The roughly hourlong procedure is typically done in an outpatient setting, and patients are usually sedated. As the laser is passed across the face, it sears through the paper-thin epidermis and into portions of the dermis—the skin's thicker layer beneath the epidermis—to purge old, damaged collagen and generate four to five times more new collagen than retinoic acid does, says Voorhees. But be prepared: Your face essentially becomes an open, oozy wound that must be rigorously cared for until healed. That means virtual house arrest for two weeks, during which skin must be soaked with ice-cold water every few hours then slathered with a layer of ointment to avoid scarring and infection. Once healed, skin may remain red for up to six months.
A newer generation of lasers ("fractionated ablatives") are less invasive, says Kauvar. Instead of burning off the skin's entire surface, microscopic beams of energy singe tiny plugs of tissue, leaving areas of untouched skin. This promotes quicker healing. Patients are usually just red and swollen for a week or so and can usually resume their daily routine in four days, says Kauvar. While one carbon dioxide laser resurfacing session may yield results that last eight years, fractionated ablatives may require two or three sessions for best effects, says Kauvar, who uses both. The traditional procedure can cost between $5,000 to $8,000, and the fractionated ablatives, between $3,000 and $5,000 per treatment, she says.
Instead try chemical peels, says Draelos. A peel promotes new collagen using acid instead of high intensity light. Healing time is less.
Cross-linked hyaluronic acid injections. For an immediate fix, many people turn to "fillers." A viscous goop is injected into facial folds and creases, much like spackle into ceiling cracks, plumping wrinkles from the inside out in about five minutes. Cells whose collagen production has waned are fooled into making more. Cross-linked hyaluronic acid is one of many materials used and is particularly effective, says Voorhees; it has essentially replaced collagen injections. How long such fillers last can depend on the amount used and wrinkle depth and can cost between $500 to $700 for each cubic centimeter injected, says Draelos. Sometimes there's a little swelling and a little bruising afterwards.