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.

The differences
between laser treatments can be confusing. Most laser treatments are either
ablative or non-ablative. An ablative laser strips away the outer layer of skin
and requires more downtime. These kind of lasers are typically used for
resurfacing treatments. Non-ablative treatments penetrate the skin and trigger
new collagen growth, often using technology such as radiofrequency. One of the
reasons I prefer using the Halo hybrid fractional laser is that it's the first
of its kind to offer both ablative and non-ablative treatments, depending on
the unique needs of each patient. It is effective for fine lines and wrinkles,
including those that form under the eyes. I recommend looking into a Halo
treatment if that's the concern you'd like to target. Best wishes.

Niy76:
Non-ablative and ablative are subsets of laser resurfacing (a more general term).
Non-ablative means that the skin surface is not removed or injured, and that energy (laser, heat, or radio energy) is delivered into the dermis (the fibrous layers of the skin). Non-ablative is typically done as a series of treatments with little or no downtime.
Fractional methods are intermediate in terms of recovery and results. These methods are technically ablative, but only ablate a portion (fraction) of the surface area.
Ablative laser treatments have a longer history and more established record of results. The treatments can be made deeper, and the results more significant. Along with this, the healing time or downtime is longer. The traditional CO2 laser or phenol peel has the most dramatic results, but higher risks. The ErbiumYAG laser is currently the most favored for eyelid skin resurfacing.
Also inquire about pre- and post-op skin care, HA fillers or other adjunctive techniques.

A better question and the one you might have wanted to ask is, what is the difference between non ablative and ablative resurfacing for the skin?
Nonablative is usually done through radiofrequency, or other wavelengths that go deeper in the skin to stimulate the deeper tissues to tighten up the skin. Wavelengths from 1300-1600 achieve this non ablative skin tightening. Radiofrequency is another way of doing this via thermage, etc. These devices although not removing the layers of the skin, can cause significant swelling and redness and this can lasts a couple of days to more time.
The ablative lasers such as co2 (Active fx, etc), and erbium yag lasers remove the top layers of the skin (ablate) and allow stem skin cells from within the hair follicles to resurface the treated areas to rejuvenate skin by decreasing wrinkles, tightening skin, decreasing pore size, removing unwanted pigmentation and removing precancerous skin cells. The strength of ablative or non ablative lasers really depend on what energy use and can be set by your doctor.

 A laser resurfacing machine is an ablative laser. Many different forms of ablative lasers can be used to resurface the eyelid skin to give it a better look and tighten the skin.

I like to use fractional ablative lasers for resurfacing of the skin. I use a combination of the Deep F/X for lines and wrinkles and the Active F/X for superficial spots and stains. I find this combination to be very effective- In addition, because it is fractional, it is still gentle enough for the lower lid area. Of course, consult with your physician/surgeon to determine what is the best therapy for your condition and your skin. Thank you.

Ablative resurfacing or laser skin resurfacing implies that the skin is removed. This may be full field in which 100% of the treated skin is removed or fractional in which a fraction ie 5-60% of skin is removed. these lasers may be erbium, carbon dioxide or ysgg.
Non-ablative or sub-surface remodeling does not remove or "ablate" skin, but rather causes sub surface skin wounds which heal with new collagen production. This also may be full field or fractional. The original fraxel laser is an example of this.
For eyelid tightening, the ablative or resurfacing lasers are "stronger". Full field is usually deeper with better results and longer healing times than fractional devices.

Skin resurfacing is done with an ablative laser. It really depends upon the settings, your skin type, your physician, and the type or wavelength of the laser. Ask your physician. We use an erbium laser for resurfacing and combine it with non-ablative lasers to remove some of the pigmented lesions. We have found a combination approach is often more powerful. I like the idea of CO2 or the Sci ton combination peel for the under eye region. Again see you plastics surgeon or dermatologist to see what they get the best results with as this is the most important aspect.