Ablative Laser Vs Laser Skin Resurfacing?

Ablative laser usually refers to the old school style of resurfacing which was a scorch and burn approach to tighten the skin.  The results were great…sometimes, but pigment loss was high, the skin was tight, and demarcation lines were noticeable. Now we have the Fractional/Fractionated types of lasers.  Laser skin resurfacing is a general term which can mean ablative (100%) or semi-ablative (5% 10-30% or more)where lasers ablate deep narrow channels of skin and allow some untreated skin to remain.  This results in quicker healing time, less pigment risk, and better scar treatment.  All the CO2, Erbium, Erbium Glass, and similar are a form of ablation/semi ablation, the percent depending on the manufacturer, model, make, and operator programming the laser for you. Seek the expertise of a Board Certified Dermatologist or Plastic Surgeon to offer you all of your options. In the right hands, these lasers can offer you an improvement in under eye lines.*   

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Laser skin resurfacing is a heading that encompasses both ablative and non-ablative resurfacing. Ablative resurfacing would include the older carbon dioxide laser and medium depth chemical peel. Non or minimally-ablative laser skin resurfacing involves Fraxel RE:store and Fraxel RE:pair. These procedres are not as “strong” as the CO2 laser. Despite which laser might be used you will have lines recur after the treatment as squinting will promote more lines to form. There is a risk of scarring with the more aggressive lasers so you want to be mindful that the “strongest” is not necessarily the best for you. See an experienced laser surgeon who has done all of these procedures so they can tell you what is best.