half of her forehead and a chemical peel with TCA on the left half, to see which worked better. The laser won, by a long shot. “I can’t wait to get it all done,” says Goerg. “I think when I get through I’ll look 50.” Contrary to some of the enthusiasts’ claims, Goerg says the healing process was painful and messy, with cold sores around her mouth that lasted several weeks. But she’s still pleased. “What price beauty?” she asks. “What do you expect?”
Some physicians are equally enthusiastic. “This is a much more precise method of rejuvenating the skin,” says dermatologist Dr. Laurence David of Hermosa Beach, Calif., president of the International Society of Cosmetic Laser Surgeons. “It’s so much more accurate, so much more predictable and much safer [than other peels].”
But most professional medical organizations urge caution. In its position paper on the subject, The American Society for Aesthetic Plastic Surgery warns that laser equipment could cause a fire or slip and damage the internal structures of the eye. Here’s a scary fact: any physician–even a psychiatrist–can legally buy the equipment and use it on patients. (But most purchasers, of course, are dermatologists and plastic surgeons.) Training courses can be as short as a three-day weekend, so anyone considering a laser peel should cheek out a doctor’s experience, and talk to other patients who’ve had the procedure. An inexperienced practitioner might zap too deep and cause tissue damage, says Dr. Craig Bradley, who has performed plastic surgery for 25 years. “Every pass of the laser is another layer of cellular injury,” he warns. And according to Dr. Daniel Man of Boca Raton, Fla., chemical peels give the skin a smoother, more uniform texture than laser peels do. “If you want to get your car washed, it’s not enough to have a sprinkle of water here and there,” he says. “You need a good rain to cover the entire car.”
If patients are careless during recovery, scarring could re-suit. Dr. Richard Gregory, director of the Cosmetic laser Center in Orlando, Fla., stresses that they must keep the skin moist with antibiotic ointment for the first few days, and then with petroleum jelly applied five times a day. And as with chemical peels, patients should scrupulously avoid the sun for several months–and always wear a sunscreen thereafter.
Another bummer: laser technology is expensive. For a full-face laser peel, lasting 30 to 60 minutes, patients pay $2,000 to $6,000–about twice as much as for a TCA peel. For just the eye or mouth area, the fee is $1,000 to $2,500. And health insurance almost never covers cosmetic skin peels. Because the current technology is only three years old, there are no long-term sci-entitle studies showing safety and efficacy. But for many folks who see the sun’s kisses turning into wrinkles, the high-tech lure of laser zapping is just too tempting to resist.
