Laser Your Way to Younger Looks

Photorejuvenation zaps blemishes, but it's pricey

While Botox injections have drawn media buzz, it's not the only new cosmetic procedure billed as a relatively painless way to get younger-looking skin.

A growing number of dermatologists and plastic surgeons offer a laser treatment, called photorejuvenation, that can remove the ravages of sun and age, from wrinkles to sun blotches and burst capillaries. Like Botox injections, the procedure is quick, requires minimal recovery time, and leaves the patient looking younger--but not in the dramatic fashion of a face-lift. Another similarity to Botox: The effects aren't permanent, and doctors can't say how long before they wear off, because the therapy is just 18 months old. That brings up another caveat: Many doctors don't have much experience with the technique.

Photorejuvenation involves the application of light to the skin at wavelengths of 500 nanometers to 1,450 nm. The beam goes through the skin's top layer to the dermis, where the energy destroys melanin, which causes pigmentation, and hemoglobin, which gives broken blood vessels their red color. It also stimulates the production of collagen, the protein that makes skin supple. Older therapies used light with wavelengths of around 10,000 nm to essentially burn off the top skin layer to promote new skin growth. That left your face raw and peeling for weeks.

Photorejuvenation technology evolved from the use of lasers to eliminate broken blood vessels. Doctors noticed the skin in the treated areas became smoother. New devices have cut treatment time, and they now have cooling mechanisms to keep the skin from getting too hot. This has made the treatment safer. The procedure takes only 20 minutes, which is why Dr. David Goldberg, director of Skin Laser & Surgery Specialists, with offices in New York and New Jersey, calls the procedure "the lunchtime laser."

For the best results, though, you'll have to give up a few lunch hours--and a lot of lunch money. Experts recommend five sessions timed about three weeks apart. "This is not a one-shot deal," says Dr. Richard Glogau, clinical professor of dermatology at the University of California in San Francisco. Since each session costs $600 to $1,000 and isn't covered by insurance, you can be out $5,000 before you get dewy-looking skin.

Although most patients start to see results after their third visit, Cozette Hupkovich says she saw improvement right after the first of her five procedures. Hupkovich, a 54-year-old office manager in Johnstown, Pa., tried the treatment last year to get rid of freckles and brown patches. "Within four days, some of my freckles started sloughing off," she says. As for side effects, she had mild swelling around her eyes and felt as though she had a sunburn for a day or so.

Doctors don't yet know how long the effects will last, but patients say the benefits have held several months after treatment. While Hupkovich still has freckles, "they're lighter now, and my skin has a smoother feel," she says.

When looking for a practitioner, you'll want to find a dermatologist or plastic surgeon experienced in the procedure. Ask for references as well as "before" and "after" photos of other patients. You should also inquire about the device the doctor intends to use for your condition. Devices emitting light with wavelengths in the 500-nm-to-600-nm range are effective for freckles and spider veins, while those using wavelengths in the 1,320-nm-to-1,450-nm range are better for fine wrinkles. Higher wavelengths are said to go more deeply into the skin to stimulate collagen production. Dr. Robert Weiss, assistant professor of dermatology at Johns Hopkins University Medical School, says he often uses two or three types of lasers in combination.

Be aware, too, that doctors are divided about the suitability of the therapy for those with dark skin, because lasers destroy pigmentation. While practitioners say the therapy is safe if you have a tendency to develop precancerous growths, it's not a good idea if you have a history of herpes or cold sores, because light activates the virus. Finally, don't expect laser therapy to give you brand-new skin. Photorejuvenation can turn back the clock a bit, but won't stop it.

By Kate Murphy

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