Skin Resurfacing
IN SYDNEY
Skin Resurfacing (Fractionated Ablative Laser & Croton-Oil Phenol Peel)
Calibrated improvement in texture, etched lines, and tone using device-based and chemical methods - selected to suit your skin and goals.
My approach is considered, curated, and grounded in a deep understanding of facial anatomy and skin biology. I match the depth and mechanism of treatment to your skin type, downtime tolerance, and priorities (fine lines, etched rhytids, scars, pigmentation, mild laxity). Plans are staged and conservative where appropriate, with a strong emphasis on sun protection, antiviral prophylaxis when indicated, and meticulous aftercare.
What is Skin Resurfacing?
Resurfacing creates controlled micro-injury in the skin to stimulate orderly repair, collagen remodeling, and a smoother surface. Two complementary pillars are used in my practice:
Fractionated ablative laser (CO₂ / Er:YAG): Microscopic columns of vaporised tissue promote new collagen and improved texture with modest skin tightening and a shorter downtime pattern.
Croton-oil phenol peel (modified phenol peel): A powerful chemical resurfacing that treats etched lines and significant texture change, especially around the perioral and periocular regions, with longer downtime but greater depth of effect.
Results vary between individuals; we’ll set realistic goals and a sensible sequence..
What are the different kinds of resurfacing procedures?
Fractionated Ablative Laser (CO₂ / Er:YAG)
How it works: Creates fractional ablative columns (microscopic treatment zones) that contract tissue and stimulate collagen while leaving surrounding skin to speed re-epithelialisation.
Best for: Fine lines, crepe texture, enlarged pores, acne scarring, dyschromia; modest tightening of mild laxity.
Areas: Full-face or focal (perioral, periocular, cheeks).
Downtime pattern: Oozing/bronzing 1–3 days, crusting 3–5 days, then pinkness that settles over 1–4+ weeks depending on settings and skin type.
Course: Often 1–3 sessions, typically spaced 6–10 weeks apart; parameters are adjusted to balance effect and recovery.
Notes: Not a substitute for a surgical lift; it complements surgical plans by improving skin quality.
Croton-Oil Phenol Peel (Modified Phenol Peel)
How it works: A precisely formulated phenol–croton oil solution produces a uniform, deeper epidermal–dermal resurfacing with significant collagen remodelling. Concentration, application technique, and number of passes define depth.
Best for: Etched perioral and periocular lines, leathery texture, selected acne scarring, and global textural rejuvenation when a single, more powerful treatment is preferred.
Areas: Focal (perioral/periocular) or full-face in selected candidates.
Anaesthesia/setting: Local anaesthetic ± sedation in an accredited setting; continuous monitoring and careful fluid/occlusion management.
Downtime pattern: Re-epithelialisation typically 7–10 days; erythema softens over 4–12+ weeks with strict sun protection and pigment care.
Notes: Requires careful patient selection - particularly for darker skin types due to post-inflammatory pigment change risk. It is a resurfacing procedure (not a lift).
COMBINE YOUR CARE
Combine & Sequence Thoughtfully
With surgery: Frequently staged around facelift, neck, or eyelid surgery to simplify recovery (e.g., laser at 6–12 weeks post-op; focal croton-oil peel perioral/periocular once surgical swelling settles).
With volume: Microfat/HA filler can fine-tune contour; typically timed before or ≥2–4 weeks after laser/once peel redness settles.
With pigment care: Pre-treat and maintain with sun protection and, in selected cases, topical pigment modulators.
With nanofat: For selected skin-quality concerns, as an adjunct - not a replacement for laser/peel.)
WHY CONSIDER RESURFACING?
Who Is the Ideal Candidate?
Fine lines/crepe changes, etched rhytids (perioral/periocular), acne scarring, or textural irregularity.
Mild laxity where modest tightening is appropriate (fractionated laser).
Willingness to follow strict aftercare and sun protection, and accept the downtime aligned with the chosen modality.
When another approach may be better
Predominantly soft-tissue descent - consider surgical options (e.g., deep plane facelift/neck work).
Uncontrolled pigment disorders or recent isotretinoin - defer until safe.
Very dark skin types seeking deep resurfacing - consider conservative or alternative strategies due to higher PIH risk.
WHAT TO EXPECT
From Consultation to Recovery - Skin Resurfacing
Undergoing any treatment is a detailed and personalised process. From your first consultation to your final review, every stage is carefully planned to support your comfort, safety, and optimal healing.
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Your Initial Consultation
Skin typing (Fitzpatrick), texture/pore/line mapping, pigment history, HSV history, medication review.
Choose fractionated laser vs croton-oil peel (or focal combinations); set goals, recovery windows, and aftercare plan.Antiviral prophylaxis if there’s a cold sore history; pigment-modulating skincare in higher-risk skin types.
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Preoperative Planning
Sun protection for several weeks prior; cease irritating actives (retinoids/AHAs) as directed.
Antiviral prophylaxis if there’s a cold sore history; pigment-modulating skincare in higher-risk skin types.
Choose fractionated laser vs croton-oil peel (or focal combinations); set goals, recovery windows, and aftercare plan.
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Treatment Day
Setting: Accredited clinic laser suite for laser; accredited day surgery/private hospital for phenol peel or when sedation/combination procedures are planned.
Anaesthesia: Topical + local for most laser; local ± sedation for croton-oil peels.
Duration: ~30–60 min (laser) / 60–120 min (peel, scope-dependent).
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Early Recovery
Laser: Cleanse/soak, occlusive ointment; bronzing/crusting resolves in 3–5 days, makeup typically from day 5–7; pinkness softens over 1–4+ weeks.
Croton-oil peel: Occlusive care and soaks; new skin forms ~7–10 days, makeup thereafter; background redness gradually settles over weeks.
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Weeks 2–8 and Beyond
Gradual texture/line softening; laser series if planned; pigment-care maintenance; strict SPF ongoing.
Review at 6–10 weeks to assess response and discuss any further steps.
YOUR RECOVERY
Postoperative Care & Follow-up
Vinegar/saline soaks and occlusive ointment until fully epithelialised.
No picking; gentle cleansing only.
Sun protection (broad-spectrum SPF, hat, shade) is non-negotiable for several months.
HSV prophylaxis as prescribed; antibiotic/antifungal care only if clinically indicated.
Re-introduce actives gradually once the barrier is stable.
RISKS
What are the Risks of Laser & Croton-Oil Peel
Redness, swelling, oozing/crusting; temporary pigment change (PIH/POH).
HSV reactivation, acne/milia flares, contact dermatitis.
Prolonged erythema; lines of demarcation (peel), hypopigmentation (rare, higher risk with deeper peels).
Infection and scarring are uncommon but possible; careful selection and aftercare reduce risk.
Eye protection and laser safety protocols are mandatory for device treatments.
Why Choose Dr Karagiannis for your Skin Resurfacing?
1. Expertise & Experience
Multiple facial aesthetic fellowships across Europe and Australia with focused exposure to fractionated ablative CO₂/Er:YAG and modified phenol–croton oil peeling.
2. Personalised Planning
Parameter-driven, anatomy- and skin-type–aware planning to balance effect and downtime.
3. Combined Approach
Integrated sequencing with surgery, volume restoration, and pigment care for coherent results.
4. Continuity of Care
Clear, guideline-compliant counselling and continuity of care in accredited facilities.
Skin Resurfacing FAQs
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Fractionated ablative laser offers modest tightening with shorter downtime. Peels focus more on etched lines and texture.
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Laser is often 1–3 sessions. A croton-oil peel is commonly a single treatment (with possible focal refinements later).
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Laser: typically day 5–7 once crusts lift. Croton-oil peel: usually after 7–10 days when re-epithelialised.
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We proceed carefully due to PIH risk. Pre-treatment pigment care, conservative parameters, or alternative strategies may be recommended.
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Yes. Timing matters. We usually stage other treatments before or ≥2–4 weeks after laser/once peel redness subsides.
Request a Consultation
If you're considering skin resurfacing treatments, I invite you to schedule a private consultation. We’ll confirm whether fractionated ablative laser, croton-oil peel, or a staged combination best suits your skin and schedule.