How Safe Are Different Types of Lasers?

I've read scores of reviews from patients who have suffered scars, milia, leathery skin, burns and laser imprints for years after their procedure. Why are so many doctors confidently using/marketing lasers when there is such a significant number of patients with terrible outcomes? How much control do doctors have over these outcomes? And is fractional laser really safer than fully ablative CO2? (on this site, Fraxel has a 55% approval, and CO2, 76%) Any docs out there who WON'T use lasers?

Doctor Answers 1

Medical Lasers are safe and effective but not free from potential complications

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As with any medical procedure (from taking an aspirin to brain surgery), risk is unavoidable.  Any medical procedure's risks and benefits must be weighed by doctors and patients alike before consenting to proceed.  Lasers have been a boon to many areas of medicine, but none more than aesthetic medicine.  The vast majority of patients who undergo these procedures (literally millions of procedures annually in the US and Canada alone) have favourable outcomes. 

Unfortunately, there are a small percentage of patients who might have an unwanted complication such as scarring, pigmentary change or failure to respond.  Complications can be limited but, unfortunately, not eliminated by observing a few rules

1) Know your doctor:  Who's doing the procedure?  How long have they been doing it and how many have they done?

2)  Know the patient (that's you!):  Are you planning on going tanning or on vacation after laser?  Do you use any medicines or skin creams that your doctor is unaware of?  Do you have any diseases that might make you more susceptible to burning?

3) Know your laser:  What laser is being used?  Is it being used for it's intended purpose or "off-label"?  What are the expected outcomes and possible complications (and how can they be reduced)?


As to your question about "approval" ratings and Fraxel/CO2 lasers:  Fraxel was developed as an alternative to ablative lasers like CO2 which, while very effective for the treatment of significant facial wrinkles, has significant post procedure healing time.  Fraxel treatment generally need to be repeated to achieve the desired results but after each treatment patients are better able to get back to their lives/work/activities faster.  It is not a matter of safety but of understanding the tool that is being used.

Toronto Dermatologic Surgeon

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.