Skin Resurfacing(Laser and Chemical Peel)
Target sun damage, fine lines, uneven texture, and selected scars with a resurfacing plan tailored to your skin and recovery goals.
What Is Skin Resurfacing?
While surgical procedures like a deep plane facelift and neck lift reposition deeper facial and neck structures, they do not change the quality or texture of the skin itself. Decades of Arizona sun exposure, environmental pollutants, and the natural aging process can leave brown spots, rough texture, enlarged pores, and fine wrinkles (rhytids).
Skin resurfacing creates a controlled treatment injury at a selected depth. Depending on the device or peel, it removes or remodels portions of the outer skin and may stimulate collagen remodeling during healing.
Whether using laser technology or a customized chemical peel, Dr. Jowett selects the treatment depth around your skin type, concerns, tolerance for downtime, and risk factors. The aim is visible improvement in tone or texture while keeping expectations and potential complications explicit.
Why Choose Dr. Jowett for Skin Resurfacing?
Skin resurfacing balances the desired degree of improvement with healing time and risks such as pigment change, prolonged redness, infection, and scarring.
Laser-Tissue Research Background
Dr. Jowett has co-authored research examining thermal effects during laser surgery. That work gives him a research-grounded perspective on device selection, treatment depth, and laser-tissue interaction. He uses it to plan an effective treatment while accounting for scarring and pigment risk; individual outcomes still depend on skin type, settings, healing, and aftercare.
Comprehensive Rejuvenation
Resurfacing may be coordinated with a facelift or blepharoplasty when both facial structure and skin quality are being addressed. Whether treatments can be combined safely depends on the procedure, treatment area, skin, and healing plan.
Customized Recovery
Downtime matters. Treatment depth is selected around the condition being treated, skin type, safety considerations, and the recovery period you can reasonably accommodate.
What Skin Resurfacing May Improve
- Fine lines: May soften fine lines around the mouth and eyes; the degree of change depends on their depth and the treatment selected.
- Sun damage: May reduce selected brown spots and areas of uneven pigmentation, although pigment can recur with sun exposure.
- Uneven texture: Can make rough areas and the appearance of enlarged pores less noticeable.
- Selected scars: May soften the appearance of some acne or traumatic scars; deeper scars often require a combined approach.
Preparing for Treatment and Recovering Afterward
Planning and aftercare influence the result as much as the device does, particularly for pigment-prone skin.
Before treatment
Skin type, pigment history, prior cold sores, medications including recent isotretinoin, active skin infection, and how previous wounds have healed are all documented. Sun avoidance beforehand is widely advised, and a preparatory skin regimen is sometimes used for pigment-prone skin. Eye protection is used for every laser treatment.
Early recovery
Redness, swelling, and crusting are expected temporary effects, and early tightness, tenderness, or burning is commonly reported and settles with time. Deeper ablative treatment involves the longest visible recovery; attentive wound care supports healing.
After healing
Daily broad-spectrum sunscreen and sun avoidance continue for months, since pigment can darken or recur with exposure. Results are improvement rather than perfection, and the degree of change varies with skin, device, settings, and aftercare.
What the Evidence Shows
Resurfacing treats texture, pigment, and fine lines. It does not replace a lift or a nerve repair.
- Fractional laser and peels are chosen for the depth of damage and the downtime a patient will accept.
- It is often paired with a lift when skin quality, not only sag, is part of the aging pattern.
- A numb or paralyzed eyelid needs surface protection first. Aggressive resurfacing is deferred until the eye is safe.
- Ablative lasers generally produce the largest change in deep wrinkles and sun-related pigment, often in fewer sessions, but carry longer healing and a higher risk of infection, scarring, and pigment change. Nonablative fractional treatment is usually a series with faster recovery and fewer adverse effects.
- A meta-analysis of randomized trials did not find a statistically significant difference between ablative and nonablative lasers for facial rejuvenation, either in the chance of excellent improvement or in side effects, although the trials were small. For atrophic acne scarring the comparison remains mixed, and several fractional sessions can approach the collagen remodeling of a single ablative treatment.
- Post-inflammatory hyperpigmentation is the most common complication and is more likely in deeper skin tones. Because fractional devices target water rather than pigment they can still be used, with modified settings and a pigment plan, rather than treating skin type as an automatic exclusion.
- Antiviral prophylaxis is commonly started before full-face ablative resurfacing even without a cold-sore history, because reactivation is reported more often after ablative than nonablative treatment. A history of cold sores is a planning issue, not usually a disqualification.
- Sun protection is part of the treatment rather than an afterthought. In one randomized study, sunscreen started the day after ablative fractional treatment reduced early pigment change, and broad-spectrum protection is advised for months afterward.
Skin Resurfacing Consultation
Skin type, prior treatments, medications, pigment history, scarring tendency, and the condition being treated all influence whether resurfacing is appropriate.
During your consultation, Dr. Nate Jowett will assess your skin and goals, then recommend the fractional or ablative laser, chemical peel, alternative treatment, or observation plan that offers the most appropriate balance of improvement, recovery, and risk.
Common questions
Questions Patients Ask
What is the difference between ablative and nonablative resurfacing?
Ablative lasers remove microscopic or continuous areas of epidermis and usually have more visible recovery. Nonablative lasers heat deeper tissue without removing the surface and commonly require multiple sessions for a more gradual effect.
Is laser resurfacing safe for darker skin?
It can be performed in selected patients, but device choice, energy, density, preparation, and aftercare must be adapted because pigment alteration and scarring risks differ by skin type and diagnosis.
What are warning signs after resurfacing?
Increasing pain, spreading redness, pus, fever, clustered blisters, delayed healing, or new eye symptoms should be reported promptly. Early treatment of infection or abnormal healing can reduce permanent change.
How many resurfacing sessions will I need?
It depends on the depth of treatment. Ablative resurfacing is often a single treatment or a small number of treatments, while nonablative fractional treatment is typically planned as a series. Several fractional sessions can approach the collagen remodeling of one ablative treatment, which is one way to trade a longer schedule for a shorter recovery each time.
Do cold sores rule me out?
Usually not. Reactivation of herpes simplex is reported more often after ablative than nonablative treatment, so antiviral medication is commonly started before full-face ablative resurfacing even in people with no cold-sore history, and reserved for those with a history or perioral treatment in lighter procedures. A cold-sore history is a planning issue, not automatic exclusion.
Does laser resurfacing help acne scars?
It can soften the appearance of atrophic acne scarring, but the evidence comparing device categories is mixed: one meta-analysis favored nonablative lasers on effectiveness and safety while ablative devices scored higher on some observer and patient ratings. Deeper or tethered scars often need a combined approach rather than laser alone, and improvement rather than erasure is the realistic goal.
Will resurfacing tighten sagging skin or replace a facelift?
No. Resurfacing works on the surface: texture, sun-related pigment, and fine lines, with collagen remodeling during healing. It does not reposition descended deeper tissue, which is what a facelift addresses, and it does not replace lost volume. When both surface quality and descent are part of the aging pattern, the two are considered as separate decisions.
When can I be in the sun again after resurfacing?
Sun avoidance is advised before treatment and daily broad-spectrum sunscreen for months afterward, because pigment can darken or recur with exposure. In one randomized study, sunscreen begun the day after ablative fractional treatment reduced early pigment change. Post-inflammatory hyperpigmentation is the most common complication overall and is more likely in deeper skin tones, which makes sun discipline part of the treatment rather than an optional extra.
Answers are general and individualized at consultation.
Medical References & Evidence-Based Guidelines
- Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury. Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Lasers Surg Med. 2004;34(5):426-438. PMID: 15216537.
- Facial Nerve Danger Zones. Roostaeian J, Rohrich RJ, Stuzin JM. Plast Reconstr Surg. 2020;145(1):99e-102e. PMID: 31881610.
- The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. Alexiades-Armenakas MR, Dover JS, Arndt KA. J Am Acad Dermatol. 2008;58(5):719-37; quiz 738-40. PMID: 18423256.
- Systematic review and meta-analysis of randomized clinical trials comparing efficacy, safety, and satisfaction between ablative and non-ablative lasers in facial and hand rejuvenation/resurfacing. Seirafianpour F, Pour Mohammad A, Moradi Y, et al. Lasers Med Sci. 2022;37(4):2111-2122. PMID: 35107665.
- Efficacy and safety of non-ablative vs. ablative lasers for acne scarring: A meta-analysis. Ke R, Cai B, Ni X, et al. J Dtsch Dermatol Ges. 2025;23(4):425-436. PMID: 40066600.
- Fractional versus ablative erbium:yttrium-aluminum-garnet laser resurfacing for facial rejuvenation: an objective evaluation. El-Domyati M, Abd-El-Raheem T, Abdel-Wahab H, et al. J Am Acad Dermatol. 2013;68(1):103-12. PMID: 23110966.
- Facial laser complications (A Five Year Review). Zhorov I, Goldstein M, Hasa A, et al. Lasers Med Sci. 2026;41(1). PMID: 41968192.
- A Prospective Comparison of Patient-Reported Outcomes after Facial Laser Resurfacing. Arias F, Gala Z, Stetz L, et al. Plast Reconstr Surg. 2025;156(1):37e-46e. PMID: 39808078.
- The use of sunscreen starting on the first day after ablative fractional skin resurfacing. Wanitphakdeedecha R, Phuardchantuk R, Manuskiatti W. J Eur Acad Dermatol Venereol. 2014;28(11):1522-8. PMID: 24320057.