Looking forward to turning back the clock, Zillah Bugeja opts for the latest CO2 fractional laser skin resurfacing at Estetika. This is the first in a series of three articles that will chronicle her experience every month.

If you’ve seen the TV programme “10 Years Younger”, you can understand my eagerness to experience the rejuvenating promise of laser skin resurfacing. The possibility of eliminating the wrinkles round my lips was something that I thought about every day.

During the first consultation at Estetika with Dr David Grech, the DEKA SmartXide DOT and Fractional Resurfacing treatment was explained in detail and I was under no illusions that this was a minor surgical procedure to be undertaken with full responsibility on my side to carry out the required follow-up care.

The benefits of fractional

laser resurfacing

The main difference between this new fractioned technology and the traditional laser is that it doesn’t take off a whole layer of skin. The fractional laser works in a dot formation, delivers heat in small columns to the epidermis (superficial skin layer) and leaves skin untouched in between where it hits. It leaves a small zone of thermal damage around each wound but also leaves a high percentage of skin untreated, so healing occurs faster from the intact segments of skin. This has the effect of reducing pain and discomfort and significantly reducing recovery time – from traditional laser treatment requiring something like three weeks being stuck indoors and feeling like your face has been ironed with a hot iron, to three days out of the sun with pain that quickly subsides.

Dr Adrian Micallef emphasised that this is a programme of four sequential treatments with progressive improvement throughout. “This is because the technique of fractional resurfacing is less aggressive than traditional resurfacing which is done as a one-time procedure but with very prolonged recovery time as well as an increased risk of infections and pigmentation.

“The fascinating concept behind laser resurfacing is that the skin appearance continues to improve with time beyond the initial superficial smoothing effect, since the stimulation of collagen production will continue to contribute to the more elastic and younger complexion.”

The photographic evidence shows remarkable improvement in deep wrinkles and acne scars, which must be a wonderful feeling for anyone bothered by them. Furrows of deep wrinkles can be reduced and shallower ones eliminated completely. The derma can produce new cells and new collagen, giving skin a smoother, younger appearance. It’s more than the removal of wrinkles, it’s the creation of new skin, without any changes to one’s natural facial expression.

The treatment is spaced out in three to four sessions, with approximately a month in between. Every time, the patient has to avoid the sun completely for three days and I will admit that this was my main preoccupation: would I go crazy indoors?

The treatment begins

I had to start a course of anti-viral tablets because of a tendency towards cold sores on my upper lip and take some pain relief (much as is done before tattooing). Photos were taken for documentation purposes. The procedure was once again explained to me and I signed the consent form. Then an anesthetic cream was applied to my face, which takes around 45 minutes to be absorbed, and I was quite relaxed.

The fractional resurfacing treatment started at around 3.30pm and was carried out from the cheek bone down. Both Dr Grech and Dr Micallef worked on me together, one of whom would apply ice to the skin before and after the laser was applied, to minimize discomfort and swelling. Two areas were worked on in close succession. I counted ‘1, 2, 3, 4’ duration for every zapping, which is quite bearable. After one side of the face was done, they stopped and applied gel and a cooling face mask for a few minutes before proceeding to the next side.

I’ll admit that I wasn’t prepared for the smell of burning skin, which was not that unpleasant, just a shock. The pain during treatment is like hot, sharp needles on the surface, on a scale of 1 to 10, hovering around 5. One’s natural reaction is to move away from pain, most especially on the face, but you have to keep still, so instead I wriggled my toes.

Upon leaving the clinic at 4.30pm, my face only looked slightly pink and mildly puffy. Wearing factor 50 sunblock, the orders were to go straight home and stay out of the sun, applying thermal water, gel and cold packs to the face every hour.

Just like with bad sunburn, the skin was very hot and constant cold packs were a necessary relief. (I used ice in zip lock plastic bags). At around 9pm small drops of blood appeared. By about 10 o’clock the pain had subsided and I had no trouble getting a good night’s sleep.

The following day I couldn’t wait to wash my face, but I had to wait 24 hours to do so with a medicated soap-free bar. My face shape had changed because the swelling gave me a square jaw instead of my characteristic pointy one.

The main thing is that there was no more pain after the first day, only a slight dryness and pulling sensation. I couldn’t help but keep looking in a magnifying mirror, eager to see the changes. Once you have the treatment, you realize that of course there is going to be a small drop of blood where the laser hits the skin, that this blood turns into a tiny blister (that eventually falls off), and the dead skin is going to flake off too. It’s when the skin has the little blisters that it looks the worst, but it soon gets better. At no point was the skin ever lobster red. By Monday the area was around 80% flake-free and was the colour of a normal blushing fit. I was prepared for the redness to last up to ten days and it’s safe to cover up with foundation.

My follow-up regimen consists of using thermal water spray and soap-free cleansing bar to clear up any flaking, and a soothing cream.

I was ready to face the world, wearing SPF50 of course, which I have to keep up for the duration of the treatment. There is already some improvement but there is also still slight swelling so it’s difficult to be sure what’s what.

I will report back in a few weeks’ time, just before my second treatment, when there should already be obvious changes. I can’t wait.