What is the difference between ablative and non-ablative lasers? Please advise, so confused!

Question

What is the best skin lasers for treating (large pores, dark spots and minor acne scars) ablative or non-ablative lasers? Please advise, so confused!

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Ablative laser skin resurfacing removes the most superficial layer of the skin along with many of the skin's imperfections and blemishes. Non-ablative laser skin resurfacing leaves the surface of the skin intact as it passes through to the deeper layers of the skin where it stimulates a new layer of skin to form. Both techniques stimulate collagen and elastic fiber production in the deep layers of the skin, which causes your body to begin creating new, fresh looking skin. I suggest that you consult with a board certified facial plastic surgeon.

Best wishes,

Best wishes,

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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

ablative burn and cause char = ie needs wound healing, looks like a burn.  nonablative heat the skin cause what looks like a sun burn == ie needs NO wound healing, looks like allergy/redness.  They have various reasons for use and can be used to treat wrinkles, pores, scars, age spots etc.  Best, Dr. Emer.

Jose Barrera, MD · Answer

Non ablative lasers typically treat the dermal layer of the skin without removing the top layer or epidermis. Lasers include the ResurFX, Fraxel, Erbium:Yag. Ablative lasers remove the epidermis and dermis by placing fractional channels through the skin. Lasers include the Lumenis CO2 active and deep FX as well as the Syneron Candela CO2RE laser.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your good question. Ablative laser skin resurfacing removes the top layers of skin. This improves skin texture, tone, elasticity and sun damage. Non-ablative lasers treat the deeper skin and give more tightening. Typically ablative lasers require one treatment whereas non-ablative lasers require several treatments. Often, a combination approach is needed to give best results for some patients (particularly patients with acne scars). I hope this is helpful.Good luck,

Brett E. Stompro, MD · Answer

HI!

At my practice we have offer both types of lasers, our lasers help with a broad range of skin issues.

For me, I would recommend the best laser based on how quickly the patient is expecting results and what are the concerns. Also take into consideration weather & travel. We wouldn't want a patient to do an Ablative laser if you would be going into the sun shortly after the procedure.

Some of the non ablative lasers do the same thing as ablative lasers but they have completely different recoveries. Most of the non ablative lasers are done in a series.

If a patient has more than 1 skin issue, I would be recommending the more Ablative laser so we can take care of all issues at once with one recovery.

If a patient comes with 1 skin concern and doesn't have any down time, than the non Ablative laser would be the best option.

Grant Stevens, MD · Answer

Hi and thank you for your question! We have many devices in our practice. We determine which one we will use
based on each individual patient, their concerns, skin condition, skin type,
budget and their desired amount of downtime. It sounds, from your
description, that you would be a good candidate for the Halo hybrid fractional
laser. This uses both ablative and non-ablative wavelengths, and treats a
portion of the skin; this is referred to as fractional. This allows healthy
skin to remain intact, which allows for quicker healing time and less risk.
Treating with both the ablative and non-ablative allows for superior results,
as compared to some other types of treatments. I suggest a consultation
with a practice that has many different devices; this will allow them to advise
you most effectively.

Best, Dr. Grant Stevens

Otto Weiglein, FRCSC · Answer

Many patients I see ask me this very same question. As others have already mentioned, the difference between ablative and non-ablative lasers is the depth of treatment. Ablative lasers strip away the top layer of skin, providing significant improvement in only 1 treatment (usually). This comes at a cost of more downtime. Non-ablative lasers target the deeper layers of skin, involve less downtime, but require multiple treatments. The Halo fractional hybrid laser that I use at my practice is rather unique in this regard. It's really the first treatment that treats both layers of skin in a single pass. It is excellent for treating the conditions you mention, and I encourage you to find a qualified plastic surgeon who offers this treatment.

Davin Lim, MBBS, FACD - Account Suspended · Answer

I think is gets slightly more complex, as one has to add fully ablative into the picture. The video below shows the explanation between fractional and fully ablative. For ablative (co2 and erbium), the upper layers of your skin are treated, whilst non ablative 1440-1550 wavelengths like Fraxel ReStore, the upper layers are intact. Really is a balance between density of coverage as well. I alway advice patients on the results they want to achieve, rather than the device. This way I can tailor a program based upon downtime and skin type. All the very best, Dr Davin LimBrisbane, Australia.

What is the difference between ablative and non-ablative lasers? Please advise, so confused!

Answers (9)

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