Demystifying Laser Resurfacing: A Guide to Your Options
Ablative, non-ablative, fractional, hybrid… with so many laser terminologies on the market, how do you choose the right one? In this guide, Dr. Contreras demystifies the science behind laser resurfacing. Learn how modern devices like the Sciton HALO and ProFractional allow us to customize treatments for wrinkles, pigment, and texture with significantly reduced downtime compared to the lasers of the past.
Key Takeaways
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Modern Safety: Laser technology has advanced significantly since the 1980s; risks like pigment loss are now rare, and healing times are faster.
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Ablative vs. Non-Ablative: Ablative lasers vaporize tissue for dramatic results (requiring more downtime), while Non-Ablative lasers heat tissue to stimulate collagen with minimal recovery (requiring multiple sessions).
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Fractional Technology: By treating only “columns” of skin rather than the entire surface, fractional lasers speed up healing while still effectively targeting deep lines and collagen production.
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Customization is Key: At Core Dermatology, we don’t use a “one size fits all” approach. We often combine different lasers, such as fully ablative for deep mouth lines and HALO for the neck, in a single session to match your specific needs.
Laser resurfacing has been refined significantly since it was first introduced. Early problems such as pigment loss in the treated areas are nearly unheard of these days. The way that laser energy is delivered to the skin with modern devices allows for excellent clinical results with decreased healing time and overall decreased risks.
Laser resurfacing is categorized in different ways, and to someone not familiar with the different options, it can be confusing and overwhelming. Adding to the confusion is the fact that there are many different laser manufacturers, each of them marketing their particular device as “the best” for wrinkles, pigment, sun damage, etc. I want to try to simplify this by reviewing the basic categories of laser resurfacing. Remember that each category will have many different devices on the market, all with similar functions. This review should help you to narrow down your options when deciding on a laser resurfacing procedure.
Ablative vs. Non-Ablative Laser Resurfacing
The first categories to review are ablative versus non-ablative laser resurfacing.
Ablative laser resurfacing of the face for sun damage and aging was first performed with a Carbon Dioxide (CO2) laser in 1989. The target of ablative lasers is water contained in the skin; when heated by laser energy, the skin tissue is vaporized and removed from the skin surface. A wound healing response is initiated by the body to replace the lost tissue with new collagen, elastin, and skin cells. In this way, textural abnormalities, wrinkles, and pigment can be erased. However, the treatment goals must be balanced by the risk of scarring, which was more common with the original devices and with more aggressive treatment settings.
Non-ablative laser resurfacing was first introduced under the name “Fraxel” laser which came out in the early 2000’s. It was developed to provide a way to improve tone, texture, and wrinkles with minimal downtime. “Non-ablative” refers to the fact that there is no vaporization of the skin tissue. Instead, the laser energy heats the skin and creates columns of coagulated tissue called microscopic treatment zones (MTZs). Only a fraction of the skin surface is treated with each session; therefore, multiple sessions (average of 5) are required for maximal improvement. The advantage is short recovery time, usually 3-5 days of moderate erythema and swelling, but without oozing or crusting.
Fully Ablative vs. Fractional Laser Resurfacing
The next category to review is fully ablative versus fractional laser resurfacing (Figure 1).
Fully ablative resurfacing removes the entire top surface of the skin to a depth determined by the settings chosen by the physician. Healing time increases with the depth of treatment. Superficial depth treatments, helpful for fine textural changes and pigment, are called “microlaser peels” and heal within a few days. Deeper treatments, particularly helpful for etched in lines around the mouth, take up to 2 weeks to heal.
Ablative fractional resurfacing was developed to improve healing time and minimize risks of scarring and pigment alteration. Columns of tissue are vaporized, often to depths greater than can be achieved safely with fully ablative lasers. Vaporized columns are quickly healed by the surrounding unaffected tissue. New collagen and elastin deposition and elimination of pigment in these columns contribute to the cosmetic result of decreased lines, diminished texture, and improved tone. Because only a fraction of the surface is treated each time, a series of 3-5 treatments is required for maximal improvement.
Advanced Technology at Core Dermatology
Core Dermatology provides patients with a full array of laser resurfacing options in all of the categories reviewed in this blog post. (See below)
- Sciton Fully ablative Erbium resurfacing (TRL)
- Ablative fractional Erbium resurfacing (ProFractional)
- HALO hybrid fractional resurfacing
- Erbium Microlaser Peel
Learn more about the laser resurfacing options available at Core.
Customized Combination Treatments
Often, laser resurfacing devices are combined in the same treatment session depending on specific patient needs. For example, a single treatment session could consist of the following:
- Erbium fully ablative resurfacing around the mouth and eyes for etched in lines.
- Erbium fractional resurfacing for the rest of the face.
- HALO hybrid fractional resurfacing on the neck and chest.
- Microlaser peel on the top of the hands.
Whatever your particular treatment goals are, Dr. Contreras posesses the knowledge and technology to help you achieve them. Call our team at Core Dermatology in Denver, Colorado near Cherry Creek to schedule your laser resurfacing consultation. 303-355-3000, extension 3.
Dr. Michael Contreras, MD, FAAD
Are you looking to improve the appearance of your skin? Are you searching for a dermatologist with almost 20 years of aesthetic treatment expertise? At Core Dermatology, patients can feel confident in knowing they are receiving the utmost care from a board-certified dermatologist, Dr. Michael Contreras. From Fort Collins to Colorado Springs, Dr. Contreras’ focus on tried-and-true technologies delivers consistent results for most patients throughout the Denver, Colorado region. From wrinkle relaxers (such as Botox and Dysport) and injectable fillers, to lasers for sun damage, scarring, and wrinkles, Dr. Contreras works one-on-one with the patient, counseling them on the most reliable and effective options for targeting specific concerns or improving overall skin appearance.
Known for his down-to-earth approach and gentle humor, Dr. Contreras has built his reputation on effectively treating patients on their specific needs, and skill using an array of injectable products and laser devices. This has allowed him to create proven plans and treatment options most appropriate for your individual needs.
Learn More About Dr. Contreras
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