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Laser resurfacing and rejuvenation
A laser delivers heat to skin cells.

How it works: Nonablative lasers (CoolTouch and Smoothbeam) allow energy to pass through the top layer of skin (epidermis) and heat only the dermis. Over the course of about five treatments, a "wound response" produces new skin cells and some collagen, which smooths fine lines. Skin texture shows the greatest improvement; results for wrinkles are more modest, says Jeffrey Dover, associate professor of dermatology at Yale University School of Medicine. Ablative lasers (CO2 and the erbium:YAG) remove the outer layer of skin and work more intensely within the dermis. "One treatment can truly make older skin look young again," says Dover. Though the procedure treats deep wrinkles and very rough skin texture, many people choose alternatives because of the two-month recovery period. Following treatment, skin becomes very red and hurts, and a surface crust forms.

On the horizon: Fraxel skin treatment is a new category of laser skin rejuvenation that promises the dramatic results of ablative treatments without the serious side effects. The Fraxel laser involves resurfacing only 17 percent of the skin's surface at a time so there's no major redness or scabbing, says Roy Geronemus, MD, director of the Laser & Skin Surgery Center of New York. Instead of delivering a solid beam of light that removes the entire outer layer of skin, the beam is split up and heats microscopic columns of tissue (leaving healthy tissue in between). It basically creates a grid of small wounds on the skin (invisible to the naked eye). After three to five treatments about a week apart, the results are similar to traditional ablative resurfacing. The technique is still in the testing phase;it may be available this year.
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