A Guide To Laser Skin Resurfacing And Other Laser-esque Anti Aging Treatments

Anti aging, pro aging, whatever you want to call it, by the time you reach your 40’s and beyond, you’re looking to turn back the clock. A lifetime of sun exposure, sleep deprivation, and nights that make up the best of memories have started to take their toll and many of us are turning to the billion dollar cosmedical industry to help us regain our youthful-looking skin.

There’s no shortage of skin care products and cosmetic procedure options to slow down the aging process, from chemical peels to more invasive procedures, but laser technology may be the fountain of youth.

As we age, wrinkles appear due to loss of collagen and fat, and loss of skin elasticity leads to loose skin. Laser skin treatments may be the best way to lift, tighten and smooth aging skin. But which one should you choose?

There doesn’t seem to be a clear cut answer and your choice of laser should be driven by what correction you’re looking for, your pain tolerance, your budget, and recovery period you have available.

And of course, a doctor is the only one who can assess your medical history to determine if you are a good candidate for any laser procedure.

How Laser Skin Resurfacing Works 

Laser skin resurfacing works by pushing tiny laser pinpoints into the skin tissue in a dot pattern to create an injury. The healthy tissue, not touched by the laser, around this injury helps speed up recovery and supports the healing process. The energy from the laser targets water in your skin and then heats this water to a certain temperature. As the skin heals, you’re left with smoother skin.

Cosmetic lasers fall into two major categories: ablative and non-ablative.

Depending on the temperature, either skin coagulation or ablation occurs. Coagulation happens at lower temperatures and is the equivalent to slight damage or disruption in the skin. Ablation happens at hotter temperatures where vaporization of the outer layer of skin occurs.  

Ablative lasers such as CO2 and Erbium are more invasive, but produce the best clinical results. They work by vaporizing and actually removing the outer layers of the skin. This process causes the skin to heal and restructure, and increases collagen production. Vaporization of the tissue is better for thick skin like the cheeks and around the mouth.

Ablative lasers are great for treating visible signs of aging and the results generally last for 1 to 5 years. They can also be used to treat acne scarring, pigmentation irregularities and unwanted lesions. 

It is important to note however, that ablative lasers present a longer recovery and a higher degree of risk than non-ablative lasers. Most patients require 1 to 2 weeks of recovery time. 

Non-ablative laser devices are far less invasive than ablative treatments. They work by heating up the targeted tissue, creating damage and disruption, but without actually destroying it. This process uses coagulation to stimulate your body’s collagen production to fill in unwanted skin imperfections such as fine lines or wrinkles. Coagulation is better for small areas with thinner skin like around your eyes.

Non-ablative treatment as this is the most comfortable treatment, with the least amount of recovery time. Because they do not resurface the skin as invasively as ablative lasers, multiple treatment sessions will be necessary to achieve modest clinical results. However, patients benefit from almost no downtime and the risk of undesirable side effects is greatly reduced. 

Popular Non-Ablative Laser Treatments

Solta Medical is behind the most commonly known non-ablative laser treatments. You may be familiar with Clear + Brilliant and Fraxel.

Clear + Brilliant is a laser treatment used for skin rejuvenation and improving the appearance of fine lines, uneven skin tone, and mild sun damage. It is a non-invasive treatment that uses a fractional laser that delivers short bursts of energy to create micro-injuries in the skin, which stimulates the production of collagen and helps to improve the overall texture and tone of the skin. The procedure typically takes about 30 minutes to an hour and involves the application of a numbing cream to the treatment area to minimize any discomfort. Results can vary, but many people experience a noticeable improvement in their skin’s texture, tone, and overall appearance after a series of treatments. The laser creates millions of microscopic treatment zones in the skin, which are referred to as “microthermal zones.” These microthermal zones stimulate the production of collagen and elastin, which can help to improve the overall texture and tone of the skin.

Fraxel DUAL 1550/1927 laser treatment targets aging and sun-damaged skin with microscopic laser columns that penetrate deep into your skin to expedite your body’s collagen remodeling. And since the laser treats only a fraction of tissue at a time, it leaves the surrounding tissue intact, promoting rapid healing. Fraxel treatment resurfaces your skin by stimulating the growth of new, healthy skin cells from the inside out. Fraxel is effective on fine lines & wrinkles, surface scarring, pigmentation, sun damage, and Actinic Keratosis (AK). A clinically proven, safe approach with less risk than fully ablative resurfacing. 

Beam Me Up Scotty: Fractional vs Q Switched vs Long Pulsed vs Pico

All Skin-Resurfacing Lasers Are Fractional. Fractional means they only treat a portion of the skin, and not ALL of the skin. Fractional lasers are a type of laser treatment that uses a high-energy beam of light to create microscopic wounds in the skin which prompts the body’s natural healing process and stimulates the production of collagen and elastin. The result is smoother, healthier-looking skin. Used in medical and cosmetic procedures to resurface the skin, fractional lasers treat a variety of conditions, including acne scars, fine lines and wrinkles, sun damage, and uneven skin tone.

Fractional technology just refers to the pattern of the laser beam. In fractional technology, the beam of light is split into thousands of microbeams that target a small area of the face. The goal behind fractional technology was to create a resurfacing technique that had similar results as traditional CO2 and Erbium laser, which pummeled the entire face, resurfacing without the redness, peeling and extended recovery. Many years ago both these systems performed invasive full skin resurfacing (removal of tissue) meaning downtime and recovery with associated risks. The development of the fractional laser using columns of energy made it possible to treat the skin without the down time and minimal risks. Whether the technology has accomplished this is open to debate, but essentially the Fraxel and others like it were developed for those patients with an appetite for traditional laser resurfacing but with less downtime.

Fractional CO2 laser use carbon dioxide (CO2) to deliver high-energy beams of light to the skin. It is effective treatment for a variety of skin concerns, including fine lines, wrinkles, and scars.

Fractional non-ablative laser uses a lower-energy beam of light to stimulate collagen production and improve the appearance of the skin. It is less invasive than other fractional lasers and has a shorter recovery time.

The main difference between a fractional CO2 laser and a fractional erbium laser is the type of laser energy they use. A fractional CO2 laser uses carbon dioxide (CO2) laser energy, which is absorbed by water in the skin. This laser energy causes the skin to vaporize, resulting in precise, controlled removal of damaged skin cells. This type of laser is typically used for more severe skin issues, such as deep wrinkles and scars, and is known for producing more dramatic results.

A fractional erbium laser, on the other hand, uses erbium laser energy, which is absorbed by water in the skin and vaporizes skin cells in a similar way to the CO2 laser. However, the erbium laser energy is not as powerful as the CO2 laser, so it is typically used for more mild to moderate skin issues, such as fine lines and uneven skin tone. It is known for producing more subtle, subtle results with a shorter recovery time.

Both types of lasers work by creating microscopic wounds in the skin, which stimulate the body’s natural healing processes and help to regenerate new skin cells. However, the CO2 laser is generally more effective for deeper, more severe skin issues, while the erbium laser is better suited for more superficial concerns.

Q-switched 1064 lasers are most often used for pigmented lesions such as tattoos, sun spots, freckles, etc. although some manufacturers do have an FDA approval for wrinkles & collagen stimulation. 

The other type of 1064 laser is a long pulsed 1064. Within this category there are several different laser manufacturers but this type of laser is most often used for leg veins and hair removal (dark skin types). 

A picosecond laser selectively destroys the target pigment without damaging healthy, normal tissue. This allows rapid clearing of the abnormal pigmentation with minimal collateral damage to surrounding tissue.

Picosecond lasers use pulse durations of less than 1 nanosecond, which causes predominantly photoacoustic damage (pulses of light that can be measured by changes in pressure ie, sound waves) rather than photothermal destruction of pigment or ink particles (measured by production of heat). This results in effective clearance of abnormal pigment, while minimizing photothermal damage to the surrounding tissue.

Picosecond lasers used for tattoo removal require fewer treatments, cause fewer side effects, and result in reduced post-procedural downtime compared to nanosecond Q-switched lasers. They can clear some tattoos that are refractory to other forms of laser therapy, and there is a reduced risk of causing scarring and hypopigmentation. The additional cost and reduced availability of picosecond lasers compared to Q-switched lasers currently restricts their widespread use.

A popular brand of pico laser, PicoSure, is known for its ability to treat a wide range of skin concerns, including acne scars, sun damage, melasma, and age spots. It is also effective at removing difficult-to-treat tattoos, including those with multiple colors or inks that are resistant to traditional laser treatments. The PicoSure laser uses ultra-short pulses of laser energy to break down pigment in the skin. These pulses are delivered in picoseconds, which is one trillionth of a second. The laser energy is absorbed by the pigment in the skin, breaking it down into smaller particles that are then absorbed by the body.

Not Types Of Laser Treatments, But Relevant


Both Intense Pulsed Light Therapy and Pulsed Dye Laser are light-based treatments used to treat a variety of skin conditions. Both treatments use intense bursts of light and heat and which could provide some discomfort.

An Intense Pulsed Light Therapy or IPL is also called a photo facial. It’s a machine that emits short bursts of powerful, polychromatic light that go just below the surface of the skin, where they target either melanin or blood vessels. The light destroys the melanin or blood vessels and thus destroys things like age spots and spider veins. IPL treatment can also stimulate collagen production and thus rejuvenate skin.

A Pulsed Dye Laser (PDL) aims an intense and focused light beam at blood vessels beneath the skin. The light becomes heat that obliterates the targeted blood vessel but leaves the neighboring skin and tissue unharmed. The PDL uses yellow light because it does not cause any long-term damage to the skin. A PDL laser treatment machine emits a cold spray just before the treatment that numbs the patient’s skin. The number of treatments needed depends on the severity of the skin condition. While many patients need only one to three sessions, patients with hemangiomas, port wine stains, or severe rosacea may probably need more treatments.

The most common side effect associated with a PDL treatment is bruising. It is most likely to develop during the first few days after treatment and should clear up within a few days. Tanned skin blocks the laser light and thus increases the chances of side effects or complications. Patients should, therefore, use sunblock sometime before undergoing treatment.

IPL is polychromatic, which means the machine emits several wavelengths at once. This means that an IPL can treat several skin conditions at one time. PDL produces only one wavelength of light. It can, therefore, be used to treat only one skin condition at a time. On the other hand, its light is stronger and more intense than that produced by an IPL. It will, therefore, be more effective than an IPL, which means you’ll need fewer treatment sessions to get the desired results.

Radio Frequency (RF) Treatments

Since 2001, radio frequency has been used for non-surgical skin tightening. Radio frequency, or RF, uses energy to stimulate collagen production, but unlike a laser, the heat energy is electrically-based rather than light-based.

Micro-insulated needles penetrate the skin at specific points, distributing radio frequency energy at precise temperatures to generate a tissue response without damaging the epidermis. During Acne treatments, micro-needling selectively destroys the sebaceous glands where acne germs reside. Once the sebaceous gland has been destroyed, no acne can reoccur in that area.

The heat from the RF treatment tightens collagen fibers in the skin while also boosting collagen, which helps support a more youthful appearance by reducing sagging skin.

Types of RF Treatments

Thermage is a non-invasive laser treatment used to tighten and lift sagging skin on the face and body. It uses radiofrequency energy to stimulate collagen production and improve skin texture and elasticity. It is often used to treat areas such as the eyes, face, neck, and abdomen. The treatment typically requires no downtime and results can be seen immediately, with continued improvement over the next few months.

The Thermage laser uses radiofrequency energy to heat the deeper layers of the skin. This heat stimulates collagen production, which helps to tighten and lift sagging skin. The laser is delivered through a handheld device, which is moved over the treatment area in a series of passes. The device also has a cooling feature to protect the outer layers of the skin from heat damage.

During the treatment, the patient may feel a series of brief pulses or a warming sensation. The procedure typically takes about an hour to complete, depending on the size of the treatment area.

After the treatment, the skin may appear slightly red or swollen, but these side effects typically resolve within a few days. Results can be seen immediately, with continued improvement over the next few months as collagen production increases.

There is a risk of damaging facial fat with the Thermage laser treatment. This risk is low, but it is possible if the laser is not used correctly or if the skin is not cooled adequately during the treatment.

It is important to choose a qualified and experienced provider for any laser treatment, including Thermage, to minimize the risk of complications. The provider should also be able to discuss the potential risks and benefits of the treatment with the patient before the procedure is performed.

Ultherapy is a non-invasive treatment that uses ultrasound energy to stimulate collagen production and tighten skin on the face, neck, and chest. It is not intended to damage facial fat. However, as with any medical procedure, there is a potential for side effects.

In rare cases, Ultherapy may cause temporary swelling or numbness in the treated area. It is also possible that the treatment may cause a slight change in the contour of the skin, although this is typically minimal and temporary.

If you are concerned about potential damage to facial fat or any other potential side effects, it is recommended to speak with a qualified dermatologist or plastic surgeon before undergoing Ultherapy. They can assess your individual needs and recommend a treatment plan that is safe and effective for your specific concerns.

Ultraformer III is a non-surgical, non-invasive RF laser treatment that uses ultrasound energy to stimulate collagen production and tighten the skin. It is often used on the face, neck, and body to treat sagging skin.

Morpheus 8 is a non-surgical procedure that uses a device called a subdermal adipose remodeling device (SARD) to treat areas of the face and body with excess fat and sagging skin. The procedure involves the use of a device that delivers radio frequency (RF) energy through small needles that are inserted into the skin. The RF energy heats the tissue and stimulates the production of collagen, a protein that helps to tighten and firm the skin.

During the procedure, the SARD device is used to create micro-injuries in the skin, which stimulates the production of new collagen and helps to tighten and lift the skin. The device also includes a cooling system to protect the skin from overheating.

Morpheus 8 is typically performed as an outpatient procedure and does not require general anesthesia. It can be used to treat areas of the face and body, including the jowls, neck, and under the eyes. 

Before & After Pictures

A picture is worth a thousand words, so investigating the before and after pictures is critical in considering which treatments are right for you. Surprisingly, when we researched final results for you, we were shocked by the number of times we couldn’t tell the difference. Was it because the tool isn’t that effective? More likely, we felt like the model they started with was too young and not really in need of the treatment to begin with. 

What the manufactures show you
What we want to see

There are several places where you can find before and after pictures of anti-aging lasers. Some options include:

  1. The website of the laser manufacturer or provider: Many companies have before and after pictures on their websites to showcase the results of their products or treatments.
  2. Online reviews or forums: You can find reviews and before and after pictures on websites such as RealSelf, which is a forum where people discuss and share their experiences with different aesthetic treatments.
  3. Your healthcare provider: Your healthcare provider should be able to show you before and after pictures of their previous patients to give you an idea of what to expect from the treatment.

Start asking around. Many women in their 40’s and 50’s have experimented with lasers and hopefully are willing to share their experience with you.

Risks To Lasers

It’s important to note that laser treatments, including anti-aging lasers, can be effective and safe when performed by a qualified and experienced healthcare provider. However, as with any medical procedure, there is always a risk of complications or adverse reactions. Some possible complications of laser treatments include:

  1. Burns or scarring: This can occur if the laser energy is too high or the treatment is not properly administered.
  2. Changes in skin color: The laser may cause the skin to become lighter or darker than the surrounding skin.
  3. Infection: There is a small risk of infection after laser treatment, especially if the treated area is not properly cared for following the procedure.
  4. Pain: Some people may experience pain or discomfort during or after the laser treatment.


Do anti aging lasers work on darker skin?

Laser treatments for anti-aging can be effective for people with darker skin, but it is important to be aware that some lasers may be less safe for use on darker skin types. This is because lasers can sometimes cause changes in skin color, and people with darker skin may be at higher risk to hyperpigmentation (darkening of the skin) as a result of laser treatment.

It is important to consult with a dermatologist or a qualified medical provider who has experience treating people with darker skin before undergoing any laser treatment. They can assess your specific skin type and discuss the risks and benefits of different treatment options with you. They can also recommend the most appropriate laser for your skin type and concerns, and provide appropriate pre- and post-treatment care to minimize the risk of side effects. A good option for darker skin is Nd:YAG laser. Specifically designed for darker skin, it may be less likely to cause hyperpigmentation. However, it is still important to be cautious and to follow your provider’s instructions carefully to minimize the risk of side effects.

Can you use anti aging lasers with fillers?

Yes, it is possible to use anti-aging lasers in combination with fillers. Laser treatments and fillers are two different types of cosmetic procedures that can be used separately or in combination to address different concerns related to aging skin. Laser treatments use focused beams of light to improve the texture and tone of the skin, while fillers are injectable substances that are used to add volume and smooth out wrinkles. Both treatments can be effective in helping to improve the appearance of aging skin, but they work in different ways and have different mechanisms of action. It’s generally not thought that laser treatments can damage fillers.

Do anti aging lasers diminish the effectiveness of botox?

There is no evidence to suggest that laser treatments can diminish the effectiveness of Botox. Botox is a neuro-modulator that is injected into specific muscles in the face to relax them and reduce the appearance of wrinkles. It works by blocking the transmission of nerve impulses to the injected muscles, causing them to relax. Laser treatments, on the other hand, use focused beams of light to improve the texture and tone of the skin. They do not directly affect the muscles in the face and do not interfere with the mechanism of action of Botox. You can use laser skin rejuvenation and Botox in combination to address different concerns related to aging skin. For example, laser treatments can be used to improve the overall tone and texture of the skin, while Botox can be used to smooth out wrinkles caused by muscle movement.


The winter months, when UV rays are less prevalent, are a great time to schedule your laser treatments. You’ll need time to heal. Be sure to use sunscreen when you’re doctor says your skin is healed and for best results long-term, don’t stop. It’s important to protect your investment.

Here’s What We’re Trying

Kimby: Skin Laundry is a skincare and laser treatment company that offers a variety of treatments at its clinics. One of the lasers they use is the YAG laser, which is a type of laser that uses an intense beam of light to remove unwanted pigment or blood vessels in the skin. The YAG laser is commonly used to treat conditions such as age spots, sun spots, freckles, and vascular lesions.

At the time I was going regularly, they also were using a fractional resurfacing technology which is the primary reason I signed up. I think my complexion looked good and there was some noticeable smoothing and tightening.

Skin Laundry recently ditched the fractional laser for RF technology and I’m not a fan. For one thing, you’re left with a noticeable “grid” on your face for 7-10 days. The old regimen left you slightly red for the remainder of the day only.

Kimby: Ulterapy

I hated this. I was left with nerve damage and paralysis, thankfully temporary, and I feel like it cooked away fat along my jawline that I couldn’t spare. This certainly could have been the error of my doctor.

I had gone to the “fancy” guy just wanting laser treatment. He talked me into Ultherapy. Lesson learned. If you’re like me and you do your own thorough research, trust yourself.

Kimby: Morpheus 8

Look, I’m fighting the good fight here. For you and me. 

My doctor did use a local anesthetic numbing cream and while it wasn’t the most pleasant experience of my life, I tolerated it well. My friend however, was in so much pain that she took Ativan for her subsequent treatments. 

Morpheus gave me some tightening along my jawline that I am so desperately seeking. My friend that recently completed some treatments saw more impressive results than I did. Was it due to her practitioner or her skin’s ability to heal? Who knows.

Kimby: Fotona 4D Laser – up next 

Fotona 4D laser is a non-invasive laser treatment used for a variety of aesthetic and medical applications. It is a combination of four different laser technologies (Er:YAG, Nd:YAG, KTP, and Alexandrite) that can be used to address a wide range of skin concerns, including wrinkles, acne scars, stretch marks, and pigmentation issues.

The treatment is called “4D” because it involves four different stages:

  1. Precision – The laser is used to precisely target specific areas of the skin.
  2. Dynamis – The laser energy is used to stimulate collagen production and improve skin texture.
  3. Vital – The laser energy is used to promote healing and revitalization of the skin.
  4. Tight – The laser energy is used to tighten and lift the skin.

Fotona 4D laser treatment is typically performed in a series of sessions. I have 5 scheduled. The Fotona is billed as a non-surgical facelift and my biggest concern is loss of elasticity in my skin. This laser is supposed to address that. I’ll keep you posted.  

Tracy: IPL Treatments

I’m most concerned with discoloration, dark spots, and freckling. Sure it’s partially vanity, but also I’m concerned at the potential for brown spots, rough spots, and freckling to become cancerous. IPL treatments should even my skin for both my aesthetic goals and long-term health.

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