As someone who has tried many different products and procedures in the pursuit of glowy skin, I've long been laser-curious, but somewhat overwhelmed by the options. Also, the thought of lasers on my face did, admittedly, feel scary. One wrong zap and my face would probably fall off – or so I thought. But I finally decided that I was ready to figure out the various laser options and then decide which one might be right for me, a 44-year-old woman with more brown spots than I care to count, a few old acne and chicken pox scars, and some wrinkles that I'd prefer not make their home on my face. So I turned to Kathryn Clayton, an Aesthetic Nurse Practitioner at SkinSpirit in Austin, Texas, to help guide me through the laser thicket.
For people over 40, Clayton says she generally starts by looking at what the patient has already been doing with their skin. "If you're just starting out, I would go with a Halo laser to get a little freshened up, then switch to IPL and Resurfix to maintain," she shares. "If you've been taking care of your skin and you want to tiptoe into lasers, IPL would be a good place to start."
All laser wavelengths are measured in nanometers (aka one-billionth of a meter), Clayton explains, with "beginner" lasers like IPL and BBL clocking in at 560 or 590 nanometers. The biggest gun in the laser arsenal is the CO2 laser, at a whopping 10,000 nanometers. Each type of laser has its strengths and weaknesses, and the laser that is right for you might not be the one that's right for me. So from least powerful to most powerful laser, here is a comprehensive guide to how to choose the best laser for you.
"These are lower-wavelength lasers used for reds and browns," Clayton says. "They're good for sun damage, brown spots, capillaries around the nose and cheeks. They're good ones to start with if it's just a pigmentation and redness issue." However, she cautions that people with darker skin should be careful with IPL and BBL treatments. "Melanin really loves this wavelength," she says. "If you have someone with darker skin, you can burn them and hyperpigment them."
There's no downtime with these lasers, but you generally will need to do a series of treatments to see results because they are so gentle.
Once a laser gets over 900 nanometers, it starts targeting water — which means it's able to address textural changes in the skin. Clayton says that any laser under 2000 nanometers don't ablate the surface of the skin, so like IPL and BBL, you don't need any downtime after getting a Resurfix or Fraxel treatment.
"You can do an IPL and then do a Resurfix on top of it, at the same appointment," Clayton explains. "That's a good combination because it targets the reds and browns as well as any mild textural issues." These lasers are also better for people with darker skin, because they target water instead of melanin. Still, she says, "you still have to be careful not to over-treat anyone. I would go to somebody who specializes in treating darker skin."
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"If you have deep wrinkles and really stubborn inset lines, you're going to need skin tightening stuff too — so we have to up the ante a little bit more," Clayton explains. The Halo laser, at 2940 nanometers, is also great at targeting acne scars. The Halo laser can also be used on darker skin, because it targets water instead of melanin like IPL (although Clayton says that darker skin tones will sometimes need to be pre-treated with hydroquinone).
But the additional power of a Halo also has some downsides. Because it's ablative, Clayton says "you're going to get more of that oozy, weepy feel" on your skin. Additionally, she cautions against people with melasma using most lasers, but especially ablative ones. "Melasma hates heat, and you can flare it up," she says. "I tend to use more chemical peels with melasma."
The CO2 laser is a fractional laser that's not for the faint of heart. Clayton recommends this laser for patients who have aggressive elastosis (a condition in which the skin loses elasticity, usually due to sun exposure) and wrinkles. But with great laser power comes great responsibility: you'll need a conscious sedation or laughing gas for the procedure. Plus, this laser has the most downtime (around two weeks), and you can really only do it once every two to five years. Patients with rosacea will sometimes see a flare-up after getting a CO2 treatment as well.
Additionally, Clayton says people with darker skin tones need to be extremely careful when getting a CO2 laser treatment. "If you go too aggressive you can cause scarring and hyperpigmentation, and you can't fix that," she cautions.
The New Age is a column about beauty over 40, written by women who are over 40. Revolutionary, when you think about it! Kate Spencer and Doree Shafrir are the hosts of Forever35 Podcast. Doree's memoir, THANKS FOR WAITING: THE JOY & WEIRDNESS OF BEING A LATE BLOOMER, is out now, and Kate's rom-com, IN A NEW YORK MINUTE, will be published in March. Learn more at doree-shafrir.com and katespencerwrites.com.