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Everything to Know About Skin Lasers

They can treat just about everything—but some caution is advised

As soon as the leaves turn, “it’s the season for lasers,” says Dr. Renita Ahluwalia, lead dermatologist at the Canadian Dermatology Centre in Toronto. That’s because many lasers don’t play well with sun exposure, so patients are advised to avoid the rays before and after every session. 

In the last 20 years or so, lasers have become mainstays in dermatology clinics due to their ability tackle everything from broken blood vessels and unwanted pigmentation to skin laxity and acne scars. But with so many on the market—and with most having names that sound like sci-fi heroes: Starwalker, Morpheus8, Sylfirm X—figuring which one is best suited to your needs can get pretty confusing. Here, two top dermatologists help shed some, um, light on the topic.

First things first, what exactly are skin lasers?

Lasers are part of a broader category of dermatology tools called energy-based devices, which, as their name suggests, utilize energy to perform an action on the skin. Other examples of energy-based devices include light therapy (like IPL and LED, for example), ultrasounds and radio-frequency. These are highly sophisticated machines that can cost tens of thousands of dollars. But as Dr. Julia Carroll of Toronto’s Compass Dermatology points out, the machine is only one part of it. “The device is important but the crucial element is having a dermatologist make the recommendation for the correct procedure and having a highly skilled laser aesthetician perform it.” When not performed properly, these procedures can present serious risks such as burns, scarring and changes in skin pigmentation. “Lasers are an unregulated technology, which means anybody can buy a laser and start doing treatments,” says Ahluwalia. That’s why you always want to make sure to do your research and choose a clinic with experience and a good reputation.

How do lasers work?

It depends on the laser. There are ablative lasers, which resurface skin by removing its top layer. These lasers can help treat tone, texture as well as fine lines and wrinkles. They’re considered to be very effective, but often involve more downtime and a higher price tag. They’re also mostly recommended for patients with lighter complexions as there could be a risk of hyperpigmentation in darker skin tones, explains Ahluwalia. Next you have non-ablative lasers, which work by heating up the underlying skin tissue. Though these treatments are associated with less downtime, more sessions are usually required to achieve significant results. Then there’s intense pulsed light (IPL) and broadband light (BBL), which are actually not technically lasers, but grouped in that broader energy-based device category. They emit short blasts of light and can be useful for a wide array of concerns. Downtimes tend to be minimal, but several sessions are needed to obtain considerable improvements. 

What are the best lasers for dark spots and evening out skin’s tone?

“Lasers can be used to target pigmentation issues by emitting specific wavelengths of light that are absorbed by pigments in the skin,” Carroll explains. “This can cause the pigment to break down, which can help to improve the appearance of dark spots, sun damage and scars.” There are many different devices that can accomplish this. IPL and BBL, which can target both brown and red pigments in the skin, can be a good first-step treatment, says Ahluwalia. Another option would be fractional lasers, which work by breaking up a single laser beam into thousands of tiny beams of light. They exfoliate skin’s surface, basically offering a laser peel. (Carroll is a fan of the Halo, which delivers both ablative and non-ablative wavelengths, while Ahluwalia’s go-to is the Secret Pro, which can be used for a wide range of treatments including fractional and ablative lasers and radio-frequency micro-needling.)  

Even though patients can get great results with these kinds of therapies, the thing about hyperpigmentation is that the pigment always wants to come back, even with minimal sun exposure. That’s especially true of melasma, says Ahluwalia. This is why a good regimen that incorporates sunscreen, retinol and antioxidants is crucial along with regular touchup treatments in a dermatologist’s office.

 

 
 
 
 
 
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What are the best lasers for skin firming?

“As we age, our body’s natural collagen production slows down,” says Carroll. “This in turn can cause our skin to become loose and saggy.” That’s where energy-based devices can come in, heating up the deeper layers of skin to stimulate collagen and improve tightness and elasticity. Carroll and Ahluwalia both cite ultrasound tightening (ex: Ulthera) and radio-frequency micro-needling (ex: Sylfirm X or Secret Pro) as two excellent, non-invasive treatment options, which can also be combined for even better results. Such devices can also help soften fine lines and wrinkles, making them a good alternative for those looking to avoid needles.

What are the best lasers for acne?

Energy-based devices can help treat acne by killing the bacteria that causes it in the first place as well as reducing inflammation and promoting the healing of the skin. “There are different types of energy-based devices that can be used for acne treatment, including broadband light and blue light,” says Carroll. Another laser that’s recently been cleared in Canada for treating acne is Aviclear, which works by targeting sebaceous glands. “We know that overproduction of sebum from the sebaceous gland is a big mechanism of action for acne, so by specifically targeting that we’re seeing a long lasting decrease in patients’ acne,” says Ahluwalia. This can be an effective option for patients who don’t want to be on systemic medications like Accutane, she adds.

 

 
 
 
 
 
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What are the best lasers for skin redness and broken capillaries?

Lasers can be used to treat these concerns by emitting specific wavelengths of light that are absorbed by the red blood cells in the capillaries. “This can cause the capillaries to break down and be absorbed by the body, which can help to improve the appearance of redness and broken capillaries,” says Carroll. The energy-based device best suited for this will depend on each patient’s skin type and concerns, but popular options include BBL and pulsed-dye lasers like VBeam. “Radio-frequency micro-needling is also a good option because it targets the basement membrane to strengthen it, which helps to treat blood vessels and redness,” says Carroll.

Last words of advice?

“Everybody’s skin is different and every individual has different concerns about what bothers them, so the best approach is to speak with someone who knows skin, who knows skin types and who knows these devices to make a completely customizable plan for you,” says Ahluwalia. Also very important, says Carroll, is following your dermatologist’s pre- and post-care instructions to a tee. “This will minimize any potential risks and ensure the best possible results.”

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