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You’ll be hard pressed to find someone who hasn’t experienced a breakout at some point in their life. According to the American Academy of Dermatology (AAD), acne is the [most common](https://www.aad.org/media/stats-numbers) skin condition in the United States, with upwards of 50 million Americans dealing with it annually. 

Some 85 percent of adolescents and young adults between the ages of 12 and 24 experience at least mild acne, and it’s not exactly like those pesky pimples magically disappear in adulthood. A [study](https://jamanetwork.com/journals/jamadermatology/fullarticle/479093) in the *Journal of the American Medical Association* found that 40 to 54 percent of adults over the age of 25 have some degree of facial acne. Adult acne is considered more common in women than [men](https://aedit.com/aedition/how-to-treat-adult-acne-in-men), though it is increasingly impacting people in their [thirties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-30s), [forties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-40s), and beyond. 

While there are an array of [professional treatments](https://aedit.com/aedition/best-professional-treatments-for-acne-and-acne-scars) and [at-home skincare](https://aedit.com/aedition/best-skincare-ingredients-to-treat-acne-blackheads-whiteheads) that can treat various aspects of breakouts, dermatologists and plastic surgeons haven’t had a singular [solution](https://aedit.com/procedure/acne-solutions) to offer patients that targets acne at the source without a laundry list of side effects – until now. In March, Cutera received clearance from the U.S. Food and Drug Administration for [AviClear™](https://www.cutera.com/solutions/aviclear/), a first-of-its-kind energy device for the treatment of mild to severe acne, and it is being hailed as the biggest acne breakthrough in decades. Here’s what you need to know.

## **What Is AviClear?**
[AviClear™](https://aviclear.com/) is the first and only FDA-cleared energy device for the treatment of mild to severe acne. “What’s amazing is that it works on all types of acne – whether it’s cystic acne, inflammatory acne, hormonal acne, mask acne,” says [Arash Moradzadeh, MD](https://aedit.com/provider/arash-moradzadeh-md-430), a board certified plastic and reconstructive surgeon in Beverly Hills, CA. “Regardless of what type of acne you have, it’s very effective.”

The laser treatment, which is safe for all [skin tones](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), uses a 1726-nanometer wavelength to address the source of breakouts. Acne forms when sebum (read: oil), dead skin cells, and bacteria on the skin get trapped in the pores. AviClear™ works by selectively targeting oil glands, so that they produce less oil and, over time, less acne without damaging the rest of the skin. “The laser is actually being absorbed by the sebaceous glands, causing them to be down regulated, or destroyed, so that you then have less acne,” Dr. Moradzadeh explains. 

## **Who Is the Ideal Candidate for AviClear?**
One of the most compelling things about AviClear™ is just how inclusive the treatment is. “Unlike other lasers that you can’t use on [dark skin](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones), you can do this on anyone,” Dr. Moradzadeh says. It also doesn’t discriminate against certain types of acne, which means it can treat patients from adolescence through adulthood. Unsurprisingly, “teenagers are one of the main groups that want this treatment,” he says – though it’s not just about short-term relief. Less acne for less periods of time will likely mean less scarring down the road. “They can get treated early and avoid getting acne scars that are then very difficult to treat and cover,” Dr. Moradzadeh shares. 

Additionally, AviClear™ is an in-office, energy-based procedure, which means it doesn’t require prescription or over-the-counter topicals, oral medications, or patients remembering to do anything at home. “You are avoiding chemicals, antibiotics, and difficult regimens that some people can’t stick to and abide by,” he says. “For example, a lot of women don’t want to be on birth control for their hormonal acne, so this is giving them a non-chemical, safe alternative.” 

## **How Does AviClear Treatment Work?**
The treatment protocol for AviClear™ is three sessions, spaced one month apart. Dr. Moradzadeh says each appointment treats the entire face – not just the areas you are prone to breakouts. “When you do the treatment, you are doing it over the whole face,” he shares. “Over the course of your three treatments, you are effectively treating all of the sebaceous glands.”

As Dr. Moradzadeh explains, patients are asked to wash their face upon arriving at the office, before the skin is “degreased” with acetone and “rehydrated” with water to improve contact. After the 15 to 30 minute treatment, he says most patients are “a little bit pink” for about 15 minutes. “There is really no downtime,” he shares. In fact, “most of my patients actually love the way they look after they leave because of that kind of micro-swelling glow in the skin,” Dr. Moradzadeh says. The effect “actually makes their acne look less visible when they walk out,” he adds. Patients can resume activities immediately after treatment.

![AviClear Before & After-2](//images.ctfassets.net/zw35sfestf1t/3iPwQlkdTBNgLWzVCIvgcT/952b4fca323e39b72051fed8e4385809/AviClearBA2.PNG)

If you’ve had a [laser treatment](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) in the past, you may be wondering about the comfort level. The AviClear™ device features a built-in sapphire cooling technology and sensory controls that work to maintain the skin’s temperature throughout the session. As such, “the treatment itself is relatively comfortable,” Dr. Moradzadeh says. “It feels a little bit hot with a needle-like sensation, but you do not require any pain medication or [numbing cream](https://aedit.com/aedition/numbing-cream-breakouts) at all.”

During the three months of treatment (and the months that follow), Dr. Moradzadeh says patients can carry on with their existing breakout-busting routine – including prescriptions like [Accutane](https://aedit.com/procedure/accutane), [spironolactone](https://aedit.com/procedure/spironolactone-for-acne-treatment), and [tretinoin](https://aedit.com/procedure/tretinoin). “You are not limited like you normally would be,” he explains. “If someone is already on Accutane, they can actually still get this treatment and then transition off their Accutane; if someone is already on spironolactone or an antibiotic or a skincare regimen, they can continue that during this treatment and then taper off.” The net-net: “Nothing has to really change,” he says.

Even so, it’s important to share your current skincare regimen with your provider to ensure you are setting yourself up for success. “I usually just review their protocol and see if there is anything better they could be doing as they get through the first six months to their clearer skin,” Dr. Moradzadeh notes. One non-negotiable during treatment? [Sunscreen](https://aedit.com/aedition/best-sunscreens-of-2022). “In terms of photosensitivity, the only thing we recommend is that you must wear sunscreen every day,” he emphasizes.

## **What Are the Results of AviClear?**
If you are familiar with Accutane, you may know that it is a brand name for isotretinoin, a potent form of vitamin A that was approved by the FDA in 1982 for the treatment of severe, resistant, nodular acne that is unresponsive to conventional therapy. The orally prescribed medication treats acne by reducing the size of oil glands and the amount of oil they produce. The results can be life-changing ([read one patient’s experience here](https://aedit.com/aedition/what-its-like-to-take-accutane)) and lasting, but it is not without a litany of side effects that makes it a difficult choice for many.

What makes AviClear™ so unique is that it treats acne in the same way, but it does so without the additional quality of life impacts. We’re highlighting the similarities between the two because the results of AviClear™ are similar to those of Accutane. “The results that have been seen are equal to Accutane, and you are also avoiding Accutane and the side effects,” Dr. Moradzadeh says. It should be noted that, during clinical testing, no significant adverse effects were observed.

So, what does that mean in practice? “When you first start Accutane, there is this phenomenon called ‘the purge’ where you get a breakout,” he explains. “With AviClear™, it is very similar.” One to two weeks after your first treatment, you can expect to have a purge period. “After your second treatment, you see less of that,” he shares. “And then, three months after your third treatment, you notice a significant reduction in your acne.” About six months after your third treatment, “you will usually love your skin,” he notes.

![AviClear Before & After-1](//images.ctfassets.net/zw35sfestf1t/2rqiD6xjS9dcmiuiUwYV62/3bb0dfffc69bf0995e981e34cbab93b9/AviClearBA1.PNG)

In the clinical studies, 80 percent of patients saw at least half of their acne clear after three treatments, and 87 percent said they were “satisfied” or “very satisfied” at week 12. The results continued to improve over the course of six months. Furthermore, any breakouts patients experienced post-treatment were reported to be shorter with fewer and smaller flare-ups. 

While AviClear™ has not yet been studied for the improvement of [acne scars](https://aedit.com/concern/acne-scars), Dr. Moradzadeh says some patients with “reddish- or pink-colored scars” find that they go away during treatment, while appearance of the remainder of their acne scars is minimized. “We are seeing skin quality improvements as a whole, but we have other treatments that are very specific for [acne scar management](https://aedit.com/procedure/acne-scar-solutions),” he notes.

## **The Takeaway**
As Dr. Moradzadeh says, AviClear™ is a “game changer” because it’s the first true acne innovation in more than 30 years. But it’s not just about the aesthetics of clearer skin. [Research](https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.16099) has found that those diagnosed with acne are at an increased risk (40 to 60 percent greater) of developing major depression, and Dr. Moradzadeh has treated patients who don’t want to leave the house or go to school because of their skin. “Acne has such a strong impact on people’s self esteem and how they feel about themselves, and it hurts to not be able to give them something that is amazing,” he says. “So, to have something now that gives them equal results to Accutane feels good.” For the first time in a long time – or maybe ever – “treating acne is a happy thing,” he notes.

Aesthetics

The 1726nm laser is being called the biggest acne breakthrough since Accutane.

The Benefits Of AviClear Laser Therapy For Treating Acne

Meet The Laser That Is Being Called The Biggest Acne Breakthrough In Decades

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In the world of aesthetic medicine, we talk a lot about ‘rejuvenation,’ but the breadth of non-surgical treatment options available today has made the idea of ‘[prejuvenation](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend)’ not only possible but popular. When it comes to taking preventative measures to keep your skin looking youthful, a solid skincare and sun care routine tops the list. From there, [neurotoxins](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time), [fillers](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time), [facials](https://aedit.com/aedition/what-its-like-to-get-a-hydrafacial-for-clear-glowing-skin), [chemical peels](https://aedit.com/aedition/guide-to-superficial-medium-deep-chemical-peels), and the like can proactively address concerns before they become, well, concerning. 

A treatment option that is growing in popularity? [Laser rejuvenation](https://aedit.com/procedure/laser-skin-resurfacing) or, in the case of patients under 35, laser prejuvenation. To better understand the concept of preventative procedures and how laser therapy fits in, we’ve spoken to a top dermatologist and a prejuventation patient.

## **What Is Prejuvenation?**
Sure, ‘prejuvenation’ might sound like nothing more than a trendy buzzword, but there is actually some substance to the concept. The term refers to the steps taken to prevent or correct early signs of aging. Compare that to ‘rejuvenation’ — which describes treatments that are designed to address visible signs of aging — and you’ll get the gist of why many plastic surgeons and dermatologists are increasingly working with patients in their late twenties and thirties.

So, what is this demographic looking for? “Younger patients tend to be concerned about skin tone, pore size, texture, and fine lines,” says [Jessica Weiser, MD](https://aedit.com/provider/jessica-weiser-md-34640), a board certified dermatologist in New York City and assistant clinical professor of dermatology at Columbia University. Treatment protocols are as unique as the patients themselves, but she encourages everyone “to commit to a [comprehensive skincare routine](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s) with [liberal sun protection](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body).” 

From there, she explores in-office remedies on a case-by-case basis. “I may recommend small amounts of [neuromodulator injections](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) for patients who have static wrinkles,” she says. For the uninitiated, ‘static’ wrinkles are the lines that stay put at rest, while ‘dynamic’ wrinkles are those that only occur with movement. For patients who start to experience [volume loss](https://aedit.com/concern/facial-volume) in their thirties, “small quantities of [dermal filler or biostimulatory injections](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables)” may be helpful, she adds.

And then there are lasers. “There are a variety of lasers that can address redness, pigmentation, and [general skin tone](https://aedit.com/concern/uneven-skin-tone),” she explains. Additionally, she says there are “a variety of other lasers and energy-based devices that are more specific to [overall skin texture](https://aedit.com/concern/uneven-skin-texture), including [acne scars](https://aedit.com/concern/acne-scars), [fine lines](https://aedit.com/concern/fine-lineswrinkles), and more.”

## **Laser Prejuvenation 101**
First, a quick primer on laser therapy. There are a few different types of lasers to keep in mind (learn more in our [complete guide to laser skin resurfacing](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing)):

- **Ablative Lasers**: Also known as ‘wounding’ lasers, these devices remove some or all of the epidermis.
- **Non-Ablative Lasers**: ‘Non-wounding’ lasers preserve the epidermis, while heating the dermis layer.
- **Fractional Lasers**: A pixelated energy beam dissipates some of the heat.
- **Non-Fractional Lasers**: The laser beam remains focused and concentrated.

Different combinations of the above (think: [ablative fractional](https://aedit.com/procedure/ablative-fractional-lasers), [ablative non-fractional](https://aedit.com/procedure/ablative-nonfractional-lasers), [non-ablative fractional](https://aedit.com/procedure/nonablative-fractional-lasers), [non-ablative non-fractional](https://aedit.com/procedure/nonablative-nonfractional-lasers)) make a device better suited for different concerns. Non-ablative [pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser), for example, are used to treat vascular lesions (think: broken capillaries and other redness), while a non-ablative fractional laser like [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant) is commonly called a ‘lunchtime laser’ because less inflammation means less downtime (but also less dramatic results).

It should come as no surprise then that the type of laser Dr. Weiser recommends for a patient depends on what they are looking to address. “For those with red scars, [rosacea](https://aedit.com/concern/rosacea), and broken capillaries, I use vascular-specific lasers to reduce or remove these concerns,” she shares. For mild texture concerns, she notes “there are lower energy and less invasive devices” that can do the trick. When it comes to [acne scars](https://aedit.com/procedure/acne-scar-treatment-laser-resurfacing), Dr. Weiser often reaches for what she describes as “more intense fractional resurfacing devices” — including non-ablative resurfacing with [Fraxel®](https://aedit.com/aedition/guide-to-fraxel-laser-skin-resurfacing-treatments) or [microneedling with radiofrequency](https://aedit.com/procedure/microneedling-with-radiofrequency) or ablative resurfacing with [CO2 laser treatments](https://aedit.com/procedure/ablative-co2-laser).

An additional prejuvenation benefit? [Collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine) production. “Some treatments do yield collagen regeneration — those that work on textural irregularities of the skin, primarily — and may provide some anti-aging benefits,” Dr. Weiser shares. As she explains, devices that target redness and pigmentation tend to provide less collagen production. But, with that said, “all heat can help stimulate healing,” she notes. Stimulating healing, stimulates collagen.

None of this matters, however, if you aren’t taking care of your complexion at home. “What usually proves to be most beneficial is early implementation of skin health awareness and sun protection,” Dr. Weiser emphasizes.

### **What to Expect From Laser Treatments**
Because there are so many different types and intensities of lasers, there is no one single treatment or recovery protocol. Generally speaking, “most energy-based devices require a series of treatments,” Dr. Weiser notes. You can usually expect at least three sessions to see results, she says, though more may be needed. “For more severe textural issues, additional treatments may be required to reach an ideal endpoint,” she adds.

While more invasive ablative lasers may call for general anesthesia (and a couple weeks of downtime), a [topical anesthetic](https://aedit.com/aedition/numbing-cream-breakouts) suffices for many laser treatments. You may feel a bit of discomfort during the treatment, and, depending on the device, swelling, [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox), and redness are common side effects. Your provider will share any additional post-op instructions prior to the procedure, but you may be encouraged to switch to a [gentle skincare routine](https://aedit.com/aedition/post-procedure-skincare-makeup-product-guide) for a period of time and be extra vigilant with your sun protection. 

It is also important to note that many lasers are not suitable for all skin tones. When performed incorrectly on melanated skin, it can lead to burns, scars, and [unwanted pigmentation](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma). This is why it is imperative to consult with a board certified laser expert who has a range of tools in their kit and experience treating a [range of skin types](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones). 

## **Patient Perspective**
Now that you have a better sense of what laser prejevenation is, it’s time to hear what it's really like. Below, a patient shares her experience undergoing laser therapy to treat early signs of aging. 

### **Lea, 28, Los Angeles**
*Lea opted for laser treatments to address the fine lines around her eyes. After consulting with a dermatologist, she decided that Fraxel® treatments would be more suitable for her than fillers or Botox®.*

<Dialogue>
  <Question party={The AEDITION}>
    What led you to book a consultation with your cosmetic dermatologist?
  </Question>
  <Response party={Lea}>
    I work in an image-oriented profession, so I spend a lot of time looking at pictures of myself. Many of my peers were getting Botox® or fillers, so I decided to start looking into options that were open to me. I was open to having injectables, but I also knew that I wanted to go easy to begin with so I have options when I get older. During the consultation, my dermatologist suggested Fraxel® as an alternative. After talking about the benefits and risks, I settled on that option.
  </Response>
  <Question party={The AEDITION}>
    What was the procedure like for you?
  </Question>
  <Response party={Lea}>
    I had five sessions in total, and each of them lasted around half an hour. The most surprising thing about the treatments was the smell. I suppose it makes sense that, if your skin is being burnt, there would be a smell to it! It wasn't off-putting enough to make me tell people not to try it — it's just something worth keeping in mind. I would say the pain level during the procedure was less than having a bikini wax. It was a little unpleasant, but, again, not enough to put you off going back for your next session.
  </Response>
  <Question party={The AEDITION}>
    How was the recovery process?
  </Question>
  <Response party={Lea}>
    I was told to expect some soreness, but it wasn't too bad. I used a mix of milk and iced water on a flannel to soothe my skin, as recommended by my dermatologist. I had my sessions on Thursdays and worked from home on Fridays. By Monday, it was absolutely fine. I made sure to reapply sunscreen every few hours when I was out for a couple of weeks after each session, and I still keep up with sunscreen to keep my results looking as good as possible for as long as I can.
  </Response>
  <Question party={The AEDITION}>
    Are you happy with the results?
  </Question>
  <Response party={Lea}>
    My goal was to even out the skin around my eyes. I felt the area was starting to show signs of aging, especially when I laughed. After the first couple of sessions, I didn't see too much difference, although a couple of friends said they noticed a difference after the second session. By the fifth session, I was pleased with the results we achieved. My skin looks smoother and regenerated, almost fuller.
  </Response>
</Dialogue>

## **The Takeaway**
While laser therapy can be a great way to address skin tone and texture concerns at any age, it is not a silver bullet. For patients starting treatment in their [twenties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s) or [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s), it is important to remember that the skin will continue to age. “It is not accurate to say that many laser or other energy-based treatments at a young age would offset more invasive procedures later on,” Dr. Weiser says. But, when coupled with other [healthy habits](https://aedit.com/aedition/skin-aging-habits), it can go a long way toward long-term benefits. “Often patients who begin laser therapy at a younger age are adopting other skin-healthy behaviors, including photoprotection, [antioxidant use](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare), good cleansing practices, and proper hydration,” she explains. “The  incorporation of laser treatment usually inspires better skincare and preventative habits!”

*Patient name has been changed 

The concept of 'prejuvenation' for patients under the age of 35 is gaining steam, and laser treatments can be used to prevent and address early signs of aging.

The Benefits Of Laser Skin Resurfacing For Younger Patients

What Is Laser Prejuvenation?

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BBL HERO® doesn’t come with a cape, but some may argue it deserves one. The acronym stands for Broadband Light High Energy Rapid Output, and it’s the latest light treatment from Sciton. In keeping with the superhero theme, the technology is faster than a speeding bullet and stronger than your average [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) treatment. Here’s what to know about this anti-aging, photo-correcting procedure.

## **What is BBL HERO?**
BBL HERO® is a new take on a tried-and-true favorite. The original BBL® treatment is a special type of IPL light treatment that uses dual-lamps to deliver visible and infrared light with quick-change smart filters that allow for quick switching between specific, targeted problems. It’s [been shown](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547222/) to rejuvenate skin at a cellular level and can be used to treat brown spots, redness (including erythema from [rosacea](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-rosacea) and [acne](https://aedit.com/aedition/how-to-treat-hormonal-acne-body-acne-cystic-acne-whiteheads-blackheads)), and skin laxity. Oh, and it’s also an option for permanent hair reduction.

The upgraded BBL HERO®, offered as part of both Forever Young™ + BBL and Forever Body™ treatments, does all of that with increased speed, shortened pulse width, high peak power, and twice the cooling capacity of the original to keep irritation away. As such, the manufacturer [claims](https://sciton.com/physicians/bbl/) you’ll see results faster (for example, you’ll enjoy improved skin tone and texture in a quarter of the time). Like its predecessor, it’s being marketed as a fix for age and sun spots, redness, discoloration, dullness, and unwanted hair. 

Much of the improvements can be credited to the duration of the pulses. For context, a typical machine may take up to one second apiece for a light flash. A BBL HERO® pulse can take as little as three milliseconds, which means you can get 1,200 to 1,500 pulses in a single face session versus 250 to 350 pulses with the original BBL®. 

## **How BBL HERO Works**
If you’re curious what this super speed means in practice, providers are most impressed with how the upgraded technology has improved treatment. “The technology allows practitioners to move the handpiece fluidly in a motion technique,” says [Julius Few, MD](https://www.fewinstitute.com/), a board certified plastic surgeon and founder of The Few Institute in Chicago. “It has made treating the face, hands, arms, legs, back, and chest a lot easier.” Previously, as he explains, providers needed to use a stamping technique in which the head of the laser or IPL nozzle is placed on each area with a pause for the light to flash before moving to the next spot.

Calling BBL HERO® a “very efficient laser,” [Ellen Marmur, MD](https://www.instagram.com/dr_ellen_marmur/?hl=en), a New York-based board certified dermatologist and founder of [MMSkincare](https://mmskincare.com/), says the treatment has been well-received in the wake of COVID-19 worries, as many patients want to [get in and out](https://aedit.com/aedition/best-aesthetic-procedures-to-combine-to-maximize-appointments) of the doctor’s office as quickly as possible. The upgraded technology allows for multiple passes of each treatment area and the changing of filters in between to address multiple skin concerns in a single visit. 

Dr. Marmur is also impressed with the uniformity of the results. “In the past, IPL or BBL® treatments of the face and especially on the chest, arms, or legs were tedious and could lead to patches of uneven skin because the handpiece had a limited ability to deliver a consistent amount of light energy quickly, even with perfect technique,” she explains. 

Another snag? It used to take multiple modalities to achieve the same result. “I used to have to combine the IPL or BBL® with [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant) or [Fraxel®](https://aedit.com/aedition/guide-to-fraxel-laser-skin-resurfacing-treatments) to get the best of both worlds, [meaning] removal of sun damage with an even finish in the fewest sessions,” she shares. She calls BBL HERO® a “game changer” for patients because it can treat “almost the entire body” quickly and evenly. In fact, it’s so fast, she quips, “we call it a car wash.”

## **Ideal Candidates for BBL HERO** 
BBL HERO® does include a wavelength option for [darker skin tones](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones), but it can be recommended for those at the light to medium end of the [Fitzpatrick scale](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types). This is especially true for [hair removal](https://aedit.com/procedure/ipl-for-unwanted-hair) patients. A consultation with a board certified dermatologist or plastic surgeon will let you know if you are a candidate.  

## **What to Expect from a BBL HERO Treatment**
As with any IPL treatment, Dr. Few says what most patients feel is the flash of warmth that accompanies each pulse. While most people can tolerate it without [anesthetic numbing cream](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), you can ask your doctor about it if you’re sensitive. As the light finds the melanin in your skin, “the pigment initially darkens, helping you know that you had an optimal treatment,” he explains. “Then, overtime, your body’s natural healing process will remove the pigmented cells, replacing them with fresh new undamaged cells.” 

While it’s considered a “no downtime” procedure, “treated skin may look and feel [sunburned](https://aedit.com/aedition/how-to-relieve-and-treat-sunburn) in the first few hours after treatment,” Dr. Few notes, adding that cool compresses and ibuprofen allow most patients to immediately go back to their regular routine. If you are treating blood vessels, he says to be on the lookout for [post-procedure bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox). And, regardless of the treatment area, you’ll want to be extra diligent with your [sunscreen](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors) routine. “The skin will be sensitive to sunlight for two weeks after treatment,” he explains.

Overall, no matter where you have BBL HERO® done (chest, back, arms, legs, and/or face), you can expect skin improvements fairly quickly. “Patients have been extremely satisfied with their results,” Dr. Marmur says. “Imagine having 10 years of sun damage and brown spots gone after a few laser treatments.”

## **BBL HERO Cost & Results**
A comparative analysis from the brand suggests you can get the results you may have expected from five or more original BBL® treatments in one to three BBL HERO® treatments. Pricing varies by provider and treatment area, but the typical cost for a full face treatment is $600 to $800. 

Realistically, Dr. Few says you can expect a return visit or two. “While results can be seen after a single BBL® treatment, optimal results often require two to five treatments depending on the condition being treated,” he shares. “Our average with the new technology is two treatments spaced six to 12 weeks apart.” Dr. Marmur agrees. “Most people will need three to five treatments to get improvement,” she says. “One treatment is unlikely to completely fix the sun damage — it’s a journey!”

The latest addition to the IPL family is so fast, it’s being likened to a ‘car wash’ for your face.

BBL Hero: Treatment, Benefits, Cost, Results

BBL Hero: All About The Latest Light Therapy Treatment

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From laser skin treatments to laser hair removal, tone matters — skin tone, that is. Laser therapy procedures are not one size fits all and the wrong treatment can cause lasting damage. So, how can you tell which laser treatments are right for [darker skin tones](https://aedit.com/aedition/the-best-skin-treatments-for-dark-complexions)? Here, we caught up with top dermatologists and an aesthetic nurse to find out why skin tone affects the outcome of certain laser procedures and the best [skin refining](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures) and [hair removal](https://aedit.com/aedition/how-to-use-at-home-laser-hair-removal-devices) laser options for those with darker complexions. 

## **The Relationship Between Lasers & Skin Tone**
Not all laser and light therapies are safe for all skin tones. Generally speaking, those who fall above type IV on the [Fitzpatrick Skin Phototype](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) scale (the go-to measure of skin type for dermatologists) need to be careful when choosing a treatment. For the uninitiated, the Fitzpatrick scale was developed in 1975 by Harvard dermatologist Thomas B. Fitzpatrick, MD, to classify a person’s tendency to burn (erythema) versus tan (induce pigmentation) — providing an estimation of the amount of melanin present in skin cells. The original scale had four types and was later broadened to six. 

The best way to determine your Fitzpatrick skin type is to visit your dermatologist, but below are the general classifications for each: 

- **Type I**: Pale skin; light blue or green eyes; red or blonde hair; always burns, never tans
- **Type II**: Fair skin; blue or green eyes; blonde hair; burns easily, tans poorly
- **Type III**: Light brown to olive skin; hazel or light brown eyes; dark blonde or light brown hair; burns mildly, tans gradually
- **Type IV**: Olive to brown skin; dark brown eyes; dark brown hair; burns minimally, tans easily 
- **Type V**: Dark brown skin; dark brown to black eyes; dark brown to black hair; tans easily, rarely burns
- **Type VI**: Dark brown or black skin; dark brown to black eyes; black hair; never burns, tans easily 

Aesthetic lasers target water, red hemoglobin, or brown melanin in the skin. Skin types IV to VI have a higher concentration of melanin, which means there is a greater risk of damage if the laser is used incorrectly. “Patients with darker skin tones and who are tan are more susceptible to complications, which is why it’s essential to see a board certified laser expert and someone with many different tools in their kit,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist in New York City. The damage caused by improper laser treatments is often permanent and ranges from [burns](https://aedit.com/aedition/how-to-treat-first-second-third-degree-burns) and [scars](https://aedit.com/aedition/minimizing-scars-after-surgery) to hypo- and hyperpigmentation. 

But that’s not to say there aren’t cosmetic laser therapies that can safely be employed on a wide range of skin tones. When performed by a well-trained professional, there is an array of skin refining and hair removal treatment options. To ensure you’re visiting a provider with the right level of experience, Dr. Frank recommends [asking the following questions](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation): 

1. Do you have more than one technology in your office to treat the various skin types?
2. Do you have experience with treating people with my skin type?

“Those are the two most important questions you can ask,” he says. And don’t be shy about asking to see before and after photos of patients who look like you — it can help you get a sense of how much experience the provider has. 

## **The Best Laser Treatments for Darker Skin**
Now that you have a better understanding of the relationship between skin tone and lasers, it’s time to learn more about which treatments are safe and effective. When it comes to refining skin tone and texture, [non-ablative](https://aedit.com/procedure/nonablative-laser-skin-resurfacing) (read: non-wounding), picosecond, and Q-switched lasers are the way to go for darker complexions and there have been some notable technological advances in the last decade. “The skin stays intact, so patients can use makeup during recovery and they can be used on darker skin types,” Dr. Frank says. 

### **Non-Ablative Lasers**
- Clear + Brilliant®
- Fraxel® Dual 
- Lutronic Ultra™

### **Picosecond Lasers**
- Enlighten®
- Pico Genesis™ 
- PicoSure®
- PicoWay®

Generally speaking, Dr. Frank says longer wavelength technologies tend to be safest for darker skin tones. Tara Garrick, nurse and aesthetic laser specialist at [Neinstein Plastic Surgery](https://neinsteinplasticsurgery.com/) in NYC, likes the Lutronic Ultra™ because the non-ablative, thulium laser works deeper in the skin without damaging the surface layer. “It’s a customizable, comfortable laser with minimal downtime,” Garrick says. It can for address fine lines and wrinkles, melasma, [hyperpigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments), acne and body scars, large pores, actinic keratosis, even [stretch marks](https://aedit.com/aedition/how-to-treat-stretch-marks) in all skin tones, she notes. 

<BeforeAfterModule
  title={Before & Afters: Laser Skin Resurfacing}
  procedureId={995}
/>

### **Laser Treatments to Avoid**
Those with darker skin tones should avoid [traditional resurfacing lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), like ablative [Fraxel®](https://aedit.com/aedition/guide-to-fraxel-laser-skin-resurfacing-treatments) and [carbon dioxide (CO2)](https://aedit.com/procedure/ablative-co2-laser) devices, because there is a risk of permanent hyperpigmentation, says [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist in NYC. 

Other light therapies that are best to steer clear of? [Intense pulsed light (IPL)](https://aedit.com/procedure/ipl) and broadband light (BBL). “We need to be extremely cautious, as IPL and BBL are really not safe for dark skin tones,” Dr. Frank says. He often sees complications in patients inappropriately treated with IPL devices by inexperienced practitioners. “You need to have laser-specific technology that works well on darker skin tones,” he explains, adding that those typically include the longer wavelength therapies mentioned above.

## **Laser Hair Removal for Darker Skin Tones**
For many years, [laser hair removal](https://aedit.com/procedure/laser-hair-removal) technology wasn't sophisticated enough to work for dark skin. “Traditionally, lasers work by beaming intense light at the follicle, which causes permanent damage so the hair no longer grows there,” Dr. Engelman explains. “The key was the contrast between the follicle and the skin.” That means people with fair skin and a dark hair follicle enjoyed the best results, while people with dark skin and dark hair or light skin and light hair didn’t have many options. 

In the case of patients with darker complexions, Dr. Engleman says the devices weren't able to distinguish between the skin pigment and the pigment of dark hair follicles. As a result, there was a risk of damaging the skin and causing hypopigmentation (light spots), blisters, or even scarring. Fortunately, the technology has come a long way. “I'm excited about the Nd:YAG laser, which safely penetrates deeper into the dermis, totally bypassing the pigment of the skin,” she shares, adding that the Q-switched device is the safest option for laser hair removal for darker skin tones.

The Deka Motus AX is another Q-switched laser that can effectively remove light *and* dark hair from all skin tones. “The one-of-a-kind wavelength used by the Motus AX allows for the treatment of fine and light hair, whereas most lasers are only effective for dark hair,” Dr. Frank explains. “Additionally, it is also effective for darker skin tones, which are not able to be treated with some other lasers.” Another benefit? It’s painless and requires half the number of sessions compared to standard treatments. “This laser is unique because it treats and heats the area very slowly, instead of the classic stamping technique of hair removal,” he says. “It also features a cooling system for increased comfort.”

## **The Takeaway**
While patients with darker skin tones should take special care in finding a provider, laser treatments (of all kinds) carry risks for everyone. “They are just instruments that rely on the performer,” Dr. Frank cautions. Generally speaking, you need to be careful using lasers on people with a history of [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter) and [psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis) or any type of skin disease, he says. Taking the time to [research and consult with](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) several providers will help ensure you get the best treatment for your needs.

From laser skin treatments to laser hair removal, tone matters — skin tone, that is. Here’s what you need to know about laser safety and efficacy.

Best Laser Skin Resurfacing And Laser Hair Removal Treatments For Darker Skin Tones

The Best Laser Treatments For Darker Skin Tones

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The stand-off between the two big light therapy therapies — [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) and laser — may be most often associated with hair removal, but the truth is these two options come up against each other in other categories, too. These include skin resurfacing, acne treatments, facial rejuvenation, and more. While they both employ light, there are key differences that set them apart and dictate their pluses and minuses — but picking the one that’s right for you isn’t always as straight-forward as you may think. 

If you find yourself faced with a choice between the two (meaning you meet the skin and hair coloring guidelines for the IPL usage you’re considering), the preference tends to come down to your feelings about your pain threshold, time commitment, recovery, results, and price. Here’s how they measure up.

## **What Is a Laser?** 
‘Laser’ is actually an acronym for light amplification by stimulated emission of radiation.  Lasers “use one strong wavelength targeting a specific chromophore,” explains [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645), a board certified dermatologist and founder of Russak Dermatology Clinic in New York City. That means they give a more concentrated pulse of light that penetrates deeper than their cousin, IPL, and they’re particularly good at stimulating [collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine). 

And, as we covered in our [guide to laser skin resurfacing](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), there are an array of tools to choose from. “Specific color wavelengths can better address certain skin issues,” Dr. Russak shares. “At the lower end of the color spectrum, [blue light](https://aedit.com/aedition/difference-between-professional-at-home-led-therapy) combats acne, targeting a more superficial depth of penetration into the skin where these lesions reside. At higher wavelengths, light can penetrate deeper into the skin, targeting brown pigment and even deeper for skin tightening.”

There are also subcategories of lasers to be aware of. “Skin resurfacing lasers can be [ablative](https://aedit.com/procedure/ablative-nonfractional-lasers) or [non-ablative](https://aedit.com/procedure/nonablative-nonfractional-lasers),” explains [Hadley King, MD](https://www.drhadleyking.com/), a board certified dermatologist and a clinical instructor of dermatology at the Weill Medical College of Cornell University in NYC. “The basic difference is that ablative lasers remove the top layer of skin, while non-ablative lasers work by heating up the underlying skin tissue without harming the surface, so that your body will produce new collagen.”  

## **What Is IPL?**
IPL stands for intense pulsed light. Like lasers, IPL uses light to treat the skin, however, “in the case of IPL, we use multiple wavelengths of light to address red and brown pigment in the skin, to tackle hair removal, and to stimulate neocollagenesis,” Dr. Russak says. 

While not as mighty as the laser, the pluses here are that IPL is usually less painful, is considered a ‘lunchtime treatment’ with little to no downtime, and, thanks to the use of different light wavelengths, can sometimes deliver dual results in one treatment. And because the ‘head’ of the device is larger and can cover more surface area, the sessions themselves tend to be shorter. It should be noted that IPL can only be used on lighter complexions, as “the risk of burning the skin increases with darker skin tones,” Dr. King explains.

## **What Do Lasers & IPL Do for Skin?**
Research shows IPL can be effective for improving [wrinkles](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6983864/), [blood vessels and vascular lesions](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6983864/),  [sun spots](https://pubmed.ncbi.nlm.nih.gov/15004823/), [acne](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051300/), and [skin texture](https://jamanetwork.com/journals/jamadermatology/fullarticle/407425). And the list for lasers is even longer, with more benefits seen in correcting [acne scars](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134658/), [tattoo removal](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411606/), and overall resurfacing ([one study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118506/) finding that after a two year follow-up 100 percent of patients reported feeling the treatment had improved their skin). 

When both are an option, the decision is often a trade-off between the degree of results people are seeking versus the intensity of the treatment. For instance, Dr. King says that for “true resurfacing” she recommends lasers. But, for the right candidate, IPL (sometimes called a photofacial) is her treatment of choice for sunspots. There are exceptions here, though. Dr. Russak points out that IPL is not recommended on patients with melasma or who tend to [hyperpigment](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments) easily. “The heat can cause overproduction of pigment,” she says.

Now that you generally understand what they can do for the skin, here’s what you need to know about the treatments:

### **IPL vs. Lasers:** What’s the Difference in Downtime?
IPL is usually said to have [less downtime](https://aedit.com/aedition/category/recovery), but there are cases where lasers outrun it. Dr. King insists the amount of time it takes for side effects to subside “will depend entirely on the laser and what settings are used for either the laser or the IPL.” Dr. Russak agrees, explaining that just because lasers reach deeper does not mean you always have a longer recovery period. However, if you’re talking ablative lasers, IPL is the clear winner in this department. “Typically, if you are comparing a skin resurfacing laser that compromises the surface, yes, you would have more downtime than IPL,” she says. 

On the flip side, some uses of IPL can end up with a more substantial recovery than you might expect. An example: “In an aggressive setting where the goal of using an IPL is primarily to address brown spots on the skin … in order to get those great results, you will require more downtime,” Dr. Russak notes.

### **IPL vs. Lasers:** How Many Treatments Will You Need?
When going head to head, laser therapy tends to require fewer treatments to see results — but it really depends on your specific case. “IPL will usually require a series of several treatments,” explains Dr. King. “With laser treatments, it will depend on the intensity of the particular laser.” Some require a series while others may only be performed, at most, once a year at most.

### **IPL vs. Lasers:** What’s the Difference in Price? 
If you’re under the assumption that IPL is less expensive, you’re not wrong. But it doesn’t always work out that way. “Price always varies depending on strength of IPL or laser, downtime, results associated, number of treatments to achieve results, and technician experience,” Dr. Russak says. So, you might want to price out your options with your doctor to see which is better for your wallet *and* your needs in the end.  

## **Which Is Best for Hair Removal?**
While this article was to focus on lasers and IPL for skin resurfacing, we’d be remiss not to mention how each can be used to [remove unwanted hair](https://aedit.com/aedition/how-to-use-at-home-laser-hair-removal-devices). First, a note: The way IPL interacts with melanin is why it isn’t recommended for darker skin tones — and it also means that folks with naturally light hair are not candidates to use it for hair removal either, as it won’t ‘find’ the hair. You also can’t have a sun tan, even if it came from a bottle. “IPL can not tell the difference between pigment within the skin caused by damage or pigment within the skin making up the patient's natural skin tone,” Dr. Russak shares. 

If you happen to qualify for both [laser hair removal](https://aedit.com/procedure/laser-hair-removal) and [IPL](https://aedit.com/procedure/ipl-for-unwanted-hair), studies have shown both IPL and laser treatments to have an impact on halting hair growth. One [study found](https://pubmed.ncbi.nlm.nih.gov/25229781/#:~:text=The%20diode%20laser%20was%20more,results%20in%20axillary%20hair%20removal.) that, in separate groups receiving one of the two treatments, both saw a significant reduction after six sessions (though the IPL treatments took place over a longer period of time). The study’s authors noted that while “the diode laser was more effective,” it was “more painful than the IPL.” Yet another reason why pain tolerance is often a determining factor in this decision for patients. 

## **The Takeaway**
Both lasers and IPL can have skin resurfacing and hair removal benefits, but it’s important to determine whether you are the right candidate. IPL for any purpose is usually only an option for those at the lighter end of the [Fitzpatrick scale](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), while those with light hair are not a good fit for hair removal. Lasers, meanwhile, may come with a higher price tag and more downtime but often offer more variety. Consulting with a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) dermatologist or plastic surgeon will ensure you receive the best treatment for your needs.

The ins and outs of the two skin resurfacing and hair removing light therapies explained.

Difference Between IPL And Laser Treatments For Skin Resurfacing, Hair Removal

IPL vs. Lasers: What’s The Difference?

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Looking into lasers? Now’s the time — especially if you’re lucky enough to work from home. There are probably no social gatherings, weddings, or birthday parties on your calendar for the foreseeable future. One laser with a lot of name recognition? Fraxel®, which addresses skin concerns ranging from hyperpigmentation and [acne scars](https://aedit.com/aedition/how-to-treat-acne-scars) to dullness to fine lines by essentially peeing them all away to reveal a fresh layer of healthy, glowing skin. 

Why is this [laser skin resurfacing](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) treatment so popular at the moment? “Now, people want the bigger bang for their buck. They have more time for downtime being home and money to spend from not going on vacations or dining out,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a New York City-based board certified dermatologist and author of *The Pro-Aging Playbook*. “Patients are doing more aggressive treatments like Fraxel® versus [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant), FaceTite versus [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy), or [tumescent liposuction](https://aedit.com/procedure/tumescent-liposuction) versus non-invasive fat removal.”

Here, top cosmetic dermatologists break down the technology, what it treats, the recovery process, how long the results last, and more. 

## **How Fraxel Works**
Fraxel® is a fractional laser treatment, which means it only targets a fraction of the skin at a time. “It is the Ferrari of laser resurfacing,” Dr. Frank says. Why? The device is both versatile and customizable, with the ability to go through every layer of skin. “The advantage of Fraxel® over other laser skin procedures and treatments is that you are not breaking the skin, the healing is rather open,” he notes. 

The Fraxel® portfolio has different treatment options depending on a patient’s skin concerns. Regardless of which device you choose, it works by creating tiny columns of microthermal treatment zones that stimulate cellular regeneration and collagen production to accelerate the body’s natural healing processes. As such, Fraxel® treats fine lines and wrinkles, such as crow’s feet and brow lines, in addition to surface scarring, explains [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist in NYC. It also addresses pigmentation issues like age spots, sun damage, actinic keratosis (a common precancerous skin condition), and the appearance of large pores.

### **Types of Fraxel**
[Fraxel® Dual](https://aedit.com/procedure/nonablative-fractional-lasers) is a non-ablative (read: non-wounding) fractional laser that features two wavelengths (1550 and 1927) to address an array of skin concerns on the face and body. The 1927 wavelength addresses skin tone (think: pigmentation concerns), while the 1550 wavelength treats skin texture (read: fine lines and wrinkles and scarring). For those interested in a more dramatic result, [Fraxel® Repair](https://aedit.com/procedure/fraxel-repair) is an ablative (i.e. wounding) fractional treatment featuring a [carbon dioxide (CO2) laser](https://aedit.com/procedure/ablative-co2-laser) wavelength. It can treat deeper scars and wrinkles, in addition to skin laxity.

## **Ideal Candidates for Fraxel**
Those looking for anti-aging, scar correction, stretch mark improvement, or preventative care are all good candidates for this treatment, Dr. Engelman shares. Fraxel® Dual is generally considered safe for most skin tones, including ones on the darker end of the [Fitzpatrick scale](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types).

While it’s an effective treatment for [hyperpigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments), those with melasma should tread carefully. “Fraxel®, like most lasers, can make melasma worse, as melasma is often worsened by heat in addition to sun, and lasers are hot,” explains [Amy Wechsler, MD](https://www.dramywechsler.com/), a board certified dermatologist in NYC. An experienced practitioner may, however, be able to assist. “Fraxel® can certainly be helpful in those who have melasma, but it should be performed by a licensed and trained physician who knows the intricacies, risks, and specific and appropriate treatment parameters,” Dr. Engelman notes. 

## **What to Expect from a Fraxel Treatment**
About a week prior to a Fraxel® treatment, your provider will likely recommend you stop using [retinol, retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), and other sensitizing skincare products. Skin should also be relatively clear (i.e. no serious breakouts, open wounds, or infections). On treatment day, the area will be [topically numbed](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) for about 45 minutes and the procedure itself will take 15 to 30 minutes. Even with the anesthetic, patients report feeling everything from mild tingling to a bee sting-like effect. A good rule of thumb? Expect to experience a prickling sensation.

## **Fraxel Recovery & Results**
It should come as no surprise that [recovery time](https://aedit.com/aedition/category/recovery) depends on the type of Fraxel® treatment you get. “Recovery time typically includes one week of potential redness (erythema) and [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) (edema), and patients have to be very strict about photoprotection during healing,” says Emma Taylor, MD, a board certified dermatologist and chief medical officer at [Symbiome](https://www.symbiome.com/). In fact, your [post-op skincare regimen](https://aedit.com/aedition/skincare-after-facial-plastic-surgery-procedures) is key to maximizing results. “Patients should avoid all types of sensitizing agents, like serums, retinols, [glycolic](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare), and other exfoliating agents for one week, and [stay out of the sun](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot) at least two weeks following treatment since the skin will be sensitive,” Dr. Frank says. 

The first two days post-procedure are usually likened to recovering from a [sunburn](https://aedit.com/aedition/how-to-relieve-and-treat-sunburn), and skin texture usually starts to roughen up and flake between days three and five. Some parts of the body respond differently than others, so this may take more or less time. It should also be noted that Fraxel® Repair often has a longer recovery process due to its ablative nature. 

Depending on your skin concerns and aesthetic goals, a series of treatments may be suggested. For people with severe sun damage, Dr. Frank usually performs a series of two to four monthly treatments. “For people who want general resurfacing, I recommend a once-a-year treatment,” he says. “People with a history of skin cancer usually get it done twice a year.”

How long results last will vary by patient and skin tone, but Dr. Wechsler says they can be enjoyed for a year or more. Dr. Engleman often recommends annual Fraxel® treatments to maintain the quality of the skin. “We lose one percent of our collagen a year by the time we reach 30, so a treatment like this once a year will help to build up our collagen as opposed to it diminishing,” she explains. 

## **The Takeaway**
Fraxel® is an effective treatment option that can address a wide variety of skin concerns for an array of skin tones, but [finding the right provider](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) is key. “It’s important to see a board certified dermatologist who is an expert not only at addressing the relevant skin conditions but also someone who understands the potential side effects to maximize benefit and minimize risk to the patient,” Dr. Taylor explains. 

Aggressive treatments on the wrong patient or skin type can lead to long-lasting pigment or scarring issues. “Certain patients with underlying health conditions and certain skin types should be treated with caution or not at all, so a proper consultation to determine a treatment plan is always recommended,” Dr. Engleman concludes.

You’ve likely heard of Fraxel®, but do you know its benefits? Top dermatologists break down the ins and outs of the skin resurfacing procedure.

Fraxel Laser Skin Resurfacing: Benefits, Treatment, Recovery

Everything You Need To Know About Fraxel Laser Treatments

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The term ‘laser’ — short for light amplification by stimulated emission of radiation — includes a host of technologies aimed at everything from correcting complexion concerns to zapping warts and cancerous lesions. There are lasers for [tattoo removal](https://aedit.com/procedure/laser-tattoo-removal), lasers for getting your glow on, and lasers that [remove unwanted hair](https://aedit.com/procedure/laser-hair-removal) (to name just a few).

We’ve touched on the [different types of lasers](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures) before, so here’s a recap:

- **Ablative**: These lasers removed some or all of the epidermis.
- **Non-Ablative**: Lasers that leave the skin intact, while heating the dermis to stimulate collagen and elastin production.
- **Fractional**: These lasers have a pixelated energy beam that dissipates some of the heat.
- **Non-Fractional**: The laser beam remains focused and concentrated to treat smaller areas.

Different combinations of the above (think: [ablative fractional](https://aedit.com/procedure/ablative-fractional-lasers), [ablative non-fractional](https://aedit.com/procedure/ablative-nonfractional-lasers), [non-ablative fractional](https://aedit.com/procedure/nonablative-fractional-lasers), [non-ablative non-fractional](https://aedit.com/procedure/nonablative-nonfractional-lasers)) make a laser better suited for different concerns. Non-ablative [pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser) like the Vbeam®, for example, are great for treating vascular lesions (i.e. broken capillaries and stretch marks). A non-ablative fractional laser like [Clear + Brilliant](https://aedit.com/procedure/clear-brilliant) is commonly called a ‘lunchtime laser’ because it produces only very slight inflammation (the ‘glow’) with minimal downtime. The tradeoff, of course, is less dramatic results.

When it comes to the big guns (so to speak) — those lasers capable of actually resurfacing the skin in the most technical sense — we’re talking about [ablative carbon dioxide (CO2)](https://aedit.com/procedure/ablative-co2-laser) and [ablative erbium](https://aedit.com/procedure/ablative-erbium-laser) lasers. Treatments with these technologies are also known as a laser peel, laser vaporization, and lasabrasion. The trend has been toward using the fractional varieties, like [Fraxel® Re:pair](https://aedit.com/procedure/fraxel-repair) (CO2) and erbium YAG (a.k.a. Er:YAG, which stands for yttrium aluminium garnet, for you science-y types).

## **Ablative Laser Skin Resurfacing 101**
Let’s back it up for a minute: what do these ‘amplification radiation’ tools really do to your skin? “Lasers are light waves that attack certain targets,” explains [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), board certified plastic surgeon in Los Angeles. “There are certain lasers that attack redness and certain lasers that attack any dark pigmentation. Those are generally for tattoo removal, red spots, or taking redness out of scars.”

So, where do the skin resurfacing lasers come into play? “Then there’s skin resurfacing lasers, which attack water,” he continues. “A carbon dioxide laser is more like a general nuke bomb that causes more heat in the area and has more thermal injury.” There is an increased risk of [hyperpigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments) after treatment because that thermal injury can also destroy melanocytes (the skin's pigment cells), he adds. Erbium lasers, meanwhile, have a “higher affinity for water,” which means they cause “less thermal damage,” Dr. Jason says. Typically, this results in a quicker recovery time compared to carbon dioxide lasabrasion.

The net net? With ablative laser resurfacing, we’re talking about creating a controlled burn to the skin to stimulate the healing process, generate elastin and collagen production, and, ultimately, produce brand spanking new skin cells.

### **What Concerns Does Ablative Laser Resurfacing Treat?**
Erbium and CO2 lasers address a myriad of aesthetic skin concerns, including:

- Fine lines and wrinkles (especially on the forehead, around the mouth, and under the eyes)
- Chickenpox and acne scars
- Sun damage
- Age spots (a.k.a. liver or sun spots)
- Warts 
- Certain birthmarks
- Sebaceous hyperplasia (tiny bumps — often on the nose — as a result of inflamed oil glands)

“Ablative resurfacing is a good option for people who have surface changes to the skin such as extensive sun damage, dark spots, large pore size, fine lines and wrinkles,” says [Adriana Lombardi, MD](https://aedit.com/provider/adriana-lombardi-md-12670), a board certified dermatologist and founder of the Skin Cancer & Cosmetic Surgery Center of New Jersey.

### **How Ablative Laser Skin Resurfacing Works**
Laser skin resurfacing machines vary, but they’re essentially vertical, box-like contraptions on wheels with some type of wand or handheld attachment that offer customizable treatment options. “You can control the depth based on the settings of the laser,” Dr. Jason says. “You can up the energy and it’s going to go a little bit deeper.” 

In addition to the machine’s settings, the degree of resurfacing is also dependent on the technique of the practitioner. “If you keep doing passes, it’s going to go deeper and deeper and deeper,” he explains. The trick is to create as little overlap as possible with each pass to ensure an even result.

We went down the rabbit hole for a second and wondered: how deep is too deep? “You don’t want to go so deep to the point where you’re causing true scarring,” he says. To explain that sweet spot, [let’s revisit skin anatomy 101](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures)…

### **How Deep Ablative Laser Skin Resurfacing Goes**
Human skin is composed of two layers: the epidermal (outer) layer and the dermal (inner) layer. The former contains mostly keratin and dead skin cells and the latter is made mostly of collagen and elastin. We’ve covered the five layers making up the epidermis already, so now let’s delve — *ahem* — deeper into the two layers that make up the dermis:

- **Papillary**: The superficial of the two dermal layers, it’s composed of highly vascular connective tissue.
- **Reticular**: A thicker and denser layer of connective tissue that makes up the majority of the dermis.

The dermis contains blood vessels, nerve endings, hair follicles, and glands. This layer supports the epidermis, helps regulate body temperature, and serves as an important physical and immunological barrier. It’s important that you don’t do too much damage to this layer or your skin won’t be able to regenerate. But certain skin concerns call for maximum penetration. “For deep wrinkles around the mouth, you need to go deep into the dermis,” Dr. Jason explains. “We tend to go down to the reticular and papillary juncture at the most.” In case you were wondering, this is precisely why you need to visit a highly trained, [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) plastic surgeon or dermatologist for any laser treatment.

If you paid attention during our [primer on the five epidermal layers](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures), you might be wondering how the epidermis ‘magically’ reappears after it's burned off. According to Dr. Jason, there are still enough skin cells left in the dermis after treatment (in the recesses of the hair follicles, for example) for your epidermis to gradually rebuild itself.

### **Preparing for Ablative Laser Skin Resurfacing**
With any type of laser skin treatment, it’s best to consult with a board certified provider. Ablative laser resurfacing absolutely requires the expertise of a board certified plastic surgeon or dermatologist, however, the rules governing exactly who can perform laser treatments vary from state to state. In California, for example, it has to be a medical professional (read: not an aesthetician). Regardless of the regulations, do your research and find someone with extensive experience.

During your [consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation), talk to your provider about your medical history. Treatment can trigger outbreaks like herpes and [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter). Your [skin type](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), as well as any skin conditions like [rosacea](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-rosacea) and melasma will certainly affect your treatment plan. You’ll also need to stop certain medications, including drugs and [supplements](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery) that inhibit blood clotting (think: aspirin, ibuprofen, [vitamin E](https://aedit.com/aedition/guide-to-topical-vitamin-e-in-skincare), turmeric).

### **What It’s Like to Get Ablative Laser Skin Resurfacing**
In a nutshell, you’ll be asleep for the entire procedure. Due to the pain involved, [general anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) — though not absolutely required — is the standard of care for ablative CO2 and erbium YAG laser skin resurfacing. Dr. Jason says that it’s too difficult to numb the face with topical anesthetic to the degree necessary to keep the patient comfortable.

Depending upon the area(s) being treated, laser skin resurfacing can take anywhere from 30 minutes to two hours, and it will set you back somewhere in the neighborhood of $2,000 to $3,000. Unless you’re undergoing more extensive plastic surgery at the same time, it’s an outpatient procedure.

### **Recovering From Ablative Laser Skin Resurfacing** 
“We have many different types of lasers, so what to expect afterwards and how much downtime there is depends on the type of laser you are receiving,” explains [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645), a board certified dermatologist and founder of Russak Dermatology Clinic in New York City. Intensive laser skin resurfacing isn’t exactly a ‘set it and forget it’ cosmetic procedure. After treatment, your face will be bandaged. Beginning 24 hours post-op, you’ll clean the area and apply ointment (like petroleum jelly) several times a day to prevent scabbing. Healing takes anywhere from 10 to 21 days, depending on the treatment area. 

[Swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) after resurfacing is common. Your doctor may prescribe steroids to keep it in check, especially if you’ve had treatment around the eyes. [Elevating the head](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing) (including while sleeping) and icing for the first 48 hours can minimize swelling. Burning or itching in the first few days is common. Expect the skin to peel about a week post-treatment.

[Avoid your usual skincare and makeup](https://aedit.com/aedition/skincare-after-facial-plastic-surgery-procedures) until the wounds heal completely. Instead, look for products specially formulated for sensitive, post-procedure skin, and use only as directed by your doctor. Redness can linger for a few months (maybe even longer, if you’re fair-skinned). Your provider will let you know when it’s safe to use a green-tinted concealer to hide residual redness. [Sunscreen](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors) and [moisturizer](https://aedit.com/aedition/difference-between-creams-lotions-moisturizers) are critical to keeping your fresh skin hydrated and protected. 

## **Combining Laser Peels with Other Procedures**
Many surgical facial rejuvenation patients (think: facelifts and blepharoplasties) opt to add on ablative laser skin resurfacing while they’re at it. Experts say that cosmetic procedures like these can be [safely combined](https://aedit.com/aedition/best-surgical-and-non-surgical-cosmetic-procedures-to-combine) in the right candidates. A resurfacing laser, he says, can be like the icing on the cake of any anti-aging facial surgery. Patients experience the added bonus of one recovery period.

“Right now, in the time of COVID-19, it’s perfect for treatments that require more downtime because most people are staying home and [wearing masks](https://aedit.com/aedition/influence-of-covid-19-face-masks-on-medical-aesthetics-trends) when they are out and don’t need their faces to be seen,” Dr. Russak notes. “ Chemical peels and strong ablative lasers are [very popular at the moment](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape).“

## **Non-Ablative Lasers & IPL**
We promise we’re not purposely trying to confuse you, but there are also erbium YAG lasers (and a whole host of other types) that are non-ablative, meaning they don’t remove the epidermis. Don’t be surprised if a ‘simple’ Google search for laser resurfacing leaves your head spinning. That’s why it’s best to consult with your trusted provider and rely on their expertise to address your particular concerns.

Technically speaking, it’s more accurate to describe [non-ablative lasers](https://aedit.com/procedure/nonablative-laser-skin-resurfacing) and [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) as skin refining rather than skin resurfacing, since they don’t remove the epidermis. Instead, these treatments use light to heat the underlying dermal layer, stimulating collagen and elastin production. Non-ablative lasers treat skin with a single wavelength of light, whereas IPL utilizes multiple wavelengths. The result? A gentler (but also less dramatic) procedure.

Dr. Lombardi’s go-to non-ablative regimen includes non-ablative erbium YAG (M22 ResurFX) and IPL. She uses them alone or in combination, depending on the patient. “Combining a non-ablative laser plus the IPL targets both surface changes as well as wrinkles and scarring and has minimal downtime,” she notes.

### **What It’s Like to Get Non-Ablative Laser & IPL Skin Resurfacing**
As Dr. Lombardi explains, IPL does not require any topical numbing medication. While the flash of light can be startling, the pain is described as similar to a snapping rubber band. Most patients find it tolerable. Non-ablative erbium YAG treatments do require topical anesthetic because the laser is going deeper into the skin and can be more painful. “We typically use a topical numbing product for 30 minutes prior to the procedure and use ice packs during it,” she shares.

Unlike the one-and-done nature of ablative resurfacing, non-ablative and IPL treatments are usually done in series. Dr. Lombardi often recommends three sessions spaced one month apart for best results. Another tip? Consider booking now. “The winter time is ideal as a patient cannot be tan prior to laser treatment,” she adds.

### **Recovering From Non-Ablative Laser & IPL Skin Resurfacing** 
Compared to ablative laser procedures, non-ablative lasers and IPL have a far more truncated recovery process. “Clear + Brilliant really doesn’t have any downtime besides the few hours of redness post laser, whereas IPL will make brown spots appear darker post-treatment and flake off after a few days and you will have swelling for a few days following,” Dr. Russak explains. “With an erbium laser you can have redness and skin peeling for up to one week.”

## **Risks of Laser Skin Resurfacing**
Removing layers of skin — your body’s first line of defense — is a delicate business. Risks of both ablative and non-ablative laser treatments include infection, burns, scarring, and unwanted pigmentation changes (either hyper- or hypopigmentation). Darker skin carries a higher risk of hyperpigmentation. Burning, itching, redness, skin peeling, and milia (tiny white bumps on treated areas) are typical and temporary post-ablative procedure side effects.

Forget everything you think you know about lasers. Here’s the scoop on the lasers capable of actually resurfacing the skin in the most technical sense.

Ablative Laser Skin Resurfacing: Treatment, Benefits, Recovery, Cost

Everything You Need To Know About Laser Skin Resurfacing

shutterstock 1344095783

Let’s face it: we tend to take our skin for granted. When we’re young, our skin seems impervious to daily abuse. Our [sunburns](https://aedit.com/aedition/how-to-relieve-and-treat-sunburn) heal, our pores survive bouts of pimple-picking, and creases instantly plump back up all thanks to a seemingly endless supply of fresh, new skin cells constantly regenerating. But, as we age, that process of cell turnover (technically known as desquamation) slows, leading to a buildup of dead skin cells on the surface. Even with the most [diligent skincare routine](https://aedit.com/aedition/aesthetic-skin-aging-concerns-skincare-cannot-treat), scars, sunspots, broken blood vessels, and fine lines (to name a few!) become more pronounced. The complexion takes on a dull, uneven, and crepey appearance.

The solution to this problem seems simple: Why not just slough it all off? And that’s the underlying premise of skin resurfacing, a category of cosmetic treatments that’s gaining popularity as technology advances. To make sense of all the procedure options, we talked to two cosmetic dermatologists about the ins and outs of skin resurfacing.

## **Skin Structure 101**
Before undergoing or even considering a skin resurfacing treatment, it’s useful to know a little about the anatomy of the body’s largest organ. Human skin is made up of two layers: the dermis and the epidermis. The innermost layer is called the dermis and contains blood vessels, nerves, sweat and oil glands, hair follicles, and the coveted collagen and elastin that gives the skin its structure. The outermost layer, meanwhile, is known as the epidermis. It is comprised of five distinct levels, Below is a breakdown from the inside out: 

1. **Stratum Basale**: Where skin cells (a.k.a. keratinocytes) are born. This layer also contains melanocytes (pigment cells) and merkel cells (receptors sensitive to touch).
2. **Stratum Spinosum**: Composed of eight to 10 cell layers, this ‘spiny’ layer contains irregularly shaped cells that fortify the skin.
3. **Stratum Granulosum**: This granular level, three to five cell layers deep, contains bundles of keratin (to give skin strength) and lipids (to provide a cohesive moisture barrier). 
4. **Stratum Lucidum**: Present only in the thicker skin of the fingers, palms, and soles, this ‘clear’ layer (named for the absence of granular bodies) is two to three cell layers thick.
5. **Stratum Corneum**: Made up of about 20 to 30 layers of keratin and dead keratinocytes, it’s the uppermost layer of our skin  and plays an important role in our immunity. 

The body has a natural skin resurfacing mechanism known as desquamation. During this process, the entire stratum corneum is replaced by new cells that have worked their way up from the stratum basale. This regeneration happens every four weeks or so. 

The desquamation process changes with age, which often results in a thicker layer of dead cells on the surface of the skin. “We build up skin cells that block the pores from receiving all the nutrient- and vitamin-rich serums we’re applying daily. Dead skin cell buildup also makes our skin appear dull and accentuates wrinkles,” explains [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645), a board certified dermatologist and founder of Russak Dermatology Clinic in New York City. “In order to get optimal product penetration and help slow down the aging process, we need to aid the process of regeneration quicker by resurfacing our skin.”

## **What Is Skin Resurfacing?**
Skin resurfacing treatments are designed to remove the skin’s outermost layers to reveal brighter, smoother, and more even skin beneath. The term ‘skin resurfacing’ encompasses a variety of cosmetic treatments that address common complexion concerns, including:

- Fine lines and wrinkles
- Pigmentation (think: sunspots and broken capillaries)
- Acne and acne scarring
- Uneven skin tone and texture

Different treatments remove layers of skin to varying degrees, which allow them to address different aesthetic concerns. “Skin resurfacing creates wounds and stimulates the healing process which, in turn, stimulates collagen production,” says [Adriana Lombardi, MD](https://aedit.com/provider/adriana-lombardi-md-12670), and board certified dermatologist and co-director at Advanced Laser and Skin Cancer Center of New Jersey. Needless to say, collagen and elastin are the hallmarks of youthful, healthy skin.

## **What Are the Main Types of Skin Resurfacing?**
Though there are several categories of skin resurfacing, the modalities share a common bond: they all use energy, in various forms, to remove layers of skin cells and/or stimulate the skin to rebuild itself. The most common types of skin resurfacing techniques include:

- Light-based therapy (think: lasers and IPL)
- Mechanical methods (like dermabrasion, dermaplaning, microneedling)
- Chemical treatments (i.e. peels)

If you feel like you've heard more talk of skin resurfacing in the past year, you’re not imagining it. “COVID-19 has given people an opportunity to have cosmetic procedures done without having to worry about ‘downtime,’” Dr. Lombardi says. “People have been working from home, major events have been placed on hold, and [people are wearing masks](https://aedit.com/aedition/influence-of-covid-19-face-masks-on-medical-aesthetics-trends).”

In the coming weeks, we’ll be diving deep into each of the categories mentioned above to bring you everything you need to know about these treatments. For now, we’re just, well, scratching the surface:

### **Laser Skin Resurfacing**
The word ‘laser’ is actually an acronym for: Light Amplification by Stimulated Emission of Radiation. In other words, a laser device focuses light energy into a concentrated beam. There are four general classifications for skin resurfacing lasers: 

1. [Ablative Fractional Skin Resurfacing](https://aedit.com/procedure/ablative-fractional-lasers)
2. [Ablative Non-Fractional Skin Resurfacing](https://aedit.com/procedure/ablative-nonfractional-lasers)
3. [Non-Ablative Fractional Skin Resurfacing](https://aedit.com/procedure/nonablative-fractional-lasers)
4. [Non-Ablative Non-Fractional Skin Resurfacing](https://aedit.com/procedure/nonablative-nonfractional-lasers)

Ablative (a.k.a. wounding) lasers completely remove the top layer of the skin, whereas non-ablative (or non-wounding) lasers heat up the skin’s underlying layers to stimulate collagen production. ‘Fractional’ means that the energy from the laser is dispersed, rather than concentrated in a beam. Breaking up — or fractionating — the energy makes the treatment gentler, with less downtime, but it also means that the laser treatment isn’t as powerful. Non-fractional lasers act on the entire surface area.

Due to the variety, laser skin resurfacing can address a myriad complexion concerns:

- Fine lines and wrinkles
- Hyperpigmentation (including both sun damage and rosacea)
- Scars
- Tattoo removal

In fact, it’s even being used to treat skin cancer. While milder laser skin treatments require only topical numbing cream, the more intense ablative lasers are best done with some form of [anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia). It’s absolutely critical to visit a highly experienced professional for any type of laser procedure to avoid the possible risks ranging from infection and burns to unwanted pigment changes and scarring.

Unlike lasers, which use a single wavelength to target complexion concerns, [intense pulsed light (IPL) therapy](https://aedit.com/procedure/ipl) uses multiple wavelengths to treat skin. Compared to lasers, IPL tends to be less targeted and less intense (think: less downtime but also less dramatic results). Case in point? “IPL does not require any topical numbing medication,” Dr. Lombardi notes. It can treat more minor skin concerns and is also used for [hair removal](https://aedit.com/procedure/ipl-for-unwanted-hair).

### **Dermabrasion, Microdermabrasion, & Dermaplaning**
Dermabrasion, its gentler cousin microdermabrasion, and dermaplaning are all mechanical forms of skin resurfacing. These techniques involve physically scraping the outer layers of the skin’s surface to remove textural irregularities like fine lines and mild scarring. Like laser skin resurfacing, dermabrasion can address irregularities like fine lines, pigmentation, age spots, and scars.

So, what’s the difference between these techniques?

- **[Dermabrasion](https://aedit.com/procedure/dermabrasion)**: This invasive, surgical procedure essentially sands the skin using a rotating abrasive brush or wheel to remove the upper layers. Depending upon the area being treated and the depth desired, some form of anesthesia is required. The skin is wounded and requires time to heal before revealing smoother skin beneath.
- **[Microdermabrasion](https://aedit.com/procedure/microdermabrasion)**: This minimally invasive treatment uses an abrasive crystalline material sprayed or rubbed onto the skin to remove only the outermost dead skin cells. Although there is no damage to the skin’s underlying layers, some inflammation and swelling occurs, resulting in a ‘glow’ effect.
- **[Dermaplaning](https://aedit.com/procedure/dermaplaning)**: Also called microplaning, this non-invasive treatment exfoliates the skin’s dead outer cells (along with any peach fuzz) with a surgical scalpel. Bolstered by COVID-19 stay-at-home orders, [DIY dermaplaning](https://aedit.com/aedition/benefits-of-face-shaving-at-home-dermaplaning) has been trending recently. It’s similar to shaving, but the blade is tailored specifically for exfoliation.

Because of the risks involved (and the anesthesia required), dermabrasion should only be performed by a plastic surgeon or experienced dermatologist. It’s safe to see a licensed aesthetician for microdermabrasion and dermaplaning, but it’s a good idea to run it by your dermatologist first — especially if you’re going the DIY route.

### **Chemical Peels**
Resurfacing the skin using a chemical solution (usually an acid) is known as a chemical peel. Chemical peels are classified into three basic categories: 

1. [Superficial chemical peels](https://aedit.com/procedure/superficial-chemical-peels)
2. [Medium chemical peels](https://aedit.com/procedure/medium-depth-chemical-peels)
3. [Deep chemical peels](https://aedit.com/procedure/deep-chemical-peels)

Superficial peels (a.k.a. ‘lunchtime’ peels) remove only the outermost, dead cells, while medium and deep peels reach — you guessed it — progressively deeper levels. Regardless of the potency, the chemical solution is applied, given time to work its magic, then neutralized. Afterwards, the skin literally peels or flakes off over time. The severity and duration is dependent upon the strength of the peel. Like their resurfacing counterparts, chemical peels address skin concerns ranging from dullness and sun damage to fine lines and wrinkles.

Medium and deep chemical peels require a doctor’s supervision, in spite of what you may have seen on the internet and social media. It’s safe, however, to have your licensed aesthetic practitioner perform a superficial peel, though you should consult your dermatologist before using any [at-home peel treatments](https://aedit.com/aedition/difference-between-medical-grade-chemical-peels-at-home-exfoliators).

### **Microneedling**
This trendy treatment (also known as collagen induction therapy) involves pricking the skin with tiny, sterile needles. Creating these micro-wounds stimulates the skin’s innate rebuilding process, while swelling and inflammation lend a temporary glow. 

Proponents of [microneedling](https://aedit.com/procedure/microneedling) cite measurable increases in new collagen and elastin production with repeated sessions, particularly with the addition of the patient’s [platelet rich plasma (PRP)](https://aedit.com/procedure/microneedling-with-prp). Other reported benefits include a reduction in fine lines, pore size, acne, acne scars, and hyperpigmentation.

Despite its ubiquity on social media, microneedling (and its [at-home counterpart dermarolling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling)) is not a one-size-fits-all, risk-free treatment. Possible complications include infection, bleeding, bruising, enlarged pores, and scarring, so make sure you do your homework and seek out a highly trained, licensed professional. Before dermarolling at home, consult with your dermatologist (and follow the directions to a T).

## **Preparing for Skin Resurfacing Treatment**
Before trying any skin resurfacing treatment — whether it be in your doctor’s office, a medspa, or at home — do your research. Not all techniques are appropriate for all [skin types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) or all skin conditions. We’ve covered many of the risks here, but it’s important to talk to a professional about your medical history and treatment options. Certain medications (like [Accutane](https://aedit.com/procedure/accutane) and [retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare)) can cause healing complications, while some medical conditions (like herpes and [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter)) can flare up post-op. 

Although downtime and side effects vary based on the treatment, it's best to avoid sun exposure and follow your post-procedure plan as directed by your provider. Whereas more invasive resurfacing options may have been avoided in the past due to the recovery time involved, there has been renewed interest during the pandemic. “Chemical peels and strong ablative lasers are very popular at the moment,” Dr. Russak notes.

## **How to Choose a Provider for Skin Resurfacing**
Skin resurfacing is typical of most other cosmetic procedures: the quality of your result depends on the skill of the practitioner you choose. But how do you determine whether it’s safe to see a licensed aesthetician for your treatment versus when you need to seek out a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) plastic surgeon or dermatologist? Generally speaking, experts agree that less invasive treatments (think: microneedling, dermaplaning, and light peels) can be safely performed by aestheticians, whereas deeper resurfacing (like ablative lasers and TCA peels) are best left to plastic surgeons and dermatologists. And for those [determined to do it yourself](https://aedit.com/aedition/dangers-of-diy-at-home-dermatology-beauty-treatments), be sure to talk to your doctor first.

From dermabrasion and microneedling to laser therapy and chemical peels, here’s what you need to know about resurfacing the skin.

Guide To Skin Resurfacing Procedures: Lasers, Chemical Peels, Microneedling, Dermabrasion, More

The Ultimate Guide To Skin Resurfacing

shutterstock 11281078

Ah, tweakment-related bruising. When you think about it, it’s logical that even supposedly ‘no downtime’ procedures (think: certain [vascular lasers](https://aedit.com/procedure/nonablative-fractional-lasers), [dermal filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers), and [neurotoxin injections](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin)) can leave you with marks and bruises that last a few days to a couple of weeks. After all, the areas of the face where people most often get this type of temporary help (the eyes, lips, and forehead) are also where the skin is quite thin and fragile — hence why they are prone to showing aging, volume loss, and texture issues in the first place.

So, what’s an easy-to-mark aesthetics fan to do? Trying what you can to prevent hematomas, caring for the ones that pop up despite your best efforts, and erasing all traces of them with makeup can all help. Here, the best practices for addressing those signs that make you feel like your face is screaming “Botox® needle was here” or “Filler just applied!” so you can tweak in peace.

## **What to Know Before You Go**
First, manage your expectations: Some people are simply more prone to bruising than others. A few things that can add to your propensity are age, certain medications, and good ol’ genetics. But it’s not all about you. Below are three other factors that may influence how much bruising and/or swelling you encounter after an injectable or laser treatment.

### **1. Find the Right Provider**
“Certainly experience and expertise matters when doing any procedure,” insists [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), board certified dermatologist at Washington Square Dermatology in NYC and a clinical assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai. That’s why visiting the most skilled provider matters. “It’s important to see a board certified dermatologist or plastic surgeon when doing cosmetic procedures, as they are trained in the anatomy of the face and have an understanding where the larger blood vessels are to minimize the risk of puncturing them,” he shares. Seeking out recommendations from people you know could be a good call, if possible. 

### **2. Ask About Technique**
Once you’ve found your doc, you’ve got another option to run by him or her when it comes to injections, says [Sarmela Sunder, MD](https://www.drcassileth.com/surgeons/dr-sarmela-sunder.html), a double board certified plastic surgeon in Beverly Hills: cannula or micro-cannula. These needles are blunt, flexible, and less likely to puncture blood vessels when going into the skin than the traditional rigid, sharp-tip variety. Whether you’re a candidate for using the technique comes down to factors like the type of product in the syringe, where it’s being injected, and doctor preference. But, according to Dr. Sunder, it’s worth asking about.

### **3. Skip Certain Supplements & Medications**
No matter the exact procedure you’re going in for, what you take beforehand can impact your recovery. “Patients must avoid all blood thinning agents such as NSAIDS, ibuprofen, Motrin, Advil, aspirin, green tea, omega-3 acids, fish oil, and many vitamins and supplements for two full weeks prior to their appointment to minimize their chance of bruising,” Dr. Sunder says. 

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If that seems like a long list, settle in because one or two days before your appointment there’s another no-no to add: Alcohol. [Research shows](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367875/#B1) it can increase bruising in non-surgical cosmetic treatment both before *and* after a treatment.

## **Bruise-Minimizing After Care**
Following your appointment, there are a few moves experts swear by to minimize bruising:

- **Ice Ice Baby**: Your doctor will likely have an ice pack handy, and Dr. Jaber says you should use it. He’s seen that periodically icing in the 24 hours post-procedure can minimize bruising.
- **Take a Rest Day**: Dr. Sunder suggests taking a break from things that get your blood pumping — like working out or being in extreme heat — for 48 hours after.
- **Sleep Strategically**: Sleeping with your head propped up with two pillows for a few days can help with swelling, as well as preventing and draining bruising.

As for treating dark marks, Dr. Jaber says his patients have taken arnica or bromelain to not only help decrease the risk of bruising but to help them fade faster, thanks to anti-inflammatory benefits that help the healing process. Some have found success using arnica topically as well to help them dissolve a few days ahead of schedule, [a strategy a 2016 research review](https://pubmed.ncbi.nlm.nih.gov/25171757/) concluded was both safe and effective. One to try: [Arnicare Gel](https://shop.boironusa.com/medicine/arnicare-gel/).

And if you really want to get rid of a bigger bruise in a hurry, there is one last option to try, though it involves going back to your doc. Dr. Jaber says to ask about KTP or [pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser), which can work on the blood vessels and “be used to treat the bruise and make it go away much more quickly.” But don’t say we didn’t warn you: Since they are vascular lasers themselves, there is a risk of light bruising. As such, it might not be the answer you’re looking for.

## **How to Conceal Post-Procedure Bruises**
Once you’ve done the best you can with ice, arnica, and the like, makeup can be an efficient way to conceal post-op bruising and dark marks. According to celebrity makeup artist [Suzy Gerstein](https://www.instagram.com/suzygerstein/?hl=en), it all starts with a high-quality densely pigmented concealer (she suggests [Kevyn Aucoin Sensual Skin Enhancer](https://www.sephora.com/product/the-sensual-skin-enhancer-P393953)). 

As for the age-old debate about whether concealer is best applied before or after foundation, she says it’s all a matter of preference. “It doesn’t really matter how you get to the party,” Gerstein explains. “Some makeup artists like to apply foundation before concealer to take the edge off of the discoloration before neutralizing and covering it completely, while others prefer to spot conceal and then blend it all together with foundation.”

Whatever your method, Gerstein insists the key to perfect concealer application is to “use a fine-topped, synthetic brush to concentrate the color just where you need it.” A concealer brush will do but she happens to love [Jenny Patinkin Luxury Vegan Pin Point Liner Brush](https://credobeauty.com/products/jenny-patinkin-pin-point-liner-brush). Then take a fluffier blending brush to buff out the edges before setting with powder.  

Final note: If there’s also swelling involved, think less is more. Not only do you need to be super careful with puffy areas (as not to irritate sore spots), but you should also go thinner with your makeup application. Gerstein says that anything thick “will draw the eye to the thing you’re trying to make recede.” Another tip? Switching to a slightly darker shade than you would usually think to use can also help. Going too light, she says, “will optically bring the area even more forward.” And that, of course, is exactly the opposite of your goal.

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

Your guide to preventing, minimizing, and treating those annoying telltale marks.