Non-ablative fractionated Lasers – a safe and gentle way to achieve radiant skin


We all hear about options out there to help achieve skin that is described as radiant or glowing. Typically, people often start with high quality skin care, sun avoidance, chemical peels and perhaps Botox. But what if you want to go to the next level? What if you want to really achieve the glowing skin you see yourself with? One option is a technology that uses a type of laser called a “diode” laser. Of all the laser types in the world, the diode is the most common. In fact, a diode is used in your Blu-ray players, laser pointers as well as many other applications. I will save the discussion on the technology and science of a laser for another blog, so stay posted.
The use of lasers on skin is a big topic and today, I’m going to focus on this type I mentioned above, a “diode” laser. While the specifics of lasers are for another topic, I will review a few things, just so we are all on the same page.

One important consideration to understand with lasers is something called wavelength. Wavelength is exactly how it sounds, the length of the wave. Think about waves in a pool or the ocean. A long wavelength means there is a large distance between the peaks of each wave while a short wavelength means there is a small distance between the peaks. When we think in terms of lasers, we think even smaller, so small we can’t see it. However, it is CRUTIAL to the function. The wavelength of the laser determines what absorbs it and what reflects it. Again, think about laser pointers, the wavelength determines the color we see. So if you have a wavelength of 650nm you see a red laser.

The point of this Science discussion is to highlight how lasers work on your skin. Some lasers are absorbed by certain colors and some by certain substances, like water, blood vessels (red or blue) or even brown spots. If you took any biology in high school or university, you may remember hearing that the majority of the human body is water, so obviously that is something that is easily targeted with lasers.
But this is only the beginning of the discussion as there are two, perhaps even more important components of laser treatments that one must understand.

The first relates to the specific effect the laser has on the skin. The key word here is Ablative. Some lasers are considered ablative and some are considered non-ablative. I think you can figure out which one is more powerful by the use of the word ablative. An ablative laser is a stronger laser and used to literally remove layers of skin from the surface down. In effect, it is a controlled and safe burn. These lasers are very effective in treating deep wrinkles however the problem is downtime, discomfort as well as the inability to use on darker skinned individuals. A non-ablative laser simply heats the skin resulting in changes in the collagen. We know that heating the deeper layers of the skin results in collagen realignment such that skin takes on a more youthful appearance.
The second key point relaters to the notion of Fractionation. A non-fractionated laser will remove a continuous layer of skin, like peeling an orange. A fractionated laser means that it treats small areas of skin but leaves healthy areas between the treated areas. Consider this; have you ever seen someone make those plugs in their lawn for aeration? I mean those holes all over their lawn where they leave normal grass between the holes? This is to aerate the lawn and is supposed to help improve the overall appearance of the lawn as the nutrients, water and air can now penetrate and stimulate the surrounding roots. Well this is almost exactly how it works with laser fractionation. The laser treats many spots of skin while leaving the areas between them intact and healthy. These microscopic areas of skin then help stimulate the surrounding skin to rejuvenate. This results in an extremely low risk of scarring as well as little or no social downtime if the treatment is non-ablative. This is sometimes called microrejuvenation.

So, lets get back to the skin discussion. I believe one of the best was to achieve revitalized skin safely and gently is to embrace the benefits of a fractionated non-ablative laser. This type of laser requires minimal downtime and can be used on all skin types. This type of laser is used to treat mild to moderate wrinkles, acne scarring, reduce pore size and to simply improve the texture of your skin.
How does this work on your skin?

Well, when you look at skin under a microscope you can see that there are distinct layers. The two key layers are the epidermis (the outside and what you see when you look at someone) and the dermis (which is where some nerves and blood vessels live as well as lots of collagen). Both are crucial to have an even textured skin. When you use a fractionated, non-ablative laser the effect of the treatment is in the deeper layers of the skin, preserving the outer layer, hence why you do not see burns or have much downtime. A 1440 diode laser is absorbed by the water in your skin and not by things like melanin, which give skin its color, hence why it is not dangerous to darker skinned individuals. So why does it not get absorbed by melanin? Because of the wavelength! The wavelength is just long enough to get under your skin and get absorbed by water. However, it gets reflected by melanin. This laser heats up the water and then stimulates new collagen and skin cells to form thus giving you brighter and more rejuvenated skin. In fact, I am currently beginning a study looking at the effect of this type of laser on skin elasticity.

Now you may wonder, what are the side effects? A study published in March of 2014 by Marmon et al in “Lasers in Surgery and Medicine” noted that the most frequent side effects of this type of laser was some redness and puffiness after the treatment. Some patients report mild discomfort during the procedure, but we offer some topical freezing (which means NO NEEDLES!) to help with that.

How many treatments do I need? Well, you will likely see a difference with just one, but we recommend continuous care if you want to maintain that glowing skin.

So, this is one option to help with your skin.

Dr James P. Bonaparte, MD, MSc, FRCSC
Otolaryngology – Head and Neck Surgery
Facial Cosmetic and Reconstructive Surgery

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Ottawa Facial Plastic Surgeon