All cosmetic treatments come with some degree of risk, whether it’s the risk of an allergic reaction to a cream or a risk of permanent scarring from a surgical procedure. And laser resurfacing is no different. While most patients recover beautifully from their facial laser treatment and get the smoother, clearer skin they desire just a few weeks later, others find that the treatment has damaged their skin — sometimes permanently. Fortunately, there are steps your doctor can take to help minimize those risks, and ensure you get the results that you desire. Here’s a list of the most common laser resurfacing complications, and how they can impact your results:

  • Itching, swelling and redness: Immediately after you’ve received your treatment, you should expect that your skin will be red and swollen—though the worst skin reactions should clear up within a week or two after treatment. While most redness disappears within 12 weeks of the laser treatment, some patients do see residual redness for several months after the laser resurfacing is completed.
  • Burns: Powerful CO2 lasers are commonly used in laser resurfacing. They basically burn away several outer layers of your skin to bring out the newer, less wrinkled or damaged layers beneath. But if the treatment goes beyond the epidermis into the deeper layers of skin — or hits areas of skin that have fewer pores — you will risk developing permanent burns on your skin. “Your face has plenty of sweat glands, so it should heal,” says Lori Cherup, MD, of Radiance Plastic Surgery in Bridgeville, Pa. “But on your legs, arms and chest, there aren’t enough sebaceous glands to guarantee that you’re going to heal.”
  • Acne breakouts: The irritation brought on by laser resurfacing could make a breakout more likely, especially if you’re a person who is prone to acne flare-ups.
  • Infection: The laser treatment removes the epidermis to decrease the look of wrinkles and other imperfections, but by removing these protective outer layers of skin, you open yourself up to a greater risk of developing a staph or strep infection or even a cold sore outbreak. “One of the more dangerous risks of laser resurfacing is probably a bad herpes infection in the face,” says Josh Korman, MD, FACS, a plastic surgeon in Mountain View, Calif. Your doctor may prescribe a set of potent antibiotics and Zamvir for several days before you have the treatment, to help minimize your risk of developing these complications after the treatment.
  • Skin Discoloration: Some patients report that laser resurfacing caused either dark patches of skin (called hyperpigmentation) or lighter areas (also called hypopigmentation). This can make successful laser treatments extremely challenging — if not impossible — on patients with darker skin. “The CO2 laser is not an option in a black patient,” says Dr. Cherup. “You’re basically taking all the color out of their skin, and there’s no guarantee that it will come back evenly enough to mimic normal black skin tones.” Many doctors suggest pretreating the area with medicated creams before the laser resurfacing is done to minimize the risk of developing discoloration. “Usually, we give our patients Retin-A and bleaching cream to prep for this surgery,” Cherup says. “The creams can thin down the superficial layer of skin, helping skin turn over and get used to a healing response. It’s like amphetamines for the skin. They program the cells to divide and multiply.”
  • Scarring: “There’s always a risk of scarring with a laser,” says Cherup. “If the laser injury goes too deep, into the middle or lower third of the dermis, it takes longer to heal.” Cherup says that if the skin doesn’t heal significantly in the first week after surgery, it may indicate that there’s a greater risk of permanent scarring.

The risk of developing these laser resurfacing complications — especially the more serious and permanent side effects — is relatively small. But it’s