Under the Light: In 2024, There’s a Whole Spectrum of (Non-surgical) Beauty Fixes Available

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Walk into any dermatologist’s office or medspa and you’re likely to see promotions for esthetic laser treatments. No matter what your skin troubles, the ads suggest, a laser can zap them away. Not only that, but the lasers offered by that particular clinic are the absolute best lasers for you.

Could it really be true? Maybe not the last part. But research confirms that lasers can address a number of common complaints of aging, such as tightening up saggy skin and evening out pigmentation. 

While the technology varies from brand to brand, esthetic lasers at the most basic level work the same way: The beams heat up a targeted area, causing controlled injury. When executed by expert practitioners, these micro-injuries can lead to some pretty desirable results.

Jean Peterson, 62, of San Rafael, tried everything before she learned about laser treatments.

“Everything. Microneedling, Retin-A. Nothing has compared to this.” She loves how a series of treatments eliminated wrinkles, sun spots and uneven texture on her face. She’s returning for a few follow-up treatments to target lingering wrinkles around her mouth.

Laser treatments have been around since the early ’80s, but they’ve gotten a lot better in recent years. The biggest change is that older lasers used to obliterate the entire top layer of skin, necessitating weeks of recovery time when you’d have to hide your oozing, peeling face from the world. 

“When lasers were first used, they created more collateral damage to the skin,” explains Dr. Linda Hwang, chief of dermatology at Kaiser Permanente San Rafael Medical Center. “Newer technologies allow lasers to minimize these unwanted side effects while being able to treat with greater precision, power and speed.”

You can still get a laser treatment that requires a recovery period — and those tend to produce the most dramatic results. But a number of no-downtime or low-downtime treatments are now offered that can be done over a lunch hour.

“Most of these lighter, ‘lunchtime’ treatments are recommended to be done in series to minimize downtime but maximize results,” Hwang says.

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The Science Behind the Treatment

It almost seems fantastical that one technology could fix so many different problems. The secret behind those results is that practitioners use different types of lasers in different ways to achieve various results.

New collagen growth: Laser beams can penetrate beyond the surface of skin, aka the epidermis, to heat the collagen and elastin in the dermis. This stimulates the development of new collagen and elastin, which results in “skin tightening, wrinkle reduction, texture and tone improvement, overall rejuvenation and healthier skin,” Hwang says.

New skin growth: Ablative lasers can remove the epidermis, either partially or completely, forcing your body to grow new, younger-looking skin. Most modern ablative lasers are fractionated, which means that the laser beam is split into a lot of microbeams, which destroy parts of the epidermis while strategically leaving swaths of it intact. This promotes faster recovery and prevents negative side effects.

Attacking imperfections: Lasers can zero in on brown “sun spots” or redness (caused by tiny blood vessels close to the skin). The intense heat breaks down the unwanted pigment or vessel. Blemishes later flake off the surface of the skin or are reabsorbed by the body.

Can Anyone Get Laser Treatment?

Because pigment in skin absorbs more energy from lasers, the darker the skin, the more cautious you and your practitioner need to be.

“If at baseline you have higher pigment, you definitely want to go to someone who is familiar with doing lasers for darker skin tones,” warns Dr. Faye Jamali, who left a career in anesthesiology to start Mill Valley’s Belle Marin Aesthetic Medicine.

Which Treatment Should You Get?

Practitioners who offer laser treatments — and in California, that needs to be a doctor, a registered nurse or a physician’s assistant — don’t recommend that you start the process by choosing a type of laser. 

“A lot of times people come in and ask for a specific treatment. And I delve into what problems they have,” Jamali says. “I can give them options that might help them even better than what they have in mind. 

That said, here are a few of the options offered by Marin dermatologists and medspas. No matter what treatment you receive, Hwang stresses the importance of following your provider’s skincare regimen to maintain the results: “It is critically important to protect skin from the ravages of UV by diligent use of good sun protection habits, high-grade sunscreens and antioxidant topical products.”

Fotona 4D 

Billed as a “non-surgical laser facelift,” this is the treatment that Peterson has been undergoing. In a series of three or more 90-minute appointments, registered nurse Thena Holmen at Skin Suite Marin uses various attachments on one laser to cover the gamut of patient’s concerns, from wrinkles and loose skin to sunspots and rosacea.

Recovery: Patients can apply makeup and go back to work immediately after treatment, but may have some pinkness or very slight peeling during the first week.

Frequency: A common recommendation is one session for every decade of age, spread about a month apart. However, Holmen says her clients often need only three sessions to start, with follow-ups as desired to target specific areas. For maintenance, clients can return annually or as needed.

Cost: Starts at about $800 per session

VBeam Perfecta

One of the most popular treatments at Kaiser San Rafael’s clinic, this laser targets redness from sun damage and rosacea, or from “broken” or dilated blood vessels.

Recovery: Some spot bruising and swelling can occur, typically resolving in a few days.

Frequency: Most patients need five to six sessions, four to eight weeks apart. Some patients choose follow-up treatments every three to six months.

Cost: Starts at about $400 per session

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Jamali calls this one of the more “intense” lasers she offers at Belle Marin Aesthetic Medicine. She recommends it to clients seeking an overall renewed skin texture and tone, or who want to eliminate fine lines, dullness and sun damage.

Recovery: 7–10 days of swollen, red and peeling skin. A lighter treatment could result in shorter downtime.

Frequency: Once or twice a year.

Cost: Starts at about $1,200 per session

Carbon dioxide resurfacing lasers

Multiple brand names, including Fraxel and DEKA, use this type of treatment, which is a high energy laser that can ablate the epidermis and heat up the dermis, stimulating both collagen growth and fresh skin. Kaiser offers a variety called DEKA Tetra, which Hwang calls “an intensive deep treatment that can result in a dramatic improvement in wrinkles, uneven pigmentation, age spots, sun damage, dull texture and acne scars for significant rejuvenation.”

Recovery: Swelling, pain and redness can last a week or two, with inflammation possible for about six weeks. DEKA’s Tetra CoolPeel, a variation that only targets the upper skin layers, causes only a couple days of pinkness and dryness, and is recommended in a series to be more effective.

Frequency: For DEKA Tetra, a common recommendation is one to two treatments over the course of six months. Follow-up treatments can be done after a few years, if needed. For DEKA CoolPeel, three monthly treatments usually do the trick, plus an annual maintenance treatment. For Fraxel, three to five sessions spaced two to four weeks apart are recommended.

Cost: Starts at about $1,500 per session

Clear + Brilliant

As a non-ablative laser, Clear + Brilliant is advertised as a gentler way to address fine lines and wrinkles, sun damage and uneven pigmentation or skin tone.

Recovery: Any redness or swelling disappears within a few hours.

Frequency: According to Clear + Brilliant, “In recent studies, consumers reported visible improvements after 4–6 treatments, though many patients choose to have routine treatments as part of their overall skincare regimen.”

Cost: Starts at about $750 per session

Intense Pulsed Light Therapy

Often offered by the same practitioners who do laser treatments, this one is technically not a laser. But IPL — sometimes called a photofacial — works a lot like lasers, by heating targeted areas in the skin. One brand is BroadBand Light HERO, aka BBL HERO. Results include reducing unwanted pigmentation, age spots, redness and sun damage.

Recovery: Although considered a no-downtime treatment, some clients experience redness or bruising for a day or two.

Frequency: Four to six treatments are recommended, spaced four to eight weeks apart. 

Cost: Starts at about $1,800 per session