Could someone explain the difference between the different types of lasers?

I would like to know how the different different types of lasers are different. Examples are Fraxel, ablative vs. nonablative, CO2, Erbium, Yag, Pulsed Dye, Yellow lasers, etc.

Doctor Answers 3

Facial aging -- Lasers (erbium/Co2), Fraxel, Radiofrequency like Intensif/Viva, Microneedling/PRP, Peels

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There are many types of lasers and now even radiofrequency technology with or without needling. I suggest you get a formal consultation to determine if an ablative laser (erbium/co2) if better for you or if a non ablative (fraxel, viva, intensif etc) is better.  Sometimes a ccombinationis better. Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Lasers differ in types of issues treated, wavelength, intensity, depth of treatment, skin type of patient, and others

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Thank you for your question. You are asking about the differences between the different types of lasers, which you list as ablative versus non-ablative, and also naming Fraxel®, CO2, Pulsed Dye and a few othes.

I can give you a perspective based on similar questions that get asked every day in our practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years, and I’ve been using lasers since the very beginning of my career, starting with the original fully ablative CO2 lasers.

Your question reflects what the information overload that both consumers and physicians have with the aggressive marketing of lasers. It’s remarkable how a brilliant technology developed after the innovative concepts brought to us by famous physicians who really changed the world. When it comes to this technology, Rox Anderson developed the concept of selective photothermolysis, meaning there are particular pigment types in the body, or things that activate and attract different wavelengths of light. The main ones are water, hemoglobin, protein in blood, and melanin. Based on those particular elements, an entire universe of lasers was introduced, and like computers, every year, continue to improve.

The challenge is the differences between them can be best explained based on what your needs are because question you ask is more of an academic question that can take hours to explain. I think the point of your confusion is everywhere you turn, you are seeing something that claims to be the best laser - a lot of them claim basically the same thing, and each one claims to be better than the other.

Ironically, physicians have been put in a situation with lasers the way medical doctors have been put in a situation with pharmaceuticals. Pharmaceuticals companies will promote particular drugs and say, “Ask your doctor about...” and everyone knows about those commercials. Laser and equipment companies have done similar things when they put a technology on a major television program, popular health programs, and talk shows, so the consumer now wants that particular service. Those same companies turn around to the doctor and say get this laser otherwise your competitor will, so it puts doctors in a very strange position.

When you understand the basic principle of what laser does, your doctor is the person who should really guide as to what is right for you. These technologies evolve because it is important to use the right technology for the right problem in the safest and most predictable way - that’s the goal of every physician. I have watched over the years how particular technologies were so aggressively promoted that they became the hottest thing, no pun intended, and a year to 2 years later, they became obsolete and didn’t work so well, even though they claimed in the beginning to work exceptionally. Laser manufacturers are also notorious for selling or leasing a lot of lasers, and before you know it they come up with a slightly different one, which they pressure the practitioners to get. There is a lot of behind the scenes business that really creates this type of consumer confusion.

To understand the differences, first understand the problems, and what role lasers have. If you have a problem with sun exposure and are a lighter skinned person, you have brown spots, fine lines and wrinkles, some laxity to your skin, and fine blood vessels. For that type of problem, your choices include the Q Switch Laser, the CO2 resurfacing laser, the Erbium laser, and also non-ablative technology such as the Nd:YAG laser. All of those things can be appropriate, but how and when you apply those technologies depend on an important concept of a treatment plan, so not just one of these lasers will solve all these problems. In the early to mid-90s, we use a laser like CO2 as almost a panacea for that scenario because we were aggressively ablating the skin, and you would have prolonged downtime and healing time, but it could work really well. Unfortunately, there are also a lot of challenges with the healing process and complications, which lead to demand for other alternatives.

I think you should meet with several doctors, get an understanding of what the lasers have in terms of a role in your particular issue, and get a deeper understanding as to why the doctor is recommending that particular laser. It is very important for you to understand some of the basic principles and the outcomes of those treatments. Generally, when it comes to skin, you don’t just do a single thing - you need a treatment plan that comes with a certain amount of maintenance. The take home message of what is the right laser for your situation, and be aware of the amount of messaging affecting both your decision and your physician’s. I hope that was helpful I wish you the best of luck, and thank you for the question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Laser Differences

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Ablative lasers resurface the texture of the skin and non-ablative lasers don't disrupt the surface of the skin.  The difference between the lasers that you have mentioned vary depending on the target you are wishing to treat.

Alison Y. Tam, DO
Las Vegas Dermatologist

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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.