Skin Laser Treatments Can Provide Powerful Results. But Are They Safe?

In the last decade or so, skin laser treatments have been growing in popularity. They’re touted to solve all kinds of skin woes. Medical spas often offer these treatments and some estheticians even do too. Your dermatologist probably even offers multiple types of laser treatments for face, neck, and other body parts. 

If you’ve seen pictures of someone after finishing a laser treatment, they can look… well, intense. But the results can be significant.

This probably has you wondering… 

→ What makes a good candidate for a laser treatment? Is this a good option for me? 
→ How risky is skin laser treatment? 
→ Could a skin laser treatment help me achieve the skin appearance or texture I’ve dreamed of? 

Spend a few minutes asking Dr. Google, and you’ll soon find – there’s an overwhelming amount of:

• Confusing terminology
• Conflicting information
• Widespread misinformation + misnomers

So how can you make an informed decision? 

At Primally Pure, we believe knowledge is power. 

That’s why we’re excited to bring you a wealth of information on facial lasers from our research and conversations with a highly–respected professional in the field. 

Without further ado, let’s dive in. 

What Is Skin Laser Treatment?

This practice uses a laser beam to address a variety of cosmetic concerns – some superficial and others deep-seated in the skin.

After researching skin laser treatments on our own, we had the pleasure of connecting with Dr. Chesnut again (we also interviewed him for our guide on fillers). Dr. Chesnut is highly trained in non-invasive cosmetic procedures but has very specific (and thorough) knowledge of the science of lasers. He gave us a great overview of how facial lasers work on the most basic level.

Here’s what we learned: 

All lasers work by having a target (chromophore). The laser beam hits that specific target and sends heat to a layer beneath the surface of the skin to address the target issue. Depending on the type of laser, sometimes the top layer of skin is targeted too.

How Do Skin Laser Treatments Work? 

Once the lasers are applied, the heat does two things: 

1. Changes gene expressions – This is a bit complicated, we’ll get into it more later. But essentially, it means that your genes are activated by a stress response to heal, regenerate, and restore aged tissue.
2. Creates collagen, elastin, and other crucial skin components through controlled wound healing responses.

Dr. Chesnut highlighted a critical point here. For the most effective laser treatment, the laser used should be specific to the chromophore (skin issue) you hope to change. 

Here’s why: Different wavelengths have different targets. 

So different lasers have different purposes.

This is why skin laser treatments have become so popular: lasers can address very specific issues instead of treatments like microneeedling that cause widespread damage and hope for healing.

What Can Facial Lasers Do for the Skin?

Most often, skin laser treatments are used for concerns like:

• Pigmentation 
• Scar treatment
• Wrinkles 
• Veins
• Skin texture
• Sun damage
• Hair removal

These aren’t the only things a laser treatment can do, but they are the main uses for facial lasers.

Types of Facial Lasers 

You might hear about a number of different lasers used on the face. There’s an array of targeting methods and purposes that go with each. 

The terminology can get confusing really quickly, but don’t stress. The biggest piece of advice that helped us: Ignore brand names. It’s far more helpful to understand the types of lasers available.

(Dr. Chesnut pointed out that brand names usually have little to do with the actual technology.) 

With the help of Dr. Chesnut, we were able to pin down and clarify the main words you need to understand to make an informed decision.

Ablative Facial Lasers

Webster's definition of ablating is: to remove or destroy, especially by cutting, abrading, or evaporating.¹  

Ablative facial lasers vaporize their “target” (AKA the tissue) immediately. Ablative lasers are considered a more intense laser option because they affect the outer and inner layers of your skin. 

Ablative lasers are considered the best for resurfacing the skin or addressing age-related wrinkles. Dr. Chesnut says ablative lasers require more downtime but are the most effective. 

Examples of ablative lasers: CO2 & erbium YAG (or er:YAG)

Non-ablative Lasers

Non-ablative facial lasers don’t create enough heat to vaporize the skin. They’re generally a more gentle treatment, but arguably less effective. 

Non-ablative lasers pass through the epidermal (outer layer of the skin). They send heat directly to the dermal layer (inner layer of the skin). The heat activates fibroblasts in your skin. Fibroblasts are cells that support the skin’s structure and create elastin and collagen in response to the controlled wound.²  

Dr. Chesnut went even further to explain how lasers work on a microscopic level. It’s pretty fascinating! 

A second, little-known component of the controlled wound response is something called heat shock proteins. These proteins are always present in your skin but respond to heat by essentially resetting your genes’ stress response.³ AKA how your skin responds to aging factors. 

According to Dr. Chesnut, all non-ablative lasers tend to fall in the temperature range of 40-100 celsius. And 100 is the vaporizing threshold for your skin. So that gives us some context for the strength of an ablative laser vs. a non-ablative laser. 

Examples of non-ablative lasers: Nd:YAG, Erbium Glass, Diode, Pulsed Dye (PDL), KTP, Ruby, Alexandrite, and more.

Photo Facials: Skin Treatments Often Confused With Lasers

Photo facials include treatments like BBL (broadband light), IPL, and LED.

They often get lumped into the laser category, but photo facials are not really lasers since they contain more than one wavelength of light. However, some of the results can be similar.

We love how Dr. Chesnut explained the difference in these treatments:

“They’re not a laser – it’s a broader wavelength of light. Not one fixed wavelength. These treatments deliver wavelengths of light that can hit multiple chromophores (multiple targets in the skin) and induce a heat change to cause a response.” 

He summed it up by saying they’re the jack of all trades, master of none.

Photo facials could be considered a “less invasive” alternative to lasers because they:

• Can cause small changes with a number of targeted concerns. 
• Are minimally invasive – but may be less effective in general since they’re considered a very mild treatment. Dr. Chesnut remarks that in his opinion, it can often be quite “hand-wavy” and hard to tell the difference.

So whether or not a photo facial will get the job done widely depends on the context of the situation and the issues you hope to resolve.

A Subcategory: Fractional vs. Non-Fractional

This is one of the more confusing terms you’ll come across when researching lasers. It’s basically a subcategory that tells you how the laser is applied to the skin – fully or partially. 

Here’s how Dr. Chesnut laid it out: 

“When you take a laser beam and make it fractional, it pixelates (fractions) how the energy is delivered. We can then better manipulate how energy is delivered to tissue. Density, width, depth – there are far more parameters to manipulate for customized results.” 

Fractional lasers are generally regarded as safer, especially if it’s an ablative facial laser because the controlled wound is more targeted. Regardless, always be sure the professional knows what they are doing and that they’re highly trained.

Deceptive Marketing Terms

Here are a few confusing terms you should generally disregard. 

• Cool lasers –  All lasers function on heat. Weaker lasers create less heat, and may be deemed “cool”. They might also have a cooling numbing agent before or after.

When we asked Dr. Chesnut about this, he helped bring clarity:

“Some lasers create both heat and sound, called a photoacoustic effect – When the energy gets delivered to the skin, it has to convert to something else. When [a laser] converts to sound instead of heat, it can be preferred for skin conditions that are highly reactive to heat, like melasma. It takes the right provider to know which devices are safe in these situations.”

• Laser peel – Also a misnomer. When we asked Dr. Chesnut about laser peels, this was his response: 

“All lasers in some sense can make you peel. You could make someone peel with any laser depending on how much heat you deliver to the skin. They’re being compared to chemical peels that treat the whole surface of the skin. Lasers are so much more specific to the type of injury we cause – the width, depth, and other parameters.”

The take-home point: Ask your provider about the TYPE of laser, not the names. Then you fully understand what the treatment will do + the intensity. Brand names just create confusion and don’t tell you anything about the treatment.   

The Benefits of Skin Laser Treatments

It’s not surprising that there’s a long list of potential skin laser benefits. But remember each laser provides different benefits. It’s best to consult a professional for your specific concern if you decide to move forward. If your provider says that their one laser does many of these at the same time, RUN!

Here are the most common benefits of facial laser treatments:

→ Improved skin texture (tighter, plumper, fewer scars or textured surfaces)
→ More even skin tone (less redness, pigmentation, sun spots)
→ Youthful appearance (fewer wrinkles, less crepiness, tighter skin, more collagen and elastin)
→ Long-term results (in some cases it’s a quicker fix and a more permanent solution)
→ Decrease in facial redness and blood vessels – a very specific laser and chromophore (red blood cells)

Of course, these skin laser benefits might make facial lasers seem like a magical answer to all your skin woes. But we don’t want to mislead you. There are significant risks that could come with skin laser treatments done incorrectly.

Possible Skin Laser Treatment Side Effects

It’s possible to have a skin laser treatment and not experience significant side effects. Whether you have intense side effects depends on two critical things:

1. The type of facial laser used 
2. The person behind the laser tool 

Here are some of the most common skin laser treatment side effects:

• Sunburn-like feeling/look (redness + swelling)
• Scabs may form as your skin recovers
• Prolonged crusting/oozing of the skin with side effects lingering for 1-2 weeks (caused by more powerful lasers)
• Sandpaper-like texture for five days afterward (or longer, in some cases)⁴
• Bleached spots and scarring (specifically a concern with non-fractional CO2 lasers)
• Itching and general discomfort during your healing 
• Infection, skin color changes, burns, or scarring are possible⁵  
• Patchwork look (done incorrectly, a fractioned laser could make your skin appear this way)⁶
• Rebound post-inflammatory hyperpigmentation can be caused in some rare cases⁴
• Oral herpes may become activated⁴

The bottom line: It’s important to have only a licensed professional administer facial lasers. If the person is not highly trained, it might be done imprecisely or you may experience severe side effects.

Things You Should Know Before a Laser Treatment

There are a few things you should be aware of if you’re considering laser treatment. These things could affect your decision – or even just the timing. 

→ Don’t get a laser skin treatment after a tan. It could cause hyperpigmentation/uneven skin tone. Winter is probably your best bet because you’re less exposed to the sun.

→ Don’t get a laser treatment if you’re pregnant, breastfeeding (especially the first 6 months), or currently have an infection or illness.

→ Tell your doctor if you have a history of any healing-related issues. This includes cold sores, staph infections, poor scarring, autoimmunity, or anything that might affect your healing.⁵ 

→ Know there are no guarantees. Every skin type will react differently to lasers. Ultimately this means your results may vary from someone else's.⁷

FAQs about Skin Laser Treatments

Let’s address the most frequent questions about skin laser treatments:

❔ Is “At-Home” Lasering a Thing?

No. You’ll find “at-home lasers” occasionally, but they are simply LED light products, not lasers. And if you do find an “at-home” laser product, please just don’t. Even if it seems legit. Lasers are very powerful and potentially dangerous tools that can cause permanent damage.

❔ Is Red Light Therapy the Same Thing as Lasers?

Dr. Chesnut’s answer:

“Not at all. Red light does directly interact with the fibroblasts in your cells to change how the skin functions. But it’s a significantly smaller change in comparison to the injury response lasers stimulate.”

Personally,. we can't deny the benefits of red light therapy for full-body health. (We don't think he would either, considering he uses red light in an infrared sauna every day!) With consistent use over time, there will be a marked improvement in your skin health. 

❔ Should I Get a Laser Treatment as a Preventative for Aging?

You could use it for anti-aging but it isn’t necessary. We love Dr. Chesnut’s honest approach.

“Anyone in their late 20s into early 30s has something that could improve with laser resurfacing. Just because you can doesn’t mean you should. But if there’s something extreme that bothers you, [lasers are] a simple solution that takes very little input.” 

❔ Can I Get More Than One Laser Treatment for Different Issues?

Lasers can definitely be overdone, so be careful. 

But yes, many practitioners will offer a “combo” laser treatment. Dr. Chesnut lovingly calls his laser cocktail protocol lasers 3.0 because he combines progressive regenerative medicine with the use of specific, focused, and safe laser treatment.

❔ Do Lasers Give You the Same Results as Microneedling?

Though both create tiny microscopic “holes” in the skin to stimulate the skin’s natural healing response, that’s about where the similarities end. When we asked Dr. Chesnut, here’s what he said:

Bonus: For more on microneedling, check out this post.

❔ Do Lasers Melt Fillers? 

Nope. This has been disproven by respected plastic surgeon Dr. Julius Few. In theory, lasers are safe with fillers – when used responsibly.

Bonus: For more information on fillers, check out this post.

Which Facial Laser Treatment Is the Best for You?

Even with all this information, choosing between skin laser treatments is a big deal. This is why we recommend letting a highly-trained, certified professional make the call if you decide to get a skin laser treatment.

Dr. Chesnut had some great advice on this: don’t choose the device – choose the provider. You want a highly-trained provider who has a variety of options at their fingertips. That way you know you’ll get a customized result instead of being convinced you need the one laser they have. 

Because as Dr. Chesnut pointed out, marketing tells you that whatever device they have is exactly what you need (convenient for them, right?).

Picking the wrong provider could come with serious consequences. Dr. Chesnut has seen it first-hand and manages these types of complications often.

“Someone new to it could do some serious damage with a strong laser. There are definitely concerns of safety with certain lasers in certain people’s hands. Generally, people think of this in the ablative realm, but I see plenty of laser complications from nonablative lasers, or specifically now, from radio-frequency microneedling devices.” 

– Dr. Chesnut

It Depends on Your Skin Issues + Goals

BBL and IPL (even though they aren’t technically lasers) are really good for red and brown spots in the skin, melasma, rosacea, and acne scars.⁸

Ablative lasers are more of an overhaul for total rejuvenation. They should probably be saved for more intense, persistent situations.

Your Decision May Depend on Personal Factors 

You’ll also have to consider your budget, time commitment, and comfort level with invasive skin procedures. 

→ Ablative facial laser treatments will be more of a “one and done” treatment, whereas most non-ablative treatments require 5-6 sessions.

It’s important to remember that lasers create change with a wound healing response. You have to heal. That’s why Dr. Chesnut personally believes in bigger treatments one time – get it done, get it over with. 

And speaking of personal beliefs, it might be that you don’t feel comfortable inflicting wounds on your skin. Even if the end goal is healing. And that’s perfectly okay. 

Sensitive or reactive skin could be enough reason to say no. At the end of the day, it’s your choice.

Making the Final Decision

Wow, what a journey, right? The world of lasers is vast and complex. And while it’s a fascinating technology, it’s ultimately a nuanced field with many factors to consider. 

The context, goals, and available options are important, but in the end, it’s a very personal decision. There are so many factors at play, which you’ll need to weigh yourself. 

Here's what we can distill from our research: If you're seeking laser skin treatments, you want to do so to target a specific issue.

Concerns like sun damage, pigmentation, or scarring can be very hard to resolve. Laser skin treatments are very specific in the way that they can target damaged skin. So if you’re considering a skin laser treatment, approach it from the mindset of targeting a specific issue as a one-time thing (or a few times) over the course of your lifetime. 

While we generally don’t agree with procedures that change or inject foreign materials into the structure of the face, laser treatment has some undeniable benefits that may feel appropriate for your situation.  Used responsibly, lasers can improve the health of the skin by fixing the damage.

Let us know what you think about skin laser treatments in the comments, or share your own laser experience! 

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Sources:

1. Merriam-Webster | Ablating Definition & Meaning 
2. National Human Genome Research Institute
3. Science Direct | Heat Shock Proteins 
4. RealSelf | Moxie Laser: What You Need to Know
5. Skin Tour | Ultimate Guide to Laser Treatments
6. The Art of Being Well With Dr. Will Cole | Dr. Julius Few: The Best Non-Invasive Skincare Secrets From The World’s Leading Plastic Surgeon  
7. Dr. Bucky Plastic Surgery | A Guide to Laser Treatments
8. The Human Upgrade with David Asprey | Face Aging with the Science of Beauty – Rachel Varga

 

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