Facial Lasers 101: Should I Zap My Face?

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By Cheryl Wischhover

Last summer, Hillary Duff, 34, evangelized about Clear + Brilliant, the laser treatment that her relatable-girl-next-door-actor elders Jennifer Aniston and Drew Barrymore have also copped to loving. Not many celebrities talk about Botox or other injectables quite so publicly as they do about lasers. 

Lasers seem to offer a halo of respectability that injectables don't, perhaps due to taboos or a few very public examples of injections gone awry. (Is torching your skin cells less offensive than injecting toxin into your face? Debatable. Full disclosure: I have done both.)  

Lasers are often the first thing outside of creams and serums that people look to when they want a little, to use a terrible euphemism, “refresher.” Lasers do seem like they’re just quick flashes of light that suddenly leave you glowy. They have the reputation of being less invasive than treatments delivered via a needle. But like needles, they do pierce your skin, except invisibly. And they’re really not as benign as a few famous people’s IG stories would suggest. 

“The reason we make this distinction between invasive and non-invasive is that we're trying to use that as a surrogate for risk, right? And if what we're really saying is risky versus non-risky, that's not the case, because lasers can be quite risky and can have really significant, detrimental outcomes, if done incorrectly,” says Dr. Michelle Henry, a board-certified dermatologist with a practice in Manhattan. Scarring and blindness are two of the more devastating potential complications. Look for a board-certified dermatologist who also works with lasers regularly, because not all of them do. 

In the hands of competent dermatologists, lasers can produce pretty incredible results. There are a lot of different types with all sorts of name brands, so it can be confusing trying to navigate which might work for you. Also know that some are not appropriate for, and can actually really injure, people with darker skin tones. Lasers also aren’t cheap. Dermatologists recommend most of them once or twice a year to stay on top of results.

How Lasers Work

Laser is actually an acronym that stands for “light amplification by stimulated emission of radiation.” Put more simply, “you're using the light to create heat,” says Dr. Ava Shamban, a board-certified dermatologist in Los Angeles. Each type of commercially available laser works at a specific wavelength to target certain structures at specific depths in the skin, some timing the pulses to change how long skin is exposed to the laser. Some lasers can treat darker pigmented skin lesions, some target the blood vessels that cause redness in skin, and some can even torch whole areas of the skin, as in the case of resurfacing treatments, which are the type that people generally turn to for aging skin concerns. In that case, the wavelengths penetrate your skin, heat up the cells, and cause cellular damage called “micro-injury,” which prompts skin to produce collagen (“collagen remodeling”) to promote healing and new plump, glowy skin cells. 

There are hundreds of different kinds of lasers now, so rather than walking into a dermatologist and saying, “I want Clear + Brilliant,” tell them your skin concerns. “One size fits none in this case,” says Dr. Shamban, who often uses a cocktail of different lasers and other modalities (yes, like Botox) to treat her patients. 

Starter Lasers

While no treatments are universal, when talking about lasers for aging concerns (fine lines, mild hyperpigmentation, etc), there are a few treatments that are considered beginner lasers. 

The first stop is often intense pulsed light treatments or IPL ($625. Note: All prices here are averages taken from RealSelf, a website for finding providers and getting information about aesthetic procedures.). Technically this isn’t a laser at all, but it’s often lumped in with them. It can minimize sun spots, redness, and acne scars, and even does a bit of collagen remodeling to improve texture. It doesn’t hurt and there’s no downtime, but it’s not recommended for darker skin tones, which absorb more energy and can result in serious injury. 

Then there’s Clear + Brilliant ($725), which Dr. Henry calls a “really versatile device” and Dr. Shamban calls “baby laser.” It can decrease pigment and mild acne scarring, and, over time, can improve skin texture. You’ll feel some warmth during the treatment and it may make you pink for a day or so. If you have deep wrinkles or are looking for tightening, it probably won’t do much. It can be safer for darker skin tones when done over several sessions. 

More Powerful Laser 

Most people have likely heard of Fraxel ($1,575). This is a more powerful resurfacing laser that is the gold standard for sun damage like wrinkles, age spots, and sagging in older, lighter skin (it’s not safe for darker skin tones). In the old days, ablative lasers — the ones that essentially burned your face off and required weeks of downtime — were the only option. Fraxel provides resurfacing with a beam that is broken up into fractions, meaning a lot of skin is untouched while still getting the collagen remodeling effect. (There are three different types of Fraxel treatments available, some more ablative than others.) 

Fraxel can cause you to be pink and flaky for several days, and I can tell you that it hurts, even with topical numbing cream. I also got some new hyperpigmentation afterwards, which can happen if you aren’t absolutely vigilant about sun protection in the weeks after. But my skin looked generally better overall and felt tighter. 

If you can’t have laser treatments because of your skin tone or other factors, microneedling with radiofrequency ($800) and chemical peels ($375) can give you some of the same benefits, says Dr. Henry. 

As with any facial procedure, find someone who does it a lot, ask plenty of questions, get comfortable with potential side effects, and respect the technology for what it is — potent.