Base-line information you need to know about your skin in order to make the informed choices if you are considering cosmetic re-surfacing of your skin:

It is important to realise several facts:

• Your skin consists of two layers: the outer epidermis and the inner dermis and below the skin lies subcutaneous fat and soft tissues.
• As cells move from the deeper epidermis outwards they die and slough off. Epidermal cells contain keratin (preventing moisture both from entering and escaping). Other cells in the skin make a pigment called melanin, which is your only natural protection against sun damage.
• The dermis is a thicker and contains structural and elastic proteins as well as glands; hair follicles; nerve endings and blood vessels.
• The subcutaneous layer or hypodermis, which is mostly fat, act as a cushion to protect and insulate you thermally.
• Many factors combine to age your skin:
• Cumulative sun exposure is a major determinant of how your skin ages ' damaging both the epidermis and dermis.
• Smoking damages and ages the skin prematurely by damaging the small blood vessels in the dermis and damaging the collagen protein and elastic fibres there.
• Your genetic make up is a major determinant of how you appear to age, with some of us luckier than others!
• Poor nutrition will prematurely age your skin, as will excessive alcohol consumption
• Drugs and medications that you take will also have an effect on your skin

Skin re-surfacing

Broadly speaking this is radical exfoliation and involves removing the outer layers of the epidermis and in so doing, stimulating re-growth and re-modelling in both the dermis and the epidermis.

In modern cosmetic practice, this can be effected either with a laser or chemical treatments applied to the skin: in both cases your skin is being burned in a controlled way to remove the outer layers, whilst leaving enough in the deeper epidermal layers to re-populate. In trained hands, this is generally a safe treatment, but even in the best hands complications occur, and at those times, an distinct advantage of being treated by an accredited Consultant Plastic Surgeon, is that you are being treated by someone who has been trained for many years to manage people with thermal and chemical burns to the skin.

Laser re-surfacing

This involves using a carbon dioxide laser to remove the outer layers of your skin. This a is a good way to remove superficial wrinkles on the cheeks and around the mouth.

It is not suitable if you have taken Accutane™ in the past 12 - 18 months or are prone to adverse scar formation (keloid scarring). Nor is it suitable if you have an active skin infection on the area to be treated. If you have had oral herpes, but do not have an outbreak when you are being treated, I will cover the treatment period with a course of Acyclovir ™ as prophylaxis.

The best candidates for laser resurfacing have fair, healthy, non-oily skin and have fine wrinkles around the lips, eyes and cheeks. Patients with darker skins have an increased risk of pigmentation changes after laser resurfacing.

Skin Peels

Trichloracetic Acid (TCA)
This is a weak acid which when used in different concentrations can be used to rejuvenate facial wrinkles (cheeks, eyes, lips) and to flatten and de-accentuate, and often remove, the eyelid xanthelasma ' the yellow-white plaques deposited in the skin around the eyes of people who have raised serum cholesterol levels.

The Obagi Blue Peel
This peel is the most effective skin treatment available outside the operating theatre and can achieve dramatic results. It can dramatically improve the appearance of acne scaring, fine wrinkles, uneven pigmentation and sun damage to leave your skin healthy and smooth.

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