Laser treatments for wrinkles, spots on the hands, broken blood vessels, and unwanted hair are growing in popularity. That may be because many of us want to look younger but want to avoid plastic surgery.
In fact, laser skin resurfacing — as anti-aging treatments to the face are called — and laser hair removal are among the most commonly performed cosmetic procedures in the United States, according to the American Society of Plastic Surgeons.
All lasers work by delivering intense beams of light to the skin, which heats it up and causes a controlled injury. That prompts the body, as part of the natural healing process, to produce collagen and create new, younger-looking skin. Lasers have been studied extensively for cosmetic purposes and found to be highly effective.
But not all lasers are alike. They are broken down into a variety of different, and overlapping, categories.
Types of lasers
Two types of lasers are used for cosmetic purposes. The carbon dioxide laser was first used in the mid-1990s. It goes deep into the skin, causing lots of damage but ultimately improving the tone and texture of the skin and smoothing wrinkles. The second type, the erbium:YAG laser, causes less damage and penetrates less deeply than the carbon dioxide laser, but a doctor can make many passes over the skin to get the same results.
Lasers are also classified by their wavelengths, which correspond to colors. Yellow and green wavelengths are good for removing red pigment from the skin, whereas infrared (invisible) light is effective for wrinkles and fine lines. Other distinctions:
Pulsed versus continuous energy. Lasers can emit continuous pulses of light or short bursts of energy.
Ablative versus non-ablative. Ablative lasers destroy both the skin on the surface and below the surface. This means that the skin on your face will be an open wound and may ooze for a week and be pink or red, itchy, and swollen for weeks to months. Non-ablative lasers don’t remove the surface skin but instead target deeper layers, and so there is less recovery time after the treatment. Your face might feel red, hot, swollen, and tight for a few days.
Fractional versus non-fractional. “Non-fractional lasers hit the skin en masse, whereas fractional lasers make small channels in the skin, creating less injury,” says Lisa M. Donofrio, M.D., associate clinical professor of dermatology at Yale University School of Medicine in New Haven, Conn., adding that “the fractional technology can be used with any kind of laser.”
Frequently asked questions
Q. Does laser treatment for aging skin hurt?
A. Yes, it does, and sometimes a lot. “I always premedicate patients with a topical numbing cream before a laser treatment,” reports Meghan Feely, M.D., a New York City dermatologist. “I can also adjust the energy level of the laser if the discomfort is intolerable.” During the treatment, some doctors also use a device that blasts cool air onto the face, and apply ice or a cooling mask afterward. And you can take acetaminophen or ibuprofen to ease the pain.
Q. How much does laser treatment cost?
A. It can range anywhere from $400 to $800 for one fractional non-ablative laser treatment (and you typically need four to six treatments to get the most benefit and then maintenance treatments) to $5,500 to have your whole face treated with an ablative laser that requires just one treatment.
Q. Are the treatments covered by insurance?
A. No, like most cosmetic procedures, they are not.
Q. How long do the results last?
A. They can last for a number of years if you have the appropriate number of treatments. “The skin is being remodeled, so you are forming new tissue, as well as collagen,” Donofrio says. Results will usually last until the aging process overtakes the new skin.
Q. What are the risks of laser treatment?
A. There are quite a few, according to Feely. Laser treatments can exacerbate skin conditions such as acne and rosacea, and can leave dark skin lighter or darker than it was before. It can also leave scars, and if you’re prone to cold sores, which are caused by the herpes virus, it may cause them to erupt. (Doctors typically prescribe medications to prevent cold sores in vulnerable people prior to laser treatment.)
For these reasons, she says, and the best results, it’s really important that you check a doctor’s credentials and be sure he or she is board-certified in dermatology or plastic surgery and skilled and trained in giving laser treatments.