Laser and light therapies are very popular service offerings in the cosmetic, dermatologic, and medical spa industries. They can be used on their own or in conjunction with other services such as neurotoxins and fillers. Patients are continuing to look for nonsurgical approaches to help reverse signs of aging and sun damaged skin. Laser and light-based therapies can remove brown spots, treat acne and rosacea, reduce red vessels, reduce wrinkles, improve skin tone, tighten skin, reduce stretch marks, improve scars, and reduce pore size. Laser therapies can be tailored for each patient based on the amount of time they have for recovery or “downtime”. Results can be seen immediately and over the coming months as collagen regenerates.
Laser therapy, whether non-ablative or ablative can be a confusing topic to patients. You may see terms such as broadband light, CO2, erbium, fractional, nanopeel, and others all promising amazing results. The easiest way to begin understanding laser therapies is to divide them into two main categories; non-ablative and ablative.
Non-ablative lasers heat up the underlying tissue by using pulses of light. They do not remove any layers of skin. Different wavelengths of light are able to target different cosmetic concerns. For instance, a 515 nm wavelength of light can target brown spots caused by ultraviolet sun damage. Another wavelength, such as 560 is able to better target deeper sun damage, as well as vascular issues such as dilated blood vessels called telangiectasias. Non-ablative lasers such as broadband light or BBL are usually used to treat cosmetic concerns, but can also help treat skin disease such as rosacea. Anytime I treat a patient with BBL they ask if it is the same as IPL or intense pulse light. Although there are similarities between IPL and BBL the latter truly is in a league of its own. In fact, Stanford University published a study showing that having regular BBL treatments can effectively change the expression of genes associated with the aging process to more closely resemble young skin. With BBL you can have the benefits of removing sun damaged skin and anti-aging in one treatment. The downtime associated with BBL is minimal and patients can return to work the next day. Most patients tolerate the procedure without trouble likening it to a rubber band snapping at the skin.
Ablative lasers remove or vaporize the outer most layer of skin called the epidermis all the way into the deeper second layer of skin called the dermis. The dermal layer is where collagen and elastin live. Collagen can help the skin appear thicker and plumper helping to fill in fine lines and wrinkles and elastin can help the skin “snap” back after being stretched. Ablative lasers truly are king when it comes to resurfacing the skin.
Ablative lasers can remove 100 percent of the skin surface or simply a percentage of the skin and we can those fractional lasers. The best way to think of a fractional laser is likening it to that of aerating a golf course putting green. It creates micro channels in your skin, but because it is only treating a percentage of total skin healthy tissue is left behind. This allows for quicker healing and less side effects.
One of the original or first-generation ablative lasers was the carbon dioxide laser or CO2 laser. This laser was excellent at evening out skin tone, improving texture, and erasing wrinkles right before your eyes. However, it came with a significant amount of downtime, prolonged redness, and higher incidences of side effects such as permanent skin lightening called hypopigmentation.
Today, the erbium ablative laser is very common, typically replacing the CO2 laser. Erbium is able to provide similar results to CO2, reduce the amount of side effects, and reduce downtime. This type of laser can provide resurfacing to 100 percent of the skin typically called deep resurfacing or full ablative, as well as function as a fractional laser to treat just a portion of the skin. Downtime associated with ablative lasers is longer than IPL or BBL. Typically expect up to a week to recover with the first 48 hours being the toughest and not wanting to go out in public. A single aggressive erbium ablative treatment can produce amazing results, however, like most treatments for the skin sometimes a series of 1 to 3 will be best for the patient. A consultation is recommended for this type of treatment to review risks, side effects, discuss possible pre-treatment medications, and post-treatment care.
Thus far, we’ve discussed separate treatments that can address brown spots, red vessels, wrinkles, and pore size. One of the latest lasers to the market is a hybrid laser. This laser, created by Sciton, marketed as Halo, utilizes both non-ablative and ablative lasers at the exact same time. The Halo treatment is able to address sun damaged skin, pore size, wrinkles, texture concerns, and can be tailored to every patient. It is a highly tunable laser that can be adjusted for not on the patient’s concern such as wrinkles or brown spots, but also the amount of downtime they have for recovery. Patients describe the Halo treatment as little pin pricks against the skin and for about 2 hours post treatment the skin is very warm. Most patients go back to work the next day as they are able to wear makeup. Healing is usually completed by day 5. This by far is my favorite treatment to complete for patients. Everyone loves the results and asks how often they need to have it completed to maintain results long-term. This is a little different than the lasers we discussed above with the longer downtime. Most patients love the results of their procedure, but are not interested to go through the downtime a second or even third time.
Laser therapy when completed in the hands of a professional can really help turn back the hands of time. It can be used by itself or in conjunction with injectables such as fillers or neurotoxins. It can even be performed as part of a surgical solution to aging such as a face lift. Ask your cosmetic provider if laser treatments might be right for you. With the development of new lasers, such as “Halo”, there’s almost no reason not to give it a try.