Laser technology as we know it, became popular for use within the aesthetics industry in the 90s, though it has been used for clinical applications as far back as the 60s. Aesthetic lasers for the skin, particularly resurfacing lasers, use various wavelengths of light to penetrate the uppermost skin layer (epidermis) – some use this light to activate receptors in the skin, but most use  heat to rejuvenate the skin.

“The heat from the laser will affect the water in skin cells, and cause a controlled trauma to stimulate growth and rejuvenation,” explains EV Expert, Aesthetic Doctor and Founder of Ashley Aesthetics, Dr. Emmaline Ashley. 

Laser treatments help treat a variety of issues, from reducing pigmentation and scarring and smoothing out fine lines and wrinkles, thanks to their ability to resurface the skin and boost collagen and elastin production. Collagen and elastin are part of our skin’s building blocks helping to keep skin firm and plump, but they  decrease with age, and this decrease is sped up by the exposure to factors like pollution, sun exposure and smoking. 

Not only can lasers help firm and smooth wrinkled and sagging skin, they also help fade scars and pigmentation to leave skin more even in tone and radiant. They also stimulate increased cell turnover, which will give a smoother appearance to the skin. “Our skin is a living layer that constantly regenerates approximately every 28 days. Cell turnover is our skin’s process to shed dead skin cells and replace them with new, younger cells. However, as we get older this cell turnover gets slower, which is what leads to dull and dry skin,” explains Dr Ashley. 

The types of lasers  that work to get all of the above done come in two forms, ablative or non-ablative, and here's the difference between the  two...

Ablative Lasers

AcuPulse (CO2) laser, Lumenis CO2, FRAXEL Re:pair, CO2RE laser, SmartSkin Performa CO2, HALO

The simplest way to explain ablative lasers is that they are wounding lasers, as they remove the top layer of skin (epidermis) and some of the second layer (dermis) to reveal smooth, clear skin underneath. “The exact depth of this removal is controlled, and this resurfacing will result in new layers of skin being produced. Because you are completely removing the top layer of skin, this treatment is more intense (than non-ablative lasers, which leave the epidermis intact) and will have more downtime. Immediately after treatment, skin will appear red and may weep, similar to an intense sunburn” shares Dr Ashley. 

Who Are Ablative Lasers For

If you have deeper wrinkles, persistent acne scarring and hyperpigmentation, ablative lasers may be the right treatment for you. However,  there are some contraindications, as with most treatments. Dr Ashley mentions patients with active infections and history of abnormal scarring (like keloids and hypertrophic scars) are not the best candidates. “They are prone to developing abnormal scarring with any trauma to the skin, and you run the risk of causing more harm and excessive scarring with an ablative laser,” explains Dr Ashley. Also, care should be taken in medical conditions that affect wound healing like diabetes.

Most importantly this may not be the best treatment depending on your skin tone. “Patients with dark skin tones are at higher risk of post-inflammatory hyperpigmentation and scarring, so patch-testing and a thorough consultation with an experienced professional is recommended,” says Dr Ashley. 

Non-Ablative Lasers

FRAXEL Re:store, FRAXEL Re:store Dual Wavelength, ReSurFX Erbium YAG laser, PICOSURE

Instead of targeting the top layer of skin, non-ablative lasers cause controlled trauma at a certain (pre-determined) depth in the dermis, Dr Ashley explains. “This is the layer where your collagen and elastin exist, so it will stimulate the production of more of these proteins to add structure to your skin. The results can be less dramatic in comparison with ablative lasers, but there’s also little to no downtime.”

Who Are Non-Ablative Lasers For

Non-ablative lasers are better suited to those mild skin concerns, think fine lines, more superficial scarring and for overall skin texture and tone. “As they are milder, non-ablative lasers are suited to all skin types and suitable for dark skin tones that are normally more prone to pigmentation. These lasers are also suited to people prone to melasma. However, those opting for non-ablative lasers will require more treatments over a longer period of time,” explains Dr Ashley. 

When considering laser treatments it’s important to find a licensed professional who has experience treating a variety of patients of all skin tones and they will be able to determine the laser most suitable for your concerns. Search our Etre Vous directory to find an approved practitioner near you.