Laser and light treatments

"Laser" is not one treatment. Different devices emit different wavelengths, and each wavelength is absorbed by a different target in the skin - water, melanin or haemoglobin. That absorption is what does the work, and it is why choosing the device is a clinical decision rather than a matter of brand preference.

How to think about the three targets

• Water - absorbed by ablative and fractional lasers, which vaporise or heat columns of tissue to resurface the skin. Used for texture, scarring and lines.
• Melanin - absorbed by pigment-targeting lasers, which break up pigment for the body to clear. Used for age spots, freckles and some birthmarks.
• Haemoglobin - absorbed by vascular lasers, which heat and close unwanted vessels. Used for facial veins, redness and rosacea.

A device that targets melanin cannot treat a vessel, and one that targets haemoglobin will not resurface. Matching the device to the target is the whole art of it.

The devices we use

CO2 laser

Ablative resurfacing. The most powerful option for deep lines, scarring and significant texture change - and the one with the most downtime and the highest risk. See CO2 laser.

Erbium laser

Ablative, more superficial than CO2, with less thermal spread and shorter recovery. See erbium laser.

Fraxel

Fractional resurfacing - treats microscopic columns of skin while leaving the skin between them intact, so healing is faster. Traded off against needing more sessions for the same total effect. Also available at our Sydney location. See Fraxel.

Nd:YAG (YAG laser)

Penetrates more deeply than most. Absorbed by both melanin and haemoglobin, so used for deeper pigmentation and for vessels. See YAG laser.

Intense pulsed light (IPL)

Not strictly a laser - broad-spectrum light filtered to target pigment and vessels. Suits diffuse redness and scattered superficial pigment across an area. See IPL.

Laser Genesis

Gently heats the upper dermis to reduce redness from dilated capillaries and stimulate collagen. Minimal downtime, used in a course. See Laser Genesis.

Photodynamic therapy (PDT)

A photosensitising agent is applied and then activated by light. Used for field treatment of sun-damaged skin, solar keratoses and some acne. See PDT.

Aura laser

Used for vascular and pigmented lesions.

What laser is used to treat

Acne and acne scars; age spots, freckles, hyper-pigmentation and melasma; redness and capillaries, facial veins, rosacea and haemangiomas; lines and wrinkles, uneven texture, open pores, scars, sun damage, birthmarks and some benign lesions.

What laser must not be used for

An unassessed lesion. Laser destroys the tissue it treats. If a pigmented lesion turns out to have been an early melanoma, there is nothing left to send to pathology, no diagnosis, and no record that it existed.

Anything with features of concern is examined and, if it needs removing, excised whole and tested. See skin cancers and skin cancer and mole removal.

Skin type matters a great deal

Darker skin contains more melanin, which competes for the energy intended for the target. That raises the risk of burns and of pigment change - both darker patches afterwards and permanent pale ones.

It does not mean darker skin cannot be treated. It means the device, wavelength and settings are chosen differently, treatment is more conservative, and in some cases a non-light-based option is the better answer. A clinic that treats every skin type the same way is one to be wary of.

What to expect

Before: avoid sun and fake tan for a period beforehand; stop retinoids and exfoliating actives as advised; tell your practitioner about medications, cold sores and pregnancy.

During: sessions run from a few minutes to an hour. Protective eyewear is worn by everyone in the room. Sensation varies from a flick or hot pinprick to something needing topical anaesthetic.

After: redness and swelling, from hours (gentle treatments) to a week or more (ablative resurfacing). Crusting, peeling and darkening of treated pigment are expected. Strict sun protection, gentle skincare, and no picking.

What results are realistic

Vascular lesions and superficial pigment often respond well and quickly - sometimes in one or two sessions. Texture, scarring and deeper pigment need a course, and results build over months as collagen remodels.

Laser does not stop the processes that caused the problem. New pigmentation, new vessels and further ageing continue, so maintenance is normal. Individual results vary with skin type, the condition treated and the device used.

Risks

• Redness, swelling, crusting and peeling
• Bruising and purpura with vascular settings
• Blistering and burns
• Changes in pigmentation - hyper- or hypo-pigmentation - which can be permanent, and are more likely in darker skin types
• Scarring
• Infection, including reactivation of cold sores after facial resurfacing
• Prolonged redness after ablative treatment
• Worsening of melasma with over-aggressive settings
• Eye injury without proper protective eyewear
• Incomplete response and recurrence
• Increased sun sensitivity afterwards

Laser is generally avoided in pregnancy, with photosensitising medication, and for a period after oral acne medication. See risks and complications.

Cost

As at September 2024 and including GST, a skin assessment is $50 and a Cosmetic Doctor consultation is $150. Dermal skin treatments start from $130. Laser is quoted after assessment, by area and number of sessions. Not covered by Medicare.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.