Your Essential Guide to Anti-Aging Lasers
Doctor’s Note
When deciding which laser is best for your particular skin, there's many options and a confusing world of laser terms, brand names, wavelengths, downtime, etc. We've tried to break down the most popular laser treatments available to help you sift through this information. Click to your right, or skim the highlights below!
What is a Laser?
A laser is a device that produces a focused light beam of a particular wavelength. When we beam these wavelengths into skin, they predictably penetrate to certain depths.
For example, we use a laser with a wavelength of 755nm ("nanometers") for laser hair removal, as it penetrates to the level of the hair root. This injures the hair bulb so it cannot function anymore. And *poof* no more hair!
That is the extent of the physics today! Pheww! All you need to know is: lasers have different wavelengths can penetrate to different levels of skin. Done!
Lasers + Anatomy
The lasers we'll discuss today are all "fractionated," meaning the laser beam divides into thousands of tiny, minuscule beams to treat only a fraction of the skin in the targeted area. This triggers the body’s natural healing process to promote the growth of new collagen. By leaving the surrounding tissue untouched, fractionated lasers allows for faster healing and reduces the risk of side effects.
Fractionated lasers come in two flavors: non-ablative and ablative:
Non-Ablative Laser
Let’s take a look at a non-ablative 🔥 laser in action. Notice how the skin reddens. It is being heated in microscopic columns by the laser. This patient is awake and alert, likely with some topical numbing cream. This recovery will be <1 day.
Ablative Laser
Now, let’s compare to an ablative laser. As you can, this laser is MUCH stronger. You can see smoke as the skin vaporizes away. You can also see the skin “shrink” with each pulse, as it is removing small microscopic columns of skin. This patient has strong numbing medication +/- sedation. Recovery will be ~2 weeks.
While we learn, let's use red font for non-ablative lasers, because it means heat! 🔥
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.
WARNING: OPINIONS INCOMING
Want to know what dermatologists *really* think about lasers? Asked and answered! Introducing "Noted Opinions," where only verified Board-Certified Dermatologists say what they *really* think about these devices with the strict condition of anonymity. All have verified credentials. Remember, these are OPINIONS only. Let's go!
Non-Ablative Lasers 🔥
Unlike ablative lasers that remove the top layer of skin, non-ablative lasers heat deeper layers of skin while leaving the epidermis intact. This results in minimal downtime, typically involving only mild redness or swelling for a few days. However, ~3 - 6 sessions are often required to achieve the desired outcome. These lasers are great for general texture, pores, pigment, and anti-aging concerns. Due to their gentle nature, non-ablative lasers are safe for all skin tones.
Clear + Brilliant
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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"
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Love clear and brilliant for sun damage.
Great for sun spots.
I like LaseMD or Clear&Brilliant for the chest in particular.
I use LaseMD or Clear&Brilliant (and topicals + sunscreen) for post-inflammatory hyperpigmentation. Works well.
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Clear&Brilliant is a great laser if you have relatively little damage or would like a regular preventative laser treatments.
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Halo
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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.
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I don’t know why Halo never became that popular. I like it. You need several sessions, but it gives good results.
Very safe machine. Helpful for fine lines, maintenance, etc. But it will not give deep ablative results.
I see a lot of swelling from Halo.
Safer than IPL.
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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.
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No one! Look at how many celebs post/talk about Fraxel or Clear&Brilliant! (Both Fraxel and C&B have the same parent company, Solta 🧐)
Clear + Brilliant Permea
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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.
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Solid handpiece. Easy to use. Patients like it.
We like Clear&Brilliant Permea or LaseMD for hyperpigmentation.
Great for melasma.
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Clear&Brilliant Permea is the most superficial of the lasers, making it perfect for addressing pigment concerns without unnecessary downtime. The most similar competitor is LaseMD (see below).
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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).
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Great for chest. We use laughing gas for comfort, though.
I’ve had great results for treating self-harm scars on forearms.
I like Fraxel and gentle ablative lasers for texture and large pores.
Fraxel is better than microneedling for stretch marks.
Love it. My desert island laser.
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The workhorse of dermatology lasers. A great machine. Many uses. We love Fraxel.
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LaseMD
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LaseMD uses shallow beams of energy to enhance the permeability of the skin.
The makers of LaseMD also make topicals designed to be used with the laser:
Vitamin C to build collagen
Tranexamic acid to brighten
Retinol for anti-aging
Resveratrol to repair
Very similar concept to the Clear and Brilliant Permea laser (see above!).
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Love LaseMD for superficial concerns.
I like LaseMD or Clear&Brilliant for the chest in particular.
I use LaseMD or Clear&Brilliant (and topicals + sunscreen) for post-inflammatory hyperpigmentation. Works well.
Not as aggressive as Fraxel but produces great results with little downtime.
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A superficial laser most effective for pigment concerns. The most similar competitor is Clear&Brilliant Permea (see above).
Fraxel Dual
Icon 1540
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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.
FDA-approved for stretch marks!
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I like the Palomar 1540 but you need the right settings.
I prefer Fraxel or Halo.
We didn’t see results with the 1540.
Underwhelming.
I like it for improving texture.
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The Icon 1540 generated mixed/leaning negative reviews from our dermatologist sampling.
Ablative Lasers
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
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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.
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Works well for deep scars. Best if performed every 4 weeks x 6 months.
I love CO2RE. It does everything: wrinkles, acne scars, surgical scars.
Good design. Easy interface.
Fraxel and CO2RE are my favorites.
I use CO2RE for deep scarring, fine lines, tone, and texture. It's great.
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No notes, 10/10, would recommend.
UltraPulse
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HEAVY DUTY
Requires an experienced operator
It is known for its DEEP penetration (4mm!!), making it effective for more severe scars, including burn scars.
It can also handle lighter work with a quick adjustment of the settings.
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Very versatile and reliable. It does everything I need.
Many patients want fractional and low downtime but the ablative results are much better.
Can back off the settings easily to have little downtime.
I love my UltraPulse. It has so many uses. Great for scars.
Ultrapulse is excellent.
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The deepest laser. Great for severe scars. Need an experienced operator.
Laser Resurfacing FAQ
Is Morpheus8 Fractional Laser Resurfacing?
No, Morpheus8 is not a fractional laser resurfacing treatment. Instead, it combines microneedling with radiofrequency energy to target deeper layers of the skin, improving texture, reducing wrinkles, and tightening the skin without the use of laser technology.
How Much Does CO2 Laser Cost?
The cost of CO2 laser treatment can range from $1,000 to $3,000 per session, depending on the provider, the area being treated, and the specific type of CO2 laser used.
What Is Laser Resurfacing?
Laser resurfacing is a cosmetic procedure that uses lasers to improve the appearance of the skin. It can reduce wrinkles, scars, and sun damage by removing the outer layers of skin and stimulating collagen production.
How Much Is CO2 Laser Treatment?
CO2 laser treatment typically costs between $1,000 and $3,000 per session, depending on the area being treated and the provider’s location.
How Can I Speed Up Healing After CO2 Laser?
To speed up healing after CO2 laser treatment, keep your skin moisturized, avoid sun exposure, and follow your provider’s aftercare instructions. Using gentle, non-irritating skincare products can also help.
How Does a CO2 Laser Work?
A CO2 laser works by emitting a concentrated beam of light that removes the outer layers of damaged skin. This stimulates the body’s natural healing process and encourages new, healthy skin to grow.
How Long After CO2 Laser Will I See Results?
You can start seeing results from a CO2 laser treatment within a few weeks, but full results may take 3 to 6 months to become apparent as the skin continues to heal and regenerate.
What to Avoid After Laser Treatment on Face?
After a laser treatment on your face, avoid sun exposure, harsh skincare products, and activities that cause excessive sweating. It’s also important not to pick or scratch at the treated area to prevent scarring.
How Long Does Laser Resurfacing Last?
The effects of laser resurfacing can last several years, depending on factors like your skin type, the type of laser used, and how well you care for your skin afterward. Sun protection and a good skincare routine can help maintain the results.
How Long Does CO2 Laser Last?
The results of a CO2 laser treatment can last several years, but this varies depending on factors like sun exposure, aging, and skincare habits. Maintenance treatments may be needed to prolong the effects.
Is CO2 Laser Worth It?
CO2 laser treatments can be worth it for people looking to improve deep wrinkles, scars, and significant sun damage. However, it requires downtime and can be more expensive than other treatments, so it’s important to weigh the benefits and costs.
How Much Is Laser Skin Resurfacing?
Laser skin resurfacing can cost anywhere from $500 to $3,500 per session, depending on the type of laser used, the size of the area treated, and the provider’s location.
What Is Skin Rejuvenation?
Skin rejuvenation refers to treatments that improve the appearance of the skin by reducing signs of aging, such as wrinkles, fine lines, and pigmentation. Laser treatments, chemical peels, and microneedling are all examples of skin rejuvenation procedures.