You’ve heard of BIG DATA, but have you heard of BIG LASER? The world of dermatology has been revolutionized by laser technology, providing innovative solutions for a multitude of skin concerns. As a board-certified internal medicine physician, I’m working with lasers daily and with so many options including fractionated lasers, erbium Yag lasers, IPLs etc, it’s important to understand how each works and who might benefit the most. So, let’s dive in, shall we?
For the novice/scaredy cats:
YAG Lasers
YAG lasers, specifically the Nd, are versatile tools often used for deeper tissue treatments. This laser is effective for vascular lesions, hair removal, and tattoo removal. It penetrates the skin more deeply than many other lasers, making it suitable for patients with thicker skin or those seeking targeted interventions. The YAG laser can also be utilized in combination with other treatments for enhanced results, appealing to those looking for comprehensive skin rejuvenation.
Most people have heard about the now famous “Laser Facials” which are typically done with minimal downtime, and are very well tolerated by almost all skin types. These laser treatments are great for treating active acne, acne scars, overall skin rejuvenation, fine lines and also help promote collagen synthesis.
Prep: No real prep is needed except for stopping any exfoliating acids at least 3 days prior, sun exposure 2 weeks prior and retinols/retinoids a week prior to treatment.
Downtime: Minimal
Visible Results: Seen as early as the next day and continues to improve over the next 2 weeks
Neogen
Neogen is in a category by itself of plasma energy, which by producing plasma from nitrogen gas, it creates a controlled thermal or heat energy that when delivered precisely to the skin, creates an injury which stimulates a cascade of positive healing effects with neocollagenesis or new collagen production and targets multiple concerts at the same time, including skin tightening, wrinkles, lines, tightening the skin around the eyes and reducing sun damage. I particularly love this treatment for anyone who wants a non-surgical eye lift as we can create significant tightening with just one treatment and minimal downtime in a safe way.
Prep: Since the radiofrequency energy produced by neogen works best in hydrated skin it is crucial to prep by staying hydrated the week prior to neogen and using a hydrating sheet mask just prior to the treatment as well. Dehydrated skin can lead to increased healing and recovery times and undesirable outcomes. In our practice, I recommend using a hydrating sheet mask for 20 mins prior to numbing the skin before the treatment is performed.
Downtime: Can range from 3 days of mild peeling and flaking with low energy treatments up to 10-14 days of redness, and peeling with high energy treatments.
Visible Results: Seen in 2-3 months after the procedure with ongoing skin remodeling and collagen production up to 6-12 months post treatment.
BBL (BroadBand Light)
Don’t be misled by the acronym; BBL does not stand for Brazilian Butt Lift! Instead, BBL is a powerful tool for photorejuvenation. It uses high-intensity pulsed light to treat various skin conditions, including sun damage, pigmentation, and even acne. The technology works by delivering energy to the skin, effectively targeting pigments and stimulating collagen production. BBL is best for those with sun-damaged skin or uneven pigmentation, offering minimal downtime and versatile applications across various skin types.
Prep: I recommend avoiding sun exposure 2 weeks before treatment and at least 4 weeks post treatment as well. Avoid spray tans, retinols and retinoids at least a week prior to treatment.
Downtime: Minimal, mild redness and swelling for 24-48 hours post treatment.
Visible Results: Seen in 1-2 weeks with brighter and more even-toned skin, improvement in sun damage and skin redness.
IPL (Intense Pulsed Light)
Similar to BBL, IPL utilizes broad-spectrum light to address skin concerns like redness, rosacea, and age spots. It functions by emitting multiple wavelengths of light that are absorbed by the targeted areas of the skin. IPL is particularly effective for those dealing with vascular lesions and photodamage. It’s suitable for a wide range of skin types but is most effective on lighter skin tones, where the contrast between the pigment and surrounding skin is more pronounced.
Prep: Same as BBL
Downtime: Minimal redness and mild swelling for 24-48 hours
Visible Results: Seen in 1-2 weeks with more even skin tone and improvement in sun damage, brown spots and skin redness.
Moxy
Moxy is a relatively newer addition to the laser family, known for its gentle, fractional ablative capabilities. It helps with skin texture, tone, and pore size, making it an excellent option for individuals looking to improve overall skin quality without the extensive downtime associated with traditional lasers. Moxy is particularly advantageous for those who may have sensitive skin or are new to laser treatments, providing a balance between efficacy and comfort. What is unique for this laser in my opinion is the radiant clear skin you get with no downtime at all.
Prep: I recommend adequate skin hydration the week prior to the treatment, if there is melasma sometimes prepping the skin with a hydroquinone for 3-4 weeks prior is recommended based on the physician’s recommendations, stopping all Vitamin A derivatives like retinols, retinoids a week prior to the treatment and avoiding sun exposure for 2 weeks pre and post treatment.
Downtime: Minimal
Visible Results: As early as a week post treatment
Give Me The Works:
Fraxel Dual
The Fraxel Dual laser is renowned for its ability to treat both superficial and deeper skin issues. This fractional laser delivers microscopic beams of light to target damaged skin cells, promoting collagen production and skin renewal. Since it targets only microscopic fractions of tissue at a time, it leaves the surrounding tissue intact (hence the name “fractional” laser), promoting very rapid healing and less down time. It is my go-to treatment for acne scarring, surgical scars, sun damage, fine lines, deep wrinkles, and even actinic keratosis.
Prep: Skin hydration for a week leading up to the treatment, prep with hydroquinone if there is melasma, stopping retinols/retinoids a week prior to treatment, avoiding sun exposure for 3-4 weeks post treatment, and using a skin barrier cream like Alastin nectar or Avene Cicalfate.
Downtime: Depends on the treatment settings used, can range from 3-7 days of redness, mild swelling and skin peeling.
Visible Results: Seen in 2-4 weeks, with clearer and smoother skin at 4 weeks and improvement of wrinkles can continue up to 3 months post treatment as well.
Clear and Brilliant
The Clear & Brilliant which is a low-level laser variant of similar wavelengths as the fraxel laser, without the down-time focuses on enhancing skin tone and texture, making it ideal for individuals looking to improve mild pigmentation or early signs of aging without significant downtime. It is particularly suited for younger patients seeking preventive care or anyone wanting a subtle refresh.
Prep: Same as fraxel
Downtime: Minimal
Visible Results: Clearer and more radiant skin seen after 1-2 weeks
Full Field or Non-fractionated Lasers
Full field or non-fractionated lasers like the CO2 lasers treat the entire skin field and are ablative which means they vaporize tissue and are more aggressive, hence can produce more dramatic results but have more risks of side-effects and complications as well, and are generally provided under anesthesia.
I hope that understanding the differences between these laser technologies empowers you to make informed decisions about your own individual skin health journey.
Prep: Avoiding sun exposure for at least 2 weeks prior and a month post treatment, no retinols/retinoids a week prior to treatment and adequate hydration is necessary.
Downtime: Could range from 2 weeks to up to a month of redness, and peeling.
Visible Results: Seen after a month with tighter and brighter skin, improvement in deeper lines and wrinkles can take up to 3 months.
