Doctor’s Note: Your Essential Guide to Anti-Aging Lasers

As dermatologists, we often see patients looking for ways to improve their skin’s tone, texture, and overall appearance. Lasers are a popular (but confusing!) choice because they target specific concerns, from fine lines to uneven pigmentation. These treatments are precise and effective, helping to refresh the skin without the need for invasive procedures.

What is a Laser?

Lasers are medical devices that use focused beams of light to treat specific skin concerns. These beams target the skin at controlled depths, either in the upper epidermis or deeper in the dermis, depending on the issue being addressed. By doing so, lasers can stimulate natural processes like collagen production or remove damaged skin layers, improving tone, texture, and elasticity over time.

The depth a laser reaches is the key to how well it works. Let’s take a look at laser depth and its effect on the skin:

  • Epidermis: This is the paper-thin outermost layer of skin where pigment-producing cells (melanocytes) live. Lasers that target this layer (purple and blue beams) are great to lighten dark spots.

  • Dermis: This thicker, supportive layer contains collagen, which gives skin its structure and firmness. To rebuild collagen and address deeper issues like wrinkles or scars, lasers must penetrate this layer. Lasers with longer wavelengths (orange, red, and dark red beams) are used for these concerns.

  • Fat Layer: Below the dermis is the fat layer, which cushions and insulates. While most skin lasers don’t reach this depth, some body-contouring lasers may target it.

The type of laser and depth of treatment are chosen based on your skin concern. For instance:

  • Shallow lasers (like Clear + Brilliant) are ideal for minor tone and texture improvements.

  • Deeper lasers (like Fraxel) address severe wrinkles, scars, and collagen loss.

Laser Depth

How Do Lasers Work?

Okay, so now we know that different lasers go to different levels in the skin. But what are the lasers actually doing when it reaches the desired level? Lasers deliver energy and this manifests in two ways: they either heat the skin (non-ablative) or physically remove layers of skin (ablative). Non-ablative lasers are less invasive, stimulating collagen production and improving skin from within without breaking the surface. Ablative lasers, on the other hand, remove precise portions of the skin's outer layers to trigger a more intensive healing and regeneration process. Let’s break down how each works and what they’re best for!

Non-Ablative Laser

These heat the deeper layers of the skin without removing the surface. They stimulate collagen production and are effective for mild wrinkles and pigmentation issues. Recovery is usually just a few days. Examples include Fraxel and Clear and Brilliant.

Non-Ablative Laser Graphic

Ablative Laser

These remove the outer layers of damaged skin, stimulating new skin to form. They are ideal for deeper wrinkles or scars but may require more downtime. Recovery can be 1 - 2 weeks. The most common example is a CO2 laser.

Ablative Laser Graphic

While we learn, let's use red font for non-ablative lasers, because it mean gently heating the skin! 🔥 

Bird’s Eye View

Let's just get a very rough overview of the devices we'll discuss today. This is a VERY GENERAL diagram. It's impossible to truly label what is stronger/strongest, as providers can adjust the energy beyond the typical settings. 

Non-Ablative vs Ablative Laser Comparison

Benefits of Lasers

Rejuvenation lasers offer several benefits for those looking to improve their skin’s appearance. These include:

  • Improved Skin Texture: Lasers smooth rough skin and minimize the appearance of fine lines and scars.

  • Even Skin Tone: They reduce dark spots, redness, and pigmentation irregularities.

  • Boosted Collagen Production: Many lasers stimulate collagen, which helps maintain firm, youthful skin.

  • Minimal Downtime: Non-ablative and fractional lasers often allow you to return to daily activities quickly.

  • Customizable Treatments: Lasers can be adjusted to suit your skin type and specific concerns.

While results vary, most patients notice significant improvements after a series of treatments.

Before and Afte Laser

What to Expect During Laser Treatment

Before Treatment: Your dermatologist will evaluate your skin and discuss your goals. They may recommend stopping certain skincare products or medications before the procedure to minimize risks.

During Treatment: The procedure is typically done in-office. You’ll wear protective goggles, and your skin may be numbed with a topical anesthetic. The dermatologist will use the laser device to treat the targeted areas. Depending on the laser type, you might feel a warming sensation or slight discomfort, similar to a rubber band snapping against your skin.

After Treatment: Your skin may appear red or swollen immediately after the procedure, similar to a mild sunburn. Ablative lasers might cause peeling or crusting as your skin heals. Non-ablative lasers usually have milder side effects, such as temporary redness or dryness.

Your dermatologist will provide specific aftercare instructions, such as:

  • Avoiding sun exposure and using sunscreen daily

  • Using gentle skincare products

  • Keeping the treated area moisturized

Best Lasers for Dark Spots

Lasers can be a great way to treat dark spots caused by sun damage, aging, or acne. Two common choices are Clear + Brilliant and its specialized version, the Permea laser. Both lasers target melanocytes, the skin cells responsible for making pigment, which sit in the very top layer of the skin called the epidermis.

Clear + Brilliant is a gentle laser that improves overall skin tone and texture, gradually fading dark spots. The Permea laser focuses more directly on pigmentation, making it especially helpful for uneven skin color. Because pigment and texture are very superficial, meaning they’re close to the skin's surface, these lasers don’t need to go deep to work effectively.

Both lasers are non-invasive, meaning they don’t damage the skin too much, and recovery time is quick. However, you might need several sessions to see the best results. Always check with a dermatologist to find out which laser is the right fit for your skin needs.

Clear + Brilliant Laser

Clear and Brilliant Laser

  • tl;dr: Clear&Brilliant is a great laser if you have relatively little damage or would like a regular preventative laser treatments. ​

  • Marketed to a younger crowd as a preventative treatment

  • Going 0.4mm into the skin is relatively superficial when compared to other lasers, which results in less downtime.

  • "Frequency over intensity" type of laser. Great for regular maintenance. 

  • AKA"Mini-Fraxel"

  • Clear&Brilliant is a great laser if you have relatively little damage or would like a regular preventative laser treatments. ​

  • Celebrity Clients: Chrissy Teigen, Jennifer Aniston, Drew Barrymore, Kim Kardashian's makeup artist, Mario

Clear + Brilliant Permea

Clear and Brilliant Permea

  • tl;dr: Clear&Brilliant Permea is the most superficial of the lasers, making it perfect for addressing pigment concerns.

  • Permea is an additional handpiece to Clear + Brilliant. 

  • Delivers wide + shallow beams of energy into the skin to enhance permeability.

    • Permea = Permeates

  • Increases topical absorption to maximize their benefits. 

  • Think of this as a "supercharging your skincare" type of laser. 

  • Won’t address wrinkles, scars, or anything else

Best Lasers for Scars + Fine Lines

Lasers like Fraxel Dual and Icon 1540 are excellent options for treating scars and fine lines because they work deep in the skin. These lasers use energy to reach the dermis, the layer underneath the outer skin (epidermis), where collagen is made. Collagen is a protein that gives skin its structure and helps it look smooth and firm.

When these lasers are used, they create tiny, controlled injuries in the skin. This process forces your body to repair itself by making more collagen, which fills in scars and smooths out wrinkles over time. At the same time, the lasers can break apart dark pigments caused by sun damage or old scars, making your skin tone more even.

Compared to gentler lasers like Clear + Brilliant, Fraxel Dual and Icon 1540 go much deeper, which is why they are better for tougher problems like deep scars or early signs of aging. If you’re thinking about laser treatment, talk to a dermatologist to find out which laser is the best choice for your skin.

Fraxel Dual

Fraxel

  • tl;dr: The workhorse of dermatology lasers. A great machine. Many uses. We love Fraxel. 

  • Fraxel Dual has two wavelengths. You can be treated with one or both:

    • 1550 = deeper, better for scars and wrinkles

    • 1927 = superficial, better for pigment

  • Bridges the gap between milder treatments (like Clear+Brilliant) and more aggressive treatments (like ablative lasers). 

  • Celebrity Clients: Kim Kardashian, Hailey Bieber, Courtney Cox, Christie Brinkley, Kelly Ripa

Icon 1540

Icon 1540

  • tl;dr: Cannot penetrate as deeply as Fraxel. Less popular.

  • ​​Palomar Icon™ is a system that also includes IPL as an additional treatment option. 

  • The ICON 1540 is more powerful than other lasers; it delivers more energy per micro-beam than competing lasers. This creates longer lasting results. 

  • Has built-in cooling system to make the treatment more comfortable and minimizes downtime.

Best Lasers for Deep Wrinkles

Choose an ablative laser if YOU NEED SH*T DONE. Think very deep wrinkles, very deep acne scars, burn scars, surgical scars, etc etc. These lasers generally require more downtime (~1-2 weeks), but you only need 1-2 treatments. And the results are generally fantastic. Because these lasers remove microscopic fractions of our epidermis (where our melanocytes live), these treatments are typically not suitable for skin of color. Two of the more popular ablative lasers include: 

CO2RE

CO2 Laser

  • tl;dr: No notes, 10/10, would recommend.

  • The CO2RE laser has different modes, customizable to your skin and desired downtime.

  • The "Light" mode can penetrate just 0.04mm into the epidermis, providing a light peel of epidermis with minimal downtime. 

  • In contrast, the "Deep" mode can penetrate 0.7mm into the dermis, perfect for wrinkles and scars.

Halo

Halo

  • tl;dr: ​A baby ablative laser. Well-liked by dermatologists. Halo is a good machine that needs better PR. It just needs one Kardashian to do an Instagram post to make it more popular. ​

  • Halo is the world's first hybrid laser! It's the only one on our list with both ablative and non-ablative wavelengths.

  • The wavelengths "stack" on top of each other to reduce downtime.

  • ​Halo provides "ablative results with non-ablative downtime."

    • AKA: great results with less downtime.

Risks and Safety

While rejuvenation lasers are generally safe when performed by a qualified dermatologist, they do carry some risks, including:

  • Temporary redness, swelling, or peeling

  • Hyperpigmentation or hypopigmentation

  • Scarring (rare, especially with proper care)

  • Infection (rare, with proper aftercare)

It’s important to follow all pre- and post-treatment instructions to minimize risks and achieve the best results. Always choose a board-certified dermatologist with experience in laser treatments.

Laser Resurfacing FAQ

Can I use hydroquinone before laser treatment?
Yes, hydroquinone is often prescribed before laser treatment to minimize the risk of post-inflammatory hyperpigmentation. However, it should be discontinued a few days before the procedure as directed by your doctor.

How can I speed up healing after CO2 laser?
To speed up healing after CO2 laser treatment:

  • Keep the skin clean and moisturized.

  • Apply prescribed ointments or creams.

  • Avoid sun exposure and use sunscreen.

  • Stay hydrated and eat a nutrient-rich diet.

  • Follow your doctor’s aftercare instructions closely.

How long after CO2 laser will I see results?
Results from CO2 laser treatment typically start to appear within 2-3 weeks as the skin heals. Full results, including improved texture and reduced wrinkles, can take 3-6 months to manifest.

Does laser treatment brighten skin?
Yes, laser treatments like fractional lasers and IPL (intense pulsed light) can brighten skin by reducing pigmentation, improving texture, and promoting collagen production.

What is Halo laser treatment?
Halo laser treatment is a hybrid fractional laser that combines ablative and non-ablative wavelengths to improve skin tone, texture, and appearance. It targets fine lines, discoloration, and enlarged pores while minimizing downtime compared to traditional lasers.

Does laser skin rejuvenation last for 12 months?
The effects of laser skin rejuvenation can last up to 12 months or longer, depending on the treatment type, skin condition, and maintenance routine. Following a good skincare regimen and sun protection can prolong results.

How much does laser resurfacing cost?
The cost of laser resurfacing varies depending on the type of laser, the treatment area, and location. On average, it ranges from $1,000 to $3,000 per session, with more intensive treatments costing up to $5,000.