The Secrets of Laser Resurfacing

Alexander E. Spacher

New technologies can zap out everything from fine lines to brown spots quickly, but are they safe?

Until recently, blasting the skin with a carbon dioxide laser was the ne plus ultra of complexion renewal, but it involved a serious trade-off. The CO2 laser produces a beam of infrared light, which is absorbed by water in the skin, and that beam does a lot of damage. “With CO2, you look like a burn victim for weeks afterward,” says Gervaise Gerstner, M.D., a dermatologist in New York City and assistant clinical professor of dermatology at Mount Sinai School of Medicine.

The recent game-changer is the fractional laser (two predominant brand names are Fraxel and Affirm). Instead of that one beam, light is delivered in thousands of tiny columns, leaving the surrounding tissue intact and allowing for faster healing. “It makes micro-cuts in the skin and targets the body’s own collagen to re-spackle,” explains Dr. Gerstner. There are settings for two wavelengths: One can lift fine wrinkles, reduce pore size and lighten deep acne scars; the other can address sun damage, brown spots and the dark coloration called the “mask of pregnancy.” A physician can control the strength and power of the laser. “I usually start with what I call the ‘Upper East Side setting,’” says Dr. Gerstner. “People will be pink for one or two days. Then, after they know how their skin heals, they might say, ‘I don’t have anything on my social schedule. Pummel me.’”

An article published in Journal Watch Dermatology warns that the neck and eyelids are especially susceptible to scarring with the procedure. “Very rarely, a patient will develop temporary hyperpigmentation after a treatment if she or he is not vigilant about sun protection,” says Dr. Gerstner.

Perhaps unsurprisingly, not everyone agrees. “There’s no question that CO2 is still the gold standard,” says Michael McGuire, M.D., a plastic surgeon in Santa Monica, California, and past president of the American Society of Plastic Surgeons. “Even people who have spent their lives working outdoors can get dramatic improvement—skin tightening, removal of sun damage. But I wouldn’t be doing CO2 if it weren’t for an oxygen amino-acid spray, which means we don’t have to use antibiotics, six weeks of preparation and that long healing process. Fraxel helps you heal faster, but you don’t get the same results.”

Tried & Tested Laser Resurfacing Methods

The idea of any laser in untrained hands seems dangerous, so with the proliferation of at-home cosmetic gadgets, Departures decided to ask the staff nurses and aestheticians at the Imber Clinic (drimber.com) to test four of the most promising new devices available.

1. WrinkleMD employs anatomically shaped patches that fit around the eye area where smile and squint lines form. A mild electric pulse delivers hyaluronic acid into the skin. This is the same stuff in Juvéderm and Restylane. The idea is to reduce wrinkles without injections.

Good News: It works. Eye wrinkles were definitely reduced for 24 hours. Great to prep for a big event.

Bad News: The electric pulses cause a pricking sensation, and the device is meant to be used for 40 minutes twice a week for the first two weeks (then once a week afterward), a commitment many will find too time-consuming. $130; universitymedical.com.

2. LightStim for Wrinkles is a handheld LED device meant to stimulate collagen production and lessen wrinkles. It is applied for three minutes five times a week.

Good News: Skin takes on a warm glow, which may be necessary for collagen production, and observers report inflammation reduced in areas with acne.

Bad News: It takes six to eight weeks to see results, and treatments can go up to 30 minutes a day for large areas. Continued use is necessary. $300; lightstim.com.

3. Tria Hair Removal Laser works on the premise that the dark pigment in hair absorbs the beams of laser energy, converting them to heat and basically disabling the hair follicle to prevent it from growing new hair.

Good News: This user-friendly laser is an excellent, comfortable hair removal device.

Bad News: It’s little. All laser hair removal requires at least five treatments over five months to attack the hairs in various stages of their growth cycles. With its tiny head, this device will be irritating to use on large, hairy areas. But for small areas on people with fair skin and dark hair, it is an inexpensive alternative to professional laser hair removal. $395; triabeauty.com.

4. Palovia Skin Renewing Laser is a junior version of professional fractional light devices. It is touted to reduce wrinkles around the eyes.

Good News: It’s well designed, comfortable to use and will help build collagen to fight and possibly even eliminate wrinkles.

Bad News: It requires a real commitment. Five minutes a day for at least 30 days to see results, even longer for a better outcome. $500; palovia.com.