Thanks to their versatility and quick results (treatments take just 5 to 30 minutes), lasers have become almost as ubiquitous as Botox. “They’re one of the fastest-growing services in-office,” says Robert Anolik, a dermatologic surgeon in New York City. Two million laser treatments were performed in 2012, according to the American Society for Dermatologic Surgery, and that number has grown at a lightning pace since. What can lasers do (or not do) for your complexion? Here, illumination.
How Do Lasers Work?
Laser is an acronym for “light amplification by the stimulated emission of radiation.” In other words, it’s “a device that focuses light energy onto a specific area,” says Tina Alster, a dermatologist and the director of the Washington Institute of Dermatologic Laser Surgery, in Washington, D.C. “For a dermatologist, that means targeting and obliterating something specific in the skin, such as water or pigment.” This creates a “controlled injury” that jump-starts the body’s healing process, says Adam Kolker, a plastic surgeon in New York City: “Nearby cells are stimulated to repair the targeted region through the production of collagen and new cells, which ultimately results in nicer-looking and feeling skin overall.”
Dozens of lasers have been invented over the years, and they fall into two general categories: traditional and fractional. And within the fractional category are ablative (which leaves skin looking visibly abraded) and nonablative (which leaves the skin surface intact). Traditional lasers emit a concentrated ray of light onto one spot, while fractional lasers emit many beams at once, allowing for numerous miniscule forays into the skin that are combined into one zap, “like pixelation in a digital image,” says Roy Geronemus, a dermatologic surgeon in New York City. Subsequently, there’s less pain and a faster recovery from each session. The only drawback: It takes multiple sessions to achieve the same results, which is why some dermatologists still opt for traditional lasers.
What’s Used for What?
The answer varies, depending on your skin texture and tone. But here are some guidelines.
The Issue: Lines and Wrinkles
The options: For the most stubborn wrinkles and the most dramatic results, dermatologists reach for traditional lasers, such as the CO2 or the Erbium. These lasers heat the water in the skin to the point where the surface skin is vaporized, prompting the production of new collagen. The catch? You pay a high price in terms of downtime and serious wound care.
For these reasons, for the treatment of lines and wrinkles, laser surgeons are increasingly recommending fractional ablative lasers (such as the Fraxel Repair) or nonablative lasers (such as the Fraxel Restore and the Clear + Brilliant Permea). These lasers leave the skin’s surface slightly red but not raw. In numerous sessions spaced about a month apart, they gradually accomplish close to what a traditional treatment does in one session. Keep in mind that you can undergo nonablative laser treatments as often as monthly (but typically annually after three initial sessions), but “you will probably need only one or two fractional ablative treatments in your lifetime,” says Fredric Brandt, a dermatologist based in New York City and Miami.
The downtime: After treatment with a fractional ablative laser, you can expect two to three days of oozing, pinpoint bleeding, and up to one week of crusting, says Paul Friedman, a dermatologist with practices in New York City and Houston. Redness will persist for several weeks. Fractional lasers of either sort offer slightly less damage and discomfort than their traditional counterparts.
The cost: Traditional or fractional ablative resurfacing, $2,000 to $5,000; fractional nonablative resurfacing, $700 to $1,500. Prices vary depending on where you live.
Pain relief: For traditional treatments, an oral prescription painkiller and, possibly, sedation. For fractional treatments of either type, a topical numbing cream.