What Can Aesthetic Lasers Do for Your Skin and How Do They Work?

Lasers for the skin are getting more popular every year—and with technological innovations and improvements in how they’re being used, they’re increasingly effective. But they’re also a broad category with many applications, from tattoo and hair removal to softening fine lines and treating redness. Different types need different regimens—how many treatments, how often—and some treatments that people call laser, such as Ultherapy, Thermage, and IPL, don’t use lasers at all. So how do you know where to get started? Here’s some guidance from experts.

“A laser is a highly focused beam of light. Different wavelengths target different things in the skin. That’s what makes lasers so versatile,” says Dr. Katie Beleznay, a dermatologist practising in Vancouver. “Different laser technology can be used to treat everything from rosacea and sun spots to acne scars and wrinkles. In simple terms, lasers either remove something we don’t want, such as broken blood vessels or sun spots, or stimulate the skin to repair itself.”

There are many laser brands, and it’s not that helpful to know their names, but understanding the categories they fall into can help when you’re thinking about a treatment. Ablative ones target the water in the skin’s surface. “They essentially destroy and remove the uppermost layers so that leads to resurfacing, meaning helping refine the texture of the skin,” explains Dr. Aegean Chan, a dermatologist and dermatopathologist in California. “I explain it to patients like they buff out fine lines. So that’s best for treating fine lines and sun damage, and can help with acne scars as well.”

Non-ablative lasers bypass the surface and work in the dermis—the middle level of skin. “They are commonly used for pigmentation, redness, and collagen stimulation with less downtime,” Beleznay explains. Removing tattoos and birthmarks such as port-wine stains are also the remit of non-ablative lasers.

Laser treatments come in both fractional and nonfractional varieties. The former have been around longer and are painful, with a significant risk of scarring and pigment loss. When fractional technology was introduced in the 2000s, it was a game-changer. “Instead of obliterating one whole patch of skin, light is sent in a grid-like fashion, so you really reduce downtime by causing little pinpoint areas of damage. You reduce the downtime, but you still get the effectiveness of the treatment,” Chan says.

Fractional non-ablative lasers might lead to redness afterward and a rough feeling for a day or two, but you can often head right back to work without your colleagues being the wiser. Since you’re targeting the surface of skin, expect more downtime from a fractional ablative laser (up to three weeks). And nonfractional ablative lasers are extremely painful, with many weeks of recovery, so they’re generally used only under specific circumstances (for example, under anaesthesia in combination with a face lift).

The number of sessions depends on what you’re treating and how, but unless you’re using a nonfractional ablative laser that effectively takes the outermost layer of your skin off, where one treatment is enough, three to six is generally about right. For something like tattoo removal, Chan says most people need six to 10 sessions to break up the dense pigment that’s been deposited deep in the skin.

These days, dermatologists will sometimes “layer” lasers. “Laser layering refers to combining different laser technologies, either in the same session or as part of a treatment plan, to address multiple concerns,” Beleznay explains. “For example, one laser may target redness, while another addresses pigmentation, and a third improves texture. The goal is to treat different issues and different depths of the skin in a complementary way.”

Lasers can deliver very noticeable results, but they’re not magic. “Certain types of pigmentation, significant skin laxity, and very deep scarring may not be fully corrected with lasers alone,” Beleznay says. Some also won’t work on all skin tones because they can’t easily distinguish between unwanted and normal skin pigment.

Results are also dependent on what you do afterward. If you’re addressing pigmentation, you need to avoid the sun and wear SPF sunscreen and a hat, or those freckles will come right back. This is so significant that Chan generally recommends doing those kinds of lasers in the fall. “Summer is not a great time to use laser to treat pigment. It’s a little bit like lighting money on fire.”

What matters most—the device, or who’s wielding it? “The clinic you visit, and the settings they use, and the person operating the device matter just as much. The best outcomes come from careful diagnosis, selecting the right technology for the patient’s skin and goals, and setting realistic expectations,” Beleznay says. “I usually recommend going to a practice that does all of these things and getting a 360 cosmetic evaluation,” Chan says. “That’s really how you’re going to get the best results. It works best when you as the patient have the most clarity on what your end goals are.”

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