Laser Resurfacing or Photo-facial for Fair Skin? (photo)

Question

I am 42 years old with ultra-fair skin (always burns and freckles, never tans) and am seeing some skin aging issues such as laugh lines, uneven texture, and larger pores (sun damage?). I went in for a facial and skin consultation and was told that my skin is too fair for laser treatment and I should go with photofacial. My skin is somewhat thin, probably average to slightly above average for fair skinned people my age. I am worried that photofacial will bring out freckles permanently. Advice??

Mark J. Lucarelli, MD · Answer

Laser resurfacing and IPL are generally oriented toward different goals.

	Erbium and CO2 resurfacing lasers can have their best effect on improving skin texture.

	Different wavelengths of IPL can be emphasized to address skin pigmentary changes such as dark spots  (lentigos),  redness from rosacea,  and very fine vessels (telangiectasia).

	Patients with fair skin tend to have fewer problems with laser skin resurfacing than do those with darker skin types.

Raffy Karamanoukian, MD, FACS · Answer

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. 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

Ron Shelton, MD · Answer

IPL can help reduce capillaries and brown spots (red coloration and sun lentigines and freckles). However the light source does not help build collagen as laser, such as Fraxel Restore, accomplishes.  Fraxel was upgraded to Fraxel Dual in many practices several years ago as the combination wavelength laser can address both the superficial coloration of brown spots with the 1927 nm. wavelength and the deeper 1550nm. wavelength for collagen production. In this way, texture and color can be addressed.  There is also the more mild Fraxel Clear and Brilliant laser that targets the same issues.

	In general, it is common medical knowledge that fair skin types typically are ideal for these lasers. Discuss the risks and advantages with your physician.

Ross A. Clevens, MD, FACS · Answer

As a general rule, the lighter your skin tone the BETTER candidate you are for IPL and skin resurfacing procedures. A photofacial will address dark spots caused by sun damage and hormonal changes as well as broken capillaries and some skin texture irregularities.  Always be sure to only have these treatments at a Board Certified Facial Plastic Surgeon’s, Plastic Surgeon’s or Dermatologist’s office to ensure that you get the best treatment for your skin tone and concerns…and the best result.

	Best of luck, Dr. Clevens

Stephen Prendiville, MD · Answer

For starters, the most ideal candidates for facial laser resurfacing are patients with fair skin (Fitzpatrick type I).  The major pigmentary contraindication to laser resurfacing relates to those patients with too much skin pigmentation.  IPL will help with brown spots and give very mild collagen remodeling, has almost no downtime, but requires a series of treatments, and will give a less enduring and less dramatic improvement than laser resurfacing ( CO2 and Erbium, fractional or ablative).  Laser resurfacing provides long lasting, dramatic results, but requires a week of hard downtime, followed by 4-12 weeks of postoperative redness and sun avoidance.  A patient's decision must be guided by their expectations, tolerance for downtime, and a thorough understanding of the risks and benefits of all alternatives.

Laser Resurfacing or Photo-facial for Fair Skin? (photo)

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Answer: Photofacial for Fair Skin

Answer: Photofacial for Fair Skin

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Answer: Photofacial or Laser

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Laser Resurfacing or Photo-facial for Fair Skin? (photo)

Answers (8)

Answer: Photofacial for Fair Skin

Answer: Photofacial for Fair Skin

Answer: Photofacial or Laser

Answer: Photofacial or Laser

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Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.