For the uninitiated, the concept of the 10-minute laser facial can seem daunting—sort of like that one-way trip to Mars too many people applied for. First of all, try free-associating the word 'laser.' Sci-fi might be the first word you come up with—or maybe something about newfangled weaponry. Laser hair removal might be in there somewhere if you happen to have experienced that, but skin resurfacing probably wasn't among the first dozen reference points. After all, lasers are a big topic. But seeing as this is a beauty site, today we'll tackle lasers as they relate to skincare—which can cover everything from a 10 second zap to take care of slight skin discoloration to the latest in nonsurgical facelifts.
The easiest way to understand what's treatable is to understand what technologies are at your disposal. But before delving too deep, there are a few important clarifications. Mainly: Not everything in this article is technically a laser. “People lump everything under that umbrella—but that’s just one specific wavelength of light,” Dr. Patricia Wexler (of recent Top Shelf fame) clarifies. As the technology has evolved, there are now many tools to transfer energy through the skin, and in effect, injure it so that it heals stronger and more youthful looking. We'll start with lasers though, since it's the name of the game:
A definition: Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. Within that, there are ablative lasers and non-ablative lasers. Both can treat color issues in the skin and stimulate collagen regrowth in the skin. The former has a greater capability of targeting the surface of the skin, all the way down to the sub-dermis, whereas non-ablative lasers can target the dermis without addressing the epidermis. “Ablating means you’re actually punching holes in the skin,” Dr. Neal Schultz explains. “With non-ablative, you’re just transferring the energy through it,” These days, non-ablative treatments tend to be more popular—they're considered less invasive, and there's significantly less downtime after the procedure. However, effects of an ablative laser tend to be longer lasting, depending on the area of the face targeted (lip lines and other problem ares caused by excessive movement are going to come back no matter what you zap them with). The downside is the downtime—lasers like a CO2 or Erbium are going to leave the skin “black and blue for a few weeks,” Dr. Schultz said. “But they'll get rid of the spot or the line the first time, every time,” An Erbium can also treat benign moles and warts.
Both types of lasers can be used to treat discoloration or photo-aging (whether that's brown from sun spots or red from broken capillaries) and skin texture. “When we talk texture, we mean rough, dull, tired-pored, tired-looking skin and even fine lines,” Schultz said. “All of these things create a skin surface that isn’t smooth. When you have junk accumulating on the surface, like dead cells and pore sludge, all of these things create irregularities where light hits and scatters instead of reflecting. The lasers that will remove that top layer of hanger-on cells tend to be non-ablative. You don’t need to drill holes to get rid of that stuff,” Afterward, there might be a little flaking on the skin for a few days, but no serious down time. “Plus, when you peel off some of those cells, you'll also be getting rid of some of the discoloration in the brown family,” Schultz continued.
Intense Pulsed Light (IPL)
While still reliant on specific wavelengths of light to target melanin or hemoglobin under the skin's surface, IPL doesn't have the same radiation associated with laser technology (all IPL is considered non-ablative, as well). It works by transferring short blasts of specific lights through the skin—different pigments are reached depending on the filter you use. As such, IPL can treat rosacea, hyperpigmentation, and some laxity related issues in the skin. All told, IPL tends to be less expensive, but it often takes several rounds of treatment to get the desired results. It may seem like an altogether more gentle procedure, but Dr. Wexler warns “since this is still a pigment sensitive area, people with darker skin have more trouble with this technique,” IPL, along with a low-intensity YAG laser are used in Skin Laundry's facial.
Ultrasound & Radiofrequency
'Anything that heats that skin and fat in a controlled fashion to a certain temperature will make it shrink,” said Schultz of heated therapies, which also prompts cells to rebuild by damaging the collagen. If you've ever heard people talking about Thermage, this is what they're referring to. “Think of it as overcooking your steak. It shrivels up, but the heat doesn’t char the outside of the steak. We’re just shrinking the fibers around the fat which will reduce the puffiness around your face,”
As for that illusive (or not illusive anymore) nonsurgical facelift—'Ultrasound is amazing,” said Wexler about the technology she admits she's the most excited about. “You're delivering a different energy to the layer of the muscle and the layer of the deep dermis,” Those are the same two levels targeted during a traditional facelift—but you'd be cutting the muscle and tightening the skin. Instead, by heating the tissue at a specific temperature over the course of an hour and a half or so, it tightens and lifts. The most impactful results are seen several months down the line, once the collagen as regrown.
Now for an important reminder: Like with any procedure, there are always potential risks. But all doctors consulted for this story said with an experienced technician, there's very little to worry about in terms of laser treatments. “They're invasive, but without collateral damage,” Dr. Schultz says about lasers and their popularity among patients. “If you want to take advantage of the laser, you also have to take the limitation of the laser—which is that you need a different laser for every single problem,” You can do too much, however, and end up with an oddly shaped face, eventual discoloration, and thin-looking skin.
'Any time a patient has a risk of cold sores, we put them on Valtrex before the procedure and keep them on it afterward, but you can always get an infection whenever you have a procedure,” Dr. Wexler said. “Cold sores in particular because you keep the virus in your body and it comes out during heat and stress,” You also want to stop using hydroquinone products and self-tanners the week before and keep off of them for at least a week after.
The best way to figure out which laser suits your needs is to talk to a doctor. “Brands and types of lasers shouldn't really come into it at first,” Dr. Schultz says about consulting your dermatologist, confirming that there is no such thing as the best laser: “One size never fits all. First talk about what the problem is and what the desired result is. And if you're in good hands, your doctor will know where to take it from there,”
Illustration by Lauren Tamaki.