The sun is a powerful source of radiation that can take away your skin’s healthy look. With laser skin treatment, light can undo whatever harm light has done.
Laser treatment is one of the first-line therapies for sun-damaged skin. The technique is precise, producing excellent cosmetic results with few side effects.
There are different types, so patients frequently ask which one is the best laser for sun damage. In this article, we explain how different lasers can rejuvenate your skin and what you can expect during therapy. We also compare the benefits and risks of laser surgery with those of other sun damage treatments and discuss measures for preventing lesion recurrences.
But first, you may want to know…
How Does Sun Damage Occur, and What Are Its Signs?
The sun emits a continuous spectrum of light energy. Each type of radiation, visible or invisible, can damage the skin.
- Ultraviolet (UV) light accelerates collagen breakdown, impedes collagen regeneration, suppresses healing mechanisms and produces uneven pigmentation. Both ultraviolet A (UVA) and ultraviolet B (UVB) rays are involved in lesion formation.
- Infrared (IR) rays destroy collagen and elastin.
- Visible (VIS) light contributes to unwanted pigment formation.
Collagen and elastin are proteins with vital functions. They don’t only keep the skin supple but also strengthen the blood vessel walls and help fight off diseases. Combining collagen and elastin breakdown with pigmentation changes, you end up with the following signs of sun-damaged skin:
- Fine and coarse wrinkles
- Dark spots, melasma, uneven skin tone or other pigmentation problems
- Spider veins, broken capillaries and easy bruising
- Loss of firmness and elasticity
- Enlarged oil glands and pores
- Actinic keratosis or other growths that can transform into skin cancer
Note that chronically sun-damaged skin can look a lot like normal aging skin. However, sun damage is more likely to produce coarse wrinkles, uneven skin thickness, sun spots, a bronzed appearance and malignant skin tumors.
Overview of Lasers Used for Treating Sun-Damaged Skin
|Laser Type||Light Color and Wavelength||Target Molecules in the Skin||Ablative or Non-Ablative?||Suitable Skin Types||Fractionation Available in the US?|
|Water in the epidermis||Ablative||Fitzpatrick I and II||Yes|
|Water in the epidermis||Ablative||Fitzpatrick I and II||Yes|
|Water in the dermis||Non-ablative||All skin types provided that the correct settings are used||Yes|
|Water in the dermis||Non-ablative||All skin types provided that the correct settings are used||Yes|
|Pulsed dye laser (Vbeam)||Green-yellow|
|Primarily hemoglobin. Can damage melanin-containing cells if the wrong settings are used||Non-ablative||All skin types provided that the correct settings are used||Yes|
|Intense pulsed light||Blue to near-IR|
|Water, hemoglobin, or melanin, depending on the equipment settings||Non-ablative||All skin types provided that the correct settings are used||Uncommon|
What Are the Best Laser Treatments for Sun Damage?
Different dermatologic lasers exist because each one damages only specific molecules in the skin. For sun damage laser treatment, the target molecule can be water, hemoglobin or melanin.
- Water absorbs IR light. The water molecules in the epidermis and upper dermis strongly absorb long IR rays, which do not get past these layers. Meanwhile, short IR waves reach the lower dermis without directly damaging the skin barrier.
- Hemoglobin, the pigment that makes your blood red, absorbs visible light, specifically green-yellow light.
- Melanin, the main epidermal pigment, strongly absorbs visible and UV rays and weakly absorbs short IR light waves.
When lasers hit their targets, only the molecules and a tiny portion of the surrounding tissues get damaged. This is the opposite of what sunlight does, which has both visible and invisible rays destroying tissues randomly.
The controlled injury inflames the skin, but only enough to stimulate its renewal and jumpstart elastin and collagen production. These changes ultimately get rid of lesions and improve skin texture. The differences in the target molecules’ light interactions and distribution in the skin explain laser therapy’s precision.
Below are the different types of lasers used for treating sun-damaged skin.
Ablative Lasers: CO2 and Erbium Lasers
Ablative lasers include the carbon dioxide (CO2) and erbium:yttrium aluminum garnet (Er:YAG) lasers. They emit long IR waves that can vaporize the superficial skin cells, creating shallow, open wounds. They cause more inflammation than their non-ablative counterparts but produce superior and more dramatic results.
Ablative lasers are suitable for many types of sun damage lesions, even severe ones like deep wrinkles, loose skin and actinic keratoses.
The Er:YAG or erbium laser creates less damage and is more precise than the CO2 laser. However, in expert hands, CO2 laser therapy can be more effective for skin rejuvenation.
Ablative laser skin resurfacing generally requires injectable pain medication and longer downtime. Additionally, it may cause some severe side effects if not properly done. Combining both ablative techniques, shortening laser exposure duration and using the fractional approach (explained below) can minimize complications without compromising the results.
Non-Ablative Lasers: Near-IR, Mid-IR and Pulsed Dye Lasers
Non-ablative lasers include the near-IR, mid-IR and pulsed dye lasers. Their light beams hit deeper targets in the skin but leave the upper epidermis intact. The results are gradual and modest, so they can treat only mild to moderate cases. Non-ablative lasers do not create open wounds or cause significant pain. Their side effects are also usually mild.
Near-IR and mid-IR lasers emit short IR rays weakly absorbed by melanin, making them the most suitable for rejuvenating skin of color. Meanwhile, pulsed dye lasers target hemoglobin and are used on areas with prominent blood vessel damage. VBeam treatment relies on this type of laser.
Non-ablative laser surgery is less painful than ablative laser resurfacing. The cold mist released by the equipment on the skin is usually enough to manage patient discomfort.
Intense Pulsed Light
Intense pulsed light or “IPL” is also non-ablative, and it uses broad-spectrum light rather than laser. Light filters limit collateral tissue damage by enhancing the equipment’s selectivity for melanin, hemoglobin or dermal water.
IPL treatment can correct various lesions, including fine lines, spider veins and dark spots. The instrument can produce short IR rays, making it suitable for any skin type. However, IPL creates more subtle and gradual results than lasers.
IPL may not be as powerful as lasers, but the equipment is used in direct contact with the skin. A cooling gel is applied on the treatment area to minimize pain during the procedure.
Fractionation is a technique that helps the dermatologist limit skin damage from light treatments. It is commonly applied to lasers, though fractionated IPL is gaining traction outside the US.
Instead of injuring large areas, fractionated lasers create microscopic cuts between columns of healthy tissue. Recovery is quick because the spared tissues fix the entire site simultaneously. This therapy induces significant collagen formation but causes little inflammation. Fractionated lasers can treat various lesions created by sun damage.
Studies show that lasers causing greater inflammation, i. e. ablative and unfractionated lasers, produce better results and require fewer sessions. But there are other factors to consider when choosing the best laser treatment option.
How Do You Know Which Laser Treatment Is the Best for You?
No single form of laser therapy works well for all blemishes and skin types. The following are the most important factors to consider when choosing one:
- The kind of skin condition you have and its severity. Severe lesions respond best to unfractionated, ablative lasers and least to IPL.
- Your doctor’s expertise. You can ensure the best results when you choose a highly skilled laser skin resurfacing and IPL specialist.
- Your expected results. Lasers will not solve all skin problems. Additionally, the benefits of any treatment must be weighed against its potential risks.
- Your skin type. Dark skin is more prone to post-laser pigmentation changes because of its high melanin content. Also, individuals of color are more vulnerable to keloid formation, making ablative lasers risky. Using the right light source and equipment settings reduces the risk of developing unwanted side effects.
- Your medical history and previous skin treatments, which let the doctor know if laser therapy is safe for you.
- The lesion’s anatomic site, which impacts the effectiveness and safety of the procedure.
- The downtime. Patients may choose non-ablative procedures over ablative laser treatment if they cannot afford to disrupt their personal routines for long periods.
Your doctor at BHSkin Dermatology will work closely with you so you may get the optimum treatment for sun-damaged skin.
What Can You Expect When Getting Laser Treatment for Sun Damage?
Our specialists at BHSkin Dermatology treat every patient caringly and professionally. Besides examining your lesions, they will give you a thorough medical evaluation during your first consultation. If they think laser surgery is your best option, they will help ensure you have a smooth treatment journey.
Before Your Session
Once you get your laser appointment, you may be advised to do the following before coming in:
- Take cold sore medication. Lasers can make you prone to the virus that causes the condition.
- Stop photosensitizing treatments and blood thinners.
- Get medical clearance if you are being treated for a chronic illness.
These measures work for ablative lasers, non-ablative lasers and IPL. If you’re undergoing an ablative laser treatment, you may also be advised to take prophylactic anti-inflammatory and antibiotic medications.
During Your Session
At the start of your procedure, you will be given a protective eye covering. The dermatologist will clean the treatment area then apply light energy in pulses. Numbing medication is necessary for ablative laser therapy, but skin cooling usually suffices for other light treatments.
After Your Session
The post-treatment period differs for each type of light treatment.
Ablative laser surgery creates open wounds and, in some patients, causes prolonged inflammation. The aftercare regimen focuses on speeding up wound healing and controlling inflammatory symptoms. You may be advised to do the following:
- Perform proper wound care, which your dermatologist will teach you.
- Put an ice pack on the treated area.
- Take over-the-counter medication to reduce pain and inflammation.
- Avoid harsh treatments and cosmetics until the wound has dried up.
- Protect the treated area from the sun.
- Apply topical ascorbic acid if skin redness persists weeks after your session.
Meanwhile, non-ablative light treatments do not create open wounds, so the aftercare regimen is less tedious. The following may be recommended:
- Put an ice pack on the area to reduce swelling, discomfort and redness.
- Use sun protection.
- Avoid activities that trigger skin flushing, e. g. exercise and sunbathing.
- Drink plenty of water to flush out the damaged cells.
- You may use makeup again only if you have no signs of skin irritation.
Regardless of the procedure, you must seek medical help immediately if you experience any intolerable side effects.
Ablative procedures lead to marked improvement even after only one session, so repeat treatments are not always necessary. However, the downtime may take weeks to months, depending on how long skin redness persists.
By comparison, non-ablative lasers and IPL generally need multiple sessions spaced four weeks apart to create significant cosmetic transformation. The upside is that the downtime is minimal to none.
What Is the Timeline of the Effects of Laser Treatment for Sun Damage?
Mild redness, swelling and discomfort are common in the first few days after any light treatment. These symptoms are expected, being normal signs of inflammation. They will go away spontaneously.
For ablative laser resurfacing, the wound created will form a scab within one week, falling off on its own by the second or third week. By that time, the outer skin layer will be healed completely. This process, otherwise known as “re-epithelialization,” prolongs the recovery period after ablative laser procedures.
The skin is very sensitive when inflamed or if re-epithelialization is not yet done. So you must be careful about using cosmetics and touching the treated site while it’s still not fully healed.
Collagen production begins as soon as the inflammation clears, reaching its peak by the third month after laser treatment. Continuous collagen formation and remodeling will improve your skin for several months to a year.
What Are the Benefits of Sun Damage Laser Treatment?
The upsides of treating sun-damaged skin with lasers are the following:
- Lasers are highly versatile. They can treat many skin concerns stemming from a myriad of causes, including excessive sun exposure.
- Lasers cause minimal damage to surrounding tissues, making them very precise tools.
- With adequate sun protection, the effects of laser skin resurfacing and IPL can last for many years.
- Light treatments are safer and more cost-effective than plastic surgery in treating a wide variety of lesions caused by sun damage.
However, you can only ensure the success of your procedure when you choose a highly experienced and widely trusted laser dermatologist to perform it.
What Are the Risks of Light Treatments?
The most frequent side effects of light treatments are mild skin redness, swelling, and discomfort, occurring right after the therapy session. As previously mentioned, they are normal inflammatory symptoms that can resolve on their own after a few days. However, sensitive patients may ice the treated site or take acetaminophen for symptom relief.
Lasers and IPL may likewise potentially cause the following:
- Persistent skin redness
- Excessive bleeding
- Cold sore reactivation
- Non-itchy white lumps called “milia”
- Pigmentation problems
- Poor healing
- Repeat injury of previously treated skin areas
- Outward turning of the lower eyelid in patients who have had lower eyelid surgery
- Visual impairment
Most of these conditions are manageable, though prevention is always best. A bona fide laser expert knows how to avoid complications. So we cannot emphasize enough the importance of getting the right provider to perform laser procedures.
Who Are the Best Candidates for Sun Damage Laser Treatment?
Light treatments are generally safe, but they are not for everybody. Patients thinking of having these procedures should satisfy the following:
- Their lesions must not be suspicious for skin cancer.
- The patient must not have had prior treatments that can complicate the procedure, such as dermabrasion, cryotherapy, chemical peel application, lower eyelid surgery, etc.
- The patient must have good cardiovascular status, immunity, blood sugar control and clotting function.
- The patient should not have a history of bad scarring or poor wound healing.
- Patients cannot be on concomitant isotretinoin or hydroxy acid treatment, which can make the skin prone to laser burns.
- People undergoing ablative laser surgery must have a fair complexion (Fitzpatrick I and II). They should likewise have the patience for long recovery periods and meticulous aftercare regimens.
- The patient must not have a mental health issue that can make them uncooperative during awake procedures.
- Patients must have realistic expectations, i. e. they know that all medical treatments have limitations.
Individuals with chronic medical conditions may still have the procedure, but only if they have medical clearance.
What Other Treatments Can a Dermatologist Give for Sun Damage?
If a patient is not a good laser candidate, the dermatologist may recommend the following alternative sun damage treatments:
Some topical beauty products have anti-aging properties. Those containing antioxidants like vitamin E and green tea can lighten brown spots and prevent further skin damage from UV exposure. Vitamin C improves wrinkles by acting as both an antioxidant and collagen synthesis promoter. Peptides are protein fragments that also enhance collagen formation.
Except for the potentially irritating weak acid vitamin C, these ingredients are mild on the skin. However, hypersensitivity is a possible complication if the beauty product contains allergens and other inflammatory substances.
- Topical Retinoids
Tretinoin and tazarotene are vitamin A-like medications FDA-approved for the topical treatment of sun-damaged skin. They enhance collagen production, reduce collagen breakdown, even the skin tone, improve skin texture and eliminate premalignant skin cells. Redness and scaling are common but transient side effects.
- Hydroxy Acids
Hydroxy acids speed up skin exfoliation, helping to reduce fine lines and unwanted pigmentation. Lactic acid, an alpha-hydroxy acid, can also moisturize the skin and enhance its barrier function.
These substances can irritate the skin and make it light-sensitive. Starting at low concentrations minimizes unwanted side effects.
- Botox Cosmetic Injection
Botox treatment takes care of “dynamic wrinkles,” or those furrows formed by repeated facial muscle contraction. Though these blemishes are not due to excessive sun exposure, they can worsen the appearance of sun damage lesions. Botox cosmetic treatment is generally safe, but complications arise when unlicensed individuals mishandle the procedure.
- Dermal Fillers
Dermal fillers are substances injected into the skin’s deeper layers to plump up the skin and get rid of wrinkles. They work instantly, although they can’t treat all sun damage lesions. Dermal fillers may cause hypersensitivity.
This cosmetic procedure entails the mechanical removal of the outermost skin layers. It can correct various skin imperfections, but as in laser treatment, scarring and infection are potential complications.
- In-Office Chemical Peels
Chemical peels contain hydroxy acids and similar substances that exfoliate the skin. However, the formulations used by dermatologists can remove thicker portions of skin than at-home treatments.
Redness, swelling, discomfort and scaling are common side effects of chemical peels. Possible complications include infection, milia, pigmentation problems and scarring. Phenol-containing formulations may cause internal organ toxicity.
- Mohs Surgery
Sun damage puts people at risk for skin cancer. Mohs surgery is the most effective treatment for malignant skin lesions. It also produces the best cosmetic outcomes. As in any surgical procedure, the most common side effects are redness, swelling and pain. Scarring, bleeding and infection are rare complications. Only highly experienced dermatologists can perform Mohs surgery.
At BHSkin Dermatology, we offer a wide range of services that can help fix sun-damaged skin safely and effectively.
How Can You Prevent Sun Damage and Ensure Skin Health After Your Laser Procedure?
As previously mentioned, the results of your laser treatment can last for a long time. Besides an overall healthy lifestyle, good skin care can help you keep your lesions from coming back. Your regimen does not have to be complicated, but the must-haves for preventing or treating sun damage include the following:
Cleansing clears impurities created by sunlight and other environmental agents. You may do this twice a day using a mild skin cleanser.
- Damage Control
After cleansing, you may apply an antioxidant formulation to get rid of the invisible, harmful particles sunlight leaves on your skin. Niacinamide and resveratrol are non-irritating antioxidants you may use topically everyday.
Moisturizers replenish the water and lipids that cleansing removes from the skin. Applying moisturizers after antioxidants helps enhance the latter’s skin penetration.
Fatty moisturizers like ceramides seal moisture in and block the entry of irritants. Water-soluble moisturizers like hyaluronic acid attract water from the surroundings, including the atmosphere. Moisture is essential to good skin barrier function.
- Sun Protection
Sun protection can be physical or chemical. Clothing and seeking shade during the daytime are examples of physical sun protection. Chemical sun protection comes primarily from sunblocks and sunscreens, which prevent sunlight from penetrating the skin.
A good sun-protecting formulation must block both UVA and UVB rays. It should also be water resistant and have SPF-30 or greater.
A complete skin care discussion is beyond the scope of this article. But remember, your dermatologist is the best person who can help you formulate the skin care routine most suitable for you.
Sun Damage Laser Treatment: Things to Remember
Sun damage creates various lesions in the skin. There are different ways of treating this condition, but laser therapy is one of the most effective.
Lasers are suitable for the complexities of sun damage treatment, being precise surgical devices. There are several types, each with its upsides and downsides. Choosing which one to use depends on various patient factors and the provider’s skill.
The results of laser treatment can last for years. A healthy lifestyle, sun protection and religious skin care can keep the lesions from coming back. Finally, to ensure the success of your procedure, entrust it only to a highly trained laser dermatologist.
At BHSkin Dermatology, You Get Expert Laser Skin Rejuvenation from LA’s Best
Sun-damaged skin is common in sunny places like California. It may lead to skin cancer if left untreated. Laser surgery is a great remedy for sun-damaged skin. But it is a highly technical procedure, requiring years of training and experience.
At BHSkin Dermatology, we offer laser services for every skin type, done by no less than LA’s top laser specialists. Visit us at our Glendale or Encino clinic or use our virtual portal for your initial consultation.
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