What's the Best Laser for Skin Resurfacing?

My dermatologist offers a laser treatment for skin "resurfacing" which is different from the laser at my favorite medispa. Are all lasers the same? How do I make sure they use the right one?

Doctor Answers 58

Combined Fractional Erbium Laser Resurfacing is a Very Effective Technique

The BEST Laser Resurfacing technique is the one done by the best, experienced, most knowledgeable doctor. It is NOT the Laser but the doctor who is using the laser that is most important for the best result.

An excellent laser physician can achieve excellent results with any of the popular lasers whether flat beam or fractional-so choose your doctor very carefully-this is your most important decision.

After 17 years of doing Laser Skin Resurfacing I am currently using a Combined Non ablative and ablative Fractional Erbium Laser Resurfacing technique.

My reasons are :

  • Good results equal to the old "gold standard" CO2
  • None of the problems-delayed healing, loss of pigment, long recovery, scarring etc seen with the old CO2
  • Ability to treat darker skin types
  • No demarcation lines
  • Quick recovery back to work-5-7 days

See link below for more infor4mation.

Have a question? Ask a doctor

For skin resurfacing there are two main types of lasers,...

For skin resurfacing there are two main types of lasers, carbon dioxide (CO2) and erbium.

  • CO2 skin resurfacing is the most aggressive and produces the most dramatic results but also requires longer healing times.
  • Erbium resurfacing is gentler and produces good results with quicker recovery.
  • There are lasers, such as the Derma K laser, which combine the advantages of both CO2 and erbium into one laser.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 163 reviews

CO2 lasers are the gold standard!!

In our practice we are very happy with the Active FX fractional CO2 laser. It provides our patients with most of the benefits of the CO2 laser without the downsides. However, no laser will be as successful at obtaining the fabulous results of a well done CO2 laser. But then again, those patients suffered from long recovery periods and very obvious hypopigmentation ("bleaching") problems.

When you are deciding on what laser to use, you have to ask yourself 3 questions:

  1. What level of results do I want?
  2. What downtime can I tolerate?
  3. How much do I want to pay?

Light therapies (BBL, IPL, etc.) are cost-effective, short downtime procedures. However, they require multiple trips, are very operator dependent, and can cost a lot after a while.

Fractional technologies (erbium and CO2) can provide more significant improvements, but have levels of recovery measured over 4-10 days. Patients usually need one or two treatments, but the treatments are significantly more expensive.

Full ablation technologies (erbium and CO2) create the best results but have downtimes in the 2-3 week range with long-standing redness. They are painful enough to often need IV sedation and a trip to the OR significantly raising the cost of treatment. One treatment is usually all that is necessary though.

I hope this helps you.

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"Best" depends on patient's goal

There are many different types of laser and light devices on the market that can treat a variety of conditions. The most common complaints are wrinkles, irregular skin pigmentation, laxity and loss of youthful glow. When determining the appropriate treatment plan, the physician must take into account the patient's goal as well as his/her acceptable downtime. In addition, multiple treatments may be required for targeted results and this should be taken into consideration by the patient. The potential risks should also be fully explained to the patient to align expectations. In general, the lasers that give more impressive results tend to have higher risks associated. Be weary of anyone who claims their laser is the "best". I hope you find this helpful. Good luck.

I've read through all the answers on this page and they...

I've read through all the answers on this page and they are excellent. In the interests of saving time, let's go through the bullet points:

  • The right laser depends on what you are treating (redness, brown spots, wrinkles, laxity, etc.)
  • The laser should be used by a physician with adequate training, experience, and credentials
  • Sometimes laser is not the best option, therefore it is important to see a physician who has different options and can offer you the one that is right for you. Sometimes a chemical peel or dermabrasion is a better choice
  • Different doctors have different lasers. Unfortunately, the truth of the matter is that nobody can afford to buy all the available lasers and have them all sitting in their offices. Hopefully your doctor has a good machine and even more importantly, sound judgment.
  • The same technology, for example, fractionated CO2, now is available from different manufacturers. Active FX and Deep FX has a fair representation on this page, and I believe, it is currently the best option for fractionated CO2 resurfacing. It is good for lines, wrinkles and some scars.
  • To make sure your doctor is using the right laser on you, look at some before and after pictures of prior patients, and make sure you have an extensive conversation with your doctor about all the options and their risks and benefits.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

The Best Laser For Skin Resurfacing

Many lasers are available for skin rejuvenation. The ideal laser treatment for you would depend on your concerns, your skin color and the amount of downtime and recovery you are willing to experience. In my Raleigh, North Carolina Plastic Surgery Practice I use the following modalities for skin rejuvenation:


  1. IPL, second generation intense pulsed light . This device can safely remove irregular pigmentation, dark spots and red splotchy skin from the face neck chest hands or any area of the body.
  2. Laser Skin Tightening with the GentleYag long pulsed Nd:Yag laser. This laser provides skin tightening to all areas of the face and body with no downtime. It can even help smooth out acne scars.
  3. Melasma Treatment with Gentlelase Alexandrite Laser. This laser treatment is best for individuals with light to medium skin. After treatment witht his laser, the skin will become very rough and dry and eventually slough off, leaving skin that is even in color.
  4. Rosacea and spider veins of the face can be treated and often eliminated with the V-Beam Pulse Dye Laser
  5. Co2 resurfacing provides a true skin resurfacing. In the early days of laser resurfacing the treatments were aggressive and the downtime considerable. Today, most plastic surgeons provide a more conservative CO2 laser resurfacing treatment. The treatment still requires downtime and a commintment to avoid the sun but the results can be beautiful. I often use CO2 resurfacing in conjunction with other facial rejuvenation procedures. I particularly like the effects of CO2 resurfacing around the eyes.
  6. Dermabrasion: I don't often perform dermabrasion, but on occassion, I think dermabrasion is the best treatment for very deep lines around the mouth. This is a treatment, like CO2 resurfacing that requires fairly significant downtime and a commitment to avoid the sun.
  7. Light or mild resurfacing treatments like microdermabrasion and light chemical peels are performed by aestheticians in my medical spa. Regular medspa treatments can be used to maintain beautiful skin and they can help prepare the skin for deeper treatments.

In order to find the best laser ftreatment for you, look for a plastic surgeon with significant experience in aesthetic lasers treatments, aesthetic plastic surgery and non-surgical aesthetic enhancement treatments.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 50 reviews

Best Laser for Resurfacing

Thanks for the great question. As with any treatment, there are different types of laser and different brands of each type. In addition, different laser types and intensities will be more or less appropriate for different skin types.  The gold standard for resurfacing is CO2 laser, though this is most commonly delivered today as a fractional CO2 (meaning that less than 100% of the surface area is hit with the laser). The key to a great resurfacing result is choosing the right settings for your goals and skin type, and careful, attentive management of preoperative preparation and postoperative care. This will likely include use of tretinoin and/or hdroquinone, as well as sunscreens and non-comedogenic moisturizers. Best of luck moving forward!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Fraxel re:pair carbon dioxide laser

Many laser types have been used over the last few decades. The Fraxel re:pair CO2 laser has been a big leap forward in our ability to provide amazing results with minimal downtime and greatly reduced chance of complications.

This laser provides a microscopic facelift with zones of uninjuried tissue to allow for rapid healing. Most patients can be back to work in 4 days and already look much improved.

Daniel P. Slaughter, MD
Austin Facial Plastic Surgeon

Best Laser for Skin Resurfacing

I would agree that there is no "best" laser for all problems and all patients... The laser I would recommend would really depend to a large extent on your skin type, skin history, and your goals for improvement.

For wrinkles, brown spots, and acne scarring, my favorite tool is the Mixto SX laser because by combining the benefits of the Carbon Dioxide modality with modern, Micro-fractional technology, I believe it offers "the best of both worlds", if you will.

You can achieve the results of the best CO2 lasers, but with the more comfortable, shorter and easier recovery associated with fractional lasers. The micro fractionation also lowers risks significantly.

There is no 'Best' laser for skin resurfacing

Skin resurfacing implies that you want to have the outer most layers removed to expose the immature layers of the skin. The older outer skin is removed and the immature skin grows and heals the skin leaving fresher looking younger skin.

No single company has the best laser. The types of lasers that will resurface the skin are the Carbon Dioxide (CO2) or Erbium lasers. These are lasers that can precisely control the depth of skin removal. They will work the best. The more aggressive you are the deeper the laser will penetrate and more skin layers will be removed. The deeper you go, the longer the recovery, the more risk of permanent complications in the skin. So be very careful in your decisions about lasers and how deep you want to be treated.

Michael J. Brown, MD
Leesburg Plastic Surgeon
4.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.