How to Choose the Right Laser Treatment for Your Skin Concern

When someone says they “got a laser,” it could mean almost anything: minimizing sun damage, softening wrinkles or even using a device that’s not technically a laser. That’s the thing, lasers can be confusing. “Patients often assume a laser is a laser,” says Washington, D.C. dermatologist Nina Hartman, MD. “But, they’re complex tools that require deep expertise and must be calibrated to your skin type, condition and goals.” If you’ve ever been laser-curious but totally lost, here’s what you need to know to find the right match.

Featured Experts

• Nina Hartman, MD is a board-certified dermatologist in Washington, D.C.
• Jill Waibel, MD is a board-certified dermatologist in Miami
• Kathleen Behr, MD is a board-certified dermatologist in Fresno, CA
• Jason Pozner, MD is a board-certified dermatologist in Boca Raton, FL
• Dr. Matthew Elias is a board-certified dermatologist in Fort Lauderdale, FL

What actually works for fading dark spots?

The right laser depends on what’s causing the discoloration. “We first need to identify whether it’s melasma, sun damage or post-inflammatory hyperpigmentation (PIH),” says Miami dermatologist Jill Waibel, MD. She uses pigment-targeting devices like Q-switched lasers for lighter freckles on fair skin, intense pulsed light (IPL) and BroadBand Light (BBL) to help fade sun damage, and thulium lasers to treat dark spots left behind by inflammation. “These treatments target melanin with precise heat while leaving the surrounding tissue intact.”

Fresno, CA dermatologist Kathleen Behr, MD prefers Picosure, Fraxel DUAL (1927 nanometer wavelength) or UltraClear to reduce spots. “I also like Clear + Brilliant. It’s like a baby Fraxel with low downtime. A series of treatments will improve brown spots and stimulate collagen.”

I’ve had acne scars for years. Can lasers really make them look better?

Yes, but improvement takes time. “We’re not erasing scars; we’re remodeling the skin to make them less visible,” says Dr. Waibel.

Most patients have more than one type of scar, so the treatment needs a tailored approach. “We often combine nonablative fractional lasers like Fraxel DUAL with pulsed-dye lasers like Vbeam to improve texture and target redness,” says Dr. Hartman.

Boca Raton, FL plastic surgeon Jason Pozner, MD says he’s had success with AVAVA, a nonablative fractional laser. “It’s fast, it requires little downtime, and patients love the texture improvements.”

To reduce active acne, Dr. Waibel says newer FDA-approved technologies like Accure and AviClear can target the sebaceous glands to reduce oil production and future breakouts.

Is there really a laser that can tighten skin to avoid surgery?

Yes, certain lasers can improve skin laxity by stimulating collagen and resurfacing the skin. “For skin tightening, ablative CO2 and erbium lasers remain the gold standard, but I also utilize energy-based devices like Thermage and Sofwave,” says Dr. Waibel. While lasers offer more dramatic results, energy-based devices are popular for subtle lifting and minimal downtime. “Sofwave is my go-to for tightening,” adds Dr. Pozner.

For a stronger effect, Dr. Behr combines ablative CO2 resurfacing lasers with micro-coring (Ellacor or UltraClear Laser-Coring), a treatment that removes tiny columns of skin to stimulate tightening without scarring.

Are lasers really safe for deeper skin tones?

Yes, when the right technology and settings are used. “Darker skin types are more prone to hyperpigmentation, hypopigmentation and scarring from lasers,” says Dr. Hartman. “But, Nd:YAG and picosecond lasers are generally considered safer because they bypass the melanin-rich outer skin. Broad- spectrum devices like IPL should be avoided altogether.”

Fort Lauderdale, FL dermatologist Dr. Matthew Elias likes the AVAVA laser for deeper skin tones. “Its Focal Point Technology targets the dermis while sparing the epidermis, allowing safe treatment across all Fitzpatrick types.”

Dr. Behr recommends UltraClear’s 3DMIRACL treatment, which is FDA- cleared for all skin types. “It uses cold fiber laser energy with minimal downtime and no thermal damage.”

How should I prep my skin, and what should I use after a laser session?

Start by staying out of the sun. “Avoid sun exposure before and after a laser treatment,” says Dr. Behr. “For patients prone to hyperpigmentation, I often pretreat their skin with a lightening agent, like hydroquinone or Alastin’s A-Luminate Serum.” She also suggests using an efficacious post-procedure product like Alastin’s Regenerating Skin Nectar to speed up healing after treatment. “It helps enhance outcomes and reduce recovery time.”

Dr. Waibel says don’t overthink it. “Cleansing the treated area two to four times daily and avoiding sun exposure is key. Avoid exfoliants, acids and actives until your skin barrier recovers. But in many cases, tinted sunscreen or makeup can be applied the same day.”

What’s the latest laser tech, and what are the new features?

Laser innovations include smarter, more personalized technology. “I’m currently beta-testing the second-generation Fraxel FTX,” Dr. Waibel says. “It has updates that allow for real-time adjustment based on the skin’s response.” She’s also working on laser platforms that use robotics and AI to make treatments more customized. “We’re getting closer to laser protocols that adapt as they go,” she adds.

Laser Lingo: What It All Means

• Ablative lasers remove the skin’s outer layer to resurface and tighten. “CO2 and erbium lasers are the gold standard for improving laxity and wrinkles,” says Dr. Waibel.
• Nonablative lasers heat the tissue beneath the surface without removing skin. Dr. Hartman says these lasers boost collagen with less downtime than ablative options.
• Fractional lasers target certain columns of skin while leaving surrounding tissue intact. Dr. Behr says this speeds healing and lowers risk compared to fully ablative lasers.
• Thulium lasers treat melasma and sun damage. Dr. Hartman calls lasers like Fraxel DUAL (it uses both thulium and erbium lasers) and MOXI “workhorses for improving clarity.”
• ND:YAG lasers target unwanted veins, hair and pigment. Their ability to bypass melanin makes them a safer choice for deeper skin tones.
• Pulsed-dye lasers target blood vessels to improve redness, small vessels and certain types of vascular birthmarks.
• Picosecond lasers like Picosure “use ultra-short pulses to effectively treat melasma with minimal risk,” says Dr. Behr.
• Intense Pulse Light (IPL) is technically not a laser, as it uses broad-spectrum light to treat redness, sun damage and spots.
• Broadband Light (BBL) uses multiple wavelengths of light to treat signs of aging, discoloration and redness. It’s often called a more advanced form of IPL.
• Micro-coring removes tiny columns of skin to tighten, using either a laser or a device called Ellacor.
• Energy-based treatments use radio frequency (Morpheus8 and EMFACE) or ultrasound (Ultherapy and Sofwave) to stimulate collagen.