The term laser has become a catchall for a very deep (and deepening) pool of plug-in dermatologic devices. But the truth is, they can function very differently. Many of these machines rely on different kinds of energy, such as ultrasound or radiofrequency, to achieve distinct effects.
A true laser—which stands for light amplification by stimulated emission of radiation—is characterized by a few key features, including its wavelength, which is absorbed by select targets in the skin, and its pulse width, or the rate at which that beam of light is delivered. Generally, the longer a wavelength, the deeper it penetrates (up to a point). And the faster a pulse width, the better it is for small targets.
Resurfacing lasers target water molecules within the collagen layer of the dermis. Heating the water creates a grid of what’s referred to as microthermal zones, which basically trick the skin into healing itself, triggering extensive repair and collagen production.
Lasers are being used to do pretty much everything these days, from erasing sun damage and wrinkles to rejuvenating tired-looking skin, and often with little to no downtime. Here’s a closer look at two of the most popular kinds.
Nonablative resurfacing lasers
Nonablative resurfacing lasers are the go-to treatment for moderate sun damage, melasma, and small scars.
The term encompasses fractional lasers and picosecond lasers outfitted with a special lens that essentially breaks up the beam. Rather than targeting lone spots, they cover widespread areas. Their main function is to refresh and rejuvenate by building new collagen, helping to smooth the skin, and getting rid of some of the pigmentation that comes with sun damage.
Nonablative resurfacing is appropriate for most skin types. As to which laser is right for you, it depends on what’s being treated. A mild fractional laser, like the Fraxel Clear + Brilliant, will provide a dramatic radiance boost, but only subtle textural improvements. On the stronger end of the spectrum, there’s the Fraxel Dual, whose wavelengths can correct significant, but not deep, UV damage on the face, neck, chest, arms, and hands.
The Dual’s 1927 wavelength is great for pigment, pores, fine lines, and even precancerous lesions, while its 1550 wavelength effectively treats deep wrinkles and scars.
With a mild resurfacer, the treated skin may be flush for an hour or so and a little dry for a day. With the stronger kinds, it’ll look red right after, then a little dirty for up to a week as the damaged cells are shed.
Ablative resurfacing lasers treat deep wrinkles, severe sun aging, and prominent scars.
These lasers act on water, too, but their higher energies, and the way in which they’re absorbed, generate greater heat, which creates a more purposeful wound on the skin’s surface than nonablative resurfacing, when the topmost layer remains intact. Ultimately, ablative resurfacing leads to even more collagen renewal.
It is a more intense process than nonablative resurfacing—in turn, it’s not recommended for dark complexions—but the latest generation of fractional ablative lasers are safer and more predictable than the old non-fractionated ablative lasers, with which depigmentation and scarring was a real risk.
That said, the downtime is still more significant than it is after a nonablative procedure. Plan on laying low for at least a week. There will likely be some significant swelling and scabbing, but the recovery