What You Need To Know About Cosmetic Lasers

What You Need To Know About Cosmetic Lasers -

10 Common Myths  About Laser Treatments

Many of my patients are new to the concept of cosmetic lasers, and are understandably concerned about their use. They have heard so much about the potential of lasers to damage and permanently scar the skin, and often are swayed by claims made in the media and advertising about the ability of various creams or beauty treatments to replace the effects of laser treatments. Here I have listed some of the common misconceptions about cosmetic laser treatments, and I hope to help dispel some of these common myths.

Myth #1: Cosmetic lasers are a ‘new’ technology and still very much in the developmental, experimental stage.

Fact : Many of the basic laser applications that we take for granted today - think laser pointers, printers, bar code readers, lighting displays and fiber optics - are all relatively new technologies. By comparison, medical lasers are no longer considered a ‘new’ technology, and have greatly aided medical science in procedures such as tumor removal, LASIK, kidney and gall-stone blasting as well as dental applications.

The first dermal laser treatments were conducted by a dermatologist named Leon Goldman in 1962 for the removal of tattoos. Since then, cosmetic lasers have been successfully developed for the treatment of scars, varicose veins, birthmarks, wrinkles, hyper-pigmentation, hair removal, and much more. There are thousands of clinical studies conducted on cosmetic lasers and their effective use in many skin concerns has been proven many times over.

Laser treatments are developed through sound scientific principles to produce specific results while minimizing unwanted side effects. In hair removal treatments, for example, the energy from the laser is tuned to heat up and thereby deactivate hair follicles, thus preventing them from further activity. In the case of tattoo removal, the pigments in the tattoo ink are targeted, and the specific wavelength is designed to break up the pigments so they can be eliminated by the body’s waste systems. Provided a laser treatment is given within the specified guidelines and with the proper diagnosis of a trained expert, the results and side effects are almost always predictable and controllable.

Myth #2: Lasers are unnecessary because all their benefits can be achieved with skin care products.

Fact: Unlike skin care products which may have all kinds of exorbitant claims, medical equipment such as cosmetic lasers are required by law to be thoroughly tested for effectiveness and safety. Laser machines cannot be marketed unless approved by the US FDA (or European equivalent CE mark) which sets stringent rules on claims that any equipment may make. For example, most hair removal lasers are not allowed to say that they give permanent hair removal, but only permanent hair reduction. This is because occasionally hair does regrow in an area after treatment, but it will be greatly reduced in quantity and appearance. Permanent hair removal is, however, possible: I’ve had many patients who have gone for years without hair regrowth after a single course of treatments, but some do come back after 18 months for touch-ups.

Skin care products on the other hand, are rarely required to prove their claims, so they can claim “better than Botox” or “as effective as laser” without repercussions. In this video, author and skin care expert Paula Begoun explains how cosmetics may claim to be able to replicate the effects of Botox, fillers and laser resurfacing, but that their claims are unsubstantiated. There are also no skin creams or serums that can remove varicose veins, resurface and smooth out severe acne scars, reduce the appearance of birthmarks such as Port Wine Stains or help remove unwanted tattoos.

Plenty of advertising, but no independent studies have proven these claims.

Myth #3: After one treatment, you can tell if lasers will be effective or suitable for you.

Fact: Every single person is different, and what works for 90% of the population may just not be right for the remaining 10%. Depending on different factors such as your skin sensitivity, pain tolerance, or even your lifestyle habits such as smoking, excessive sun exposure or usage of certain drugs or skin care products, you may respond differently to a laser treatment. That is why it is important for you to trust your doctor, and allow him or her to determine the course of your treatment and deciding if you need to change the settings from your previous procedure or not.  

Myth #4: Having laser treatments causes the skin to thin out and become weak.

Fact: Lasers do not cause the skin to become weak and thin, in fact the controlled heating and wound action of a laser treatment actually induces the natural skin reaction of collagen and elastin formation  to replace the damaged skin. Even repeated usage of lasers will not cause the skin to be damaged or weakened, provided your laser provider has a thorough understanding of the limitations of the equipment he or she is applying to your skin. 

Some cosmetic laser treatments, such as Clear+Brilliant or Q-switch lasers are designed to be a milder treatment that should be repeated at regular intervals. They work by inducing micro-treatment zones that stimulate collagen production, to provide long-term anti-aging and skin rejuvenating benefits without the downtime associated with more severe procedures.

Myth #5: All laser equipment provide the same range of treatments.

Fact: Lasers are not a one size fits all, and most equipment is highly specialized and calibrated for specific purposes. There are two main types of lasers – namely ablative and non-ablative. Ablative or cutting lasers work by physically destroying the top layers of the skin, and are used in procedures such as mole removal, laser resurfacing and scar revision.

Non-ablative lasers work by targeting specific depths or colors while leaving the top layer of the skin unharmed. Different laser modalities are calibrated for various uses including hair removal, skin rejuvenation, de-pigmentation and tattoo removal. While a single machine can often be used to treat a range of different concerns, the wavelength and energy levels must be adjusted for each specific purpose.

Different laser machines are also calibrated differently and may have specific strengths, ie. The Fraxel Dual, is very good for acne scar revision and skin rejuvenation, but differs from the Candela V-Beam which targets hair and vein removal. Even rival hair removal lasers can differ in the skin / hair types which they are used for, so having a professional who knows the in and outs of the equipment is essential for effective and safe treatment.

Myth #6: Lasers are all the same, no matter the companies who create them

Fact: Lasers may be an established and well understood medical tool, but just like a kitchen knife has the potential to be deadly, a laser in the wrong hands has the potential for serious damage. A laser that is unreliable and poorly engineered is even worse, which is why you need to ensure the laser equipment you are being treated with is safe.

Brand names like Louis Vuitton and Hermes are famous for their high standards of quality and pursuit of perfection. When it comes to lasers and other aesthetic procedures, brand names can also help you determine a trustworthy procedure. Major medical laser brands such as Fraxel, Lumenis, and Sciton among others, are well-established brands that have invested in a great deal of research and development on their medical equipment. They have on-going clinical tests and keep doctors informed and updated on latest discoveries and techniques to make patient experiences better. Even two machines which use the same kind of laser energy can be calibrated differently so they must create their own protocols and guidelines for use, so the company that produces the machine must have thoroughly tested it to understand its’ usage. When it comes to treatments that have the potential to cause serious damage, you must always ensure you can trust both the practitioner and his tools.

Myth #7: Once you start using lasers, stopping treatments will cause your skin to rapidly deteriorate.

Fact: A laser treatment simply changes the conditions of your skin at the time of the treatment, and does not produce a dependency. An example of a treatment that does produce dependency is moisturizing cream, where your skin is no longer stimulated to produce its natural hydrating secretion since you are applying it artificially. When you begin to use moisturizers regularly, you will notice that not applying it causes the skin to dry out and feel uncomfortable.

This is not the case with laser treatments. For example, after an extreme laser treatment such as a resurfacing procedure which vaporizes skin cells to encourage cell renewal, your skin will heal and become smoother, even, and more supple. You may need several treatments to achieve your end goal, but certainly there is no need to continually undergo treatments once you have solved the problems you wish to address. Eventually on-going aging and lifestyle factors will cause pigmentation, wrinkling or other problems to recur, which is when further treatments may again be necessary.

Myth #8: Lasers can cause your face to change so you end up looking unrecognizable and ‘plastic’.

Fact: A laser treatment cannot change the shape of your face or your facial features because it treats only the topmost fraction of your skin, not affecting your underlying muscles, fatty layers or bone structure in any way. It is physically impossible for a laser treatment to make you look like anything except yourself, it can only transform and improve the appearance of your skin. Other treatments such as Botox, fillers, radiofrequency skin tightening such as Thermage are often combined with laser treatments when a patient has needs that involve the muscles or fat components.

Myth #9: Having a laser treatment means all your facial problems will be solved.

Fact: As previously discussed, most laser treatments address specific problems, such as treating pigmentation problems or erasing a tattoo. Unless you have asked your doctor to also address your other concerns, chances are the laser treatment would not improve those as well. Laser resurfacing is one treatment that gives multiple benefits, and can fade discoloration, improve skin texture and diminish facial lines with one treatment, but deeper lines or different pigmentation types, for example, may be a different problem that needs a separate treatment. Discuss all your treatment goals with your doctor to ensure you are satisfied with the results of your procedure.

Myth #10: A laser treatment shouldn’t be painful and if it produces a severe reaction, it is a failure.

Fact: One of the laser specialists I once encountered told me something that he discovered in the course of his 15 year career in the field of cosmetic lasers: most patients seem to really believe in the old ‘no pain, no gain’ adage. While pain management techniques have really improved patient comfort levels, patients will often feel they have no faith in a treatment because they ‘didn’t feel a thing’. In the case of laser resurfacing, the redness and heat that they experience post-procedure is sometimes the only sensation they have. Without this redness and flushing to the skin, some have even questioned if the procedure was even performed at all!

It is important to remember that a laser procedure is in fact a serious thing, and it is designed to cause controlled damage to induce the skin to heal and renew itself. A laser resurfacing procedure commonly produces a bronzing effect, as if you have had a sun-burn, as the skin injury causes old and pigmented cells to die off and be replaced. Some swelling after the treatment may also be seen, and this is particularly common in the case of CO2 laser treatments which heat up the treated areas, inducing inflammation for improved blood circulation and accelerated healing. Many doctors believe that the more severe the reaction (tissue swelling, intense redness, flushing and sensation of heat), the better the results of the treatment. Other treatments such as hair removal may not produce as severe reactions, and any blistering or pus formation after a laser treatment is most certainly not desired. It is usually best to check with your doctor to determine if your post-laser reaction is indeed normal or if it needs attention, but bear in mind, a severe reaction is not necessarily a bad thing.

- Cosmetic Medicine, MD


Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. or email.