Laser Resurfacing for Smile Lines at the Eyes
Laser resurfacing is one of several options for the lines at the outer corners of the eyes, and the aftercare it asks for is substantial. That makes it a treatment worth judging by its finish: what the skin should look like, how long it takes to get there and what the care in between involves.
The procedure is easiest to follow step by step: what the laser does, the two common laser types, who is usually a poor match, how long a session runs and what healing asks of the patient. Each step is a point to raise at a consultation, and the consultation still decides the plan.
What the laser takes off the skin
The American Society for Dermatologic Surgery describes ablative laser resurfacing as a procedure that uses a wand-like laser instrument to remove the upper layers of skin from crow's feet, a procedure sometimes called laser peeling because it removes old skin cells to reveal newer, more youthful cells.
The surface is only half the story. The American Society of Plastic Surgeons explains that the laser beam removes the outer layer of skin, called the epidermis, while it simultaneously heats the underlying skin, called the dermis, which stimulates the growth of new collagen fibers, and that as the treated area heals, the new skin that forms is smoother and firmer. The American Society for Dermatologic Surgery makes the same point for the eye area, saying that ablative laser resurfacing heats the skin layers underneath to promote collagen production, which stimulates the skin in the treatment area to heal in a smoother, more even appearance.
For a reader judging results, that means the finished result is not what the skin looks like right after treatment. It is what the skin looks like once it has healed, and the sections below set out how long that takes. A general page on laser skin resurfacing describes the procedure in broader terms.
Two lasers, two sets of trade-offs
The American Society for Dermatologic Surgery names carbon dioxide (CO2) lasers, which are used to treat wrinkles, scars, warts and other conditions, and erbium lasers, which are used to remove superficial and moderately deep lines and wrinkles on the face, hands, neck and chest, as the two most common types of resurfacing lasers. It adds that erbium lasers cause fewer side effects than CO2 lasers.
Which laser is used is a fair question for any consultation. A provider should be able to say which type they recommend for the eye area, why they chose it and what the trade-off is in side effects.
It helps to put the same questions to every provider you consult: the laser type, the area to be treated, the healing plan and the expected timeline for redness. The wording of the answers matters less than whether they are specific. Specific answers can be compared across providers, and vague ones cannot.
Who is usually not a good candidate
The American Society for Dermatologic Surgery says that patients who have active acne or very dark skin usually are not good candidates for laser resurfacing.
A thorough consultation covers both points before any date is set. If skin tone or active breakouts never come up, ask about them directly. Beyond those two points, bring your own history to the consultation, including anything the provider has not asked about, and let them say whether it changes the plan. The society's description of crow's feet also helps frame which lines are being treated and which treatments suit them.
How long the session takes
Cleveland Clinic notes that wrinkles around the eyes, mouth or forehead may be treated individually or as part of a full-face laser resurfacing, and that a partial-face treatment takes 30 to 45 minutes while a full-face treatment takes one-and-a-half to two hours.
The choice between treating the eye area alone and treating the whole face changes the length of the visit and the area that has to heal. It is worth asking which of the two is being proposed and why.
The healing checklist
After treatment, the American Society for Dermatologic Surgery says the dermatologist will bandage the treatment area, and patients will be required to clean it after the first 24 hours and then four to five times a day thereafter.
The American Society for Dermatologic Surgery also states that healing typically takes 10 to 21 days, depending on the size and location of the procedure.
For the months after that, the American Society for Dermatologic Surgery advises using only oil-free makeup for at least two to three months and avoiding sun exposure while applying an appropriate sunscreen to the area, which will have a lighter appearance following resurfacing.
Treat these points as a test of the provider's instructions. Written aftercare should cover the bandage, the cleaning schedule, the makeup rule and sun protection. If any of those four items is missing, ask about it.
How long the redness stays
Cleveland Clinic reports that the redness in laser-treated sites generally fades in two to three months but may take as long as six months to disappear, and that it generally persists longer in blondes and redheads.
That timeline matters for planning. A reader with an event on the calendar should compare it with the healing window and the redness window before booking, and should ask the provider what the skin is likely to look like at the date that matters. A clinical overview of crow's feet, treatment and prevention is a reasonable companion read when weighing laser resurfacing against other options.
Judging the healed skin
A well-done resurfacing leaves skin that looks smoother and more even once it has healed, after a recovery that followed written instructions. Before agreeing to it, get clear answers on which laser will be used, whether the eye area alone or the whole face is being treated, whether acne or skin tone is a concern, what the aftercare schedule is and when the redness is expected to clear.
If those answers are vague, or if the plan does not leave room for the full healing window, the plan has a gap. Ask the provider which other treatments suit the same lines, and compare the healing demands of each side by side.