How Do Lasers Work?
Esthetic lasers use a high-powered, direct beam of intense light to target and destroy something unwanted, such as melanin (brown spots and dark hair follicles), hemoglobin (broken capillaries or spider veins), water (for skin resurfacing and new collagen formation), dyes (tattoo lasers) and fat cells (body contouring and cellulite reduction).
However, one laser cannot do all those things. In fact, lasers are highly effective but highly specialized, with different wavelengths that go to different skin depths, with specific targets. The provider needs to have the type of laser that treats the specific condition you're most concerned about. It's also important that the provider has the right laser for your skin type. Darker skin, for instance, needs special equipment.
Lasers Vs. IPL
Lasers are not the same as IPL, or intense-pulsed-light, which is best at treating both brown spots and broken capillaries, though not as effectively as a laser that targets one or the other.
Both lasers and IPL use intense blasts of light and heat, and both can be painful, depending on the treatment and your own pain tolerance. While cooling gels, cooling devices built into the machine, and operator skill can minimize pain, you should expect discomfort at the very least. Talk to the person giving you the treatment beforehand to get a realistic idea of how it will feel.
There are many different types of lasers on the market -- ruby, diode, and Erbium YAG are just a few. There are also many different brands, or manufacturers, including Sciton, Palomar, Syneron, and Fraxel.
In the 1980s and 1990s, ablative lasers like Co2 and erbium were the gold standard for improving the texture of the skin, reducing wrinkles, acne scars, and sun damage. However, they worked by destroying the epidermis and getting down into the dermis, or raw, living skin. It was an extremely painful and left the skin raw, with significant down-time for healing.
Today, the trend is towards non-ablative lasers, called fractional resurfacing, that produce similar results without the wounding and downtime. They work by preserving the epidermis, or outer layer of the skin, while stimulating collagen production in the dermis.
Laser hair removal on legs, underarms and the bikini area is one of the most common uses of laser, often at chains.
Who Can Give You A Laser Treatment?
Unfortunately, the answer is almost anyone! Lasers are a technology that are not being carefully watched or regulated by the states. In most states you aren't even required to have an esthetics license to use a laser, much less any special training. In the worst case scenario, someone with no license, training, experience or certification is hired, shown some settings and how to push the button, and in comes their first customer.
What can go wrong? If the settings are too high or the operator uses you can blister or, worse, get third degree burns that leave permanent scarring. If the operator tries to use the wrong equipment -- an IPL to remove a tattoo, or a laser hair removal device that isn't designed for dark skin tones -- they can create burning and damage.
That said, it's pretty easy to learn how to do it safely," says Gregory Absten, executive director of The Laser Training Institute, which provides training all over the country. "The real problem is people who are just in it for the money. It boils down to the ethics of the person."
Absten advises that you look for someone who has some kind of credentials -- an esthetics license, certificates of training, and even certification. "That's not to say that someone who doesn't have those things won't do a good job -- or that someone who does have them will -- but it's a good place to start."
I recommend you carefully research the medical spa or day spa where you plan to have the treatments done, and ask a few questions beforehand
Question To Ask Before You Get a Laser Treatment
- "What laser are you going to use on my skin, and why?" During a face to face consult, this gives you an idea of how knowledgeable they are, and that they are going to treat what you're concerned about.
- "What licenses do you have, and what's your training on lasers?" This tells you whether they're a skin care specialist or someone who was hired off the street. You can also ask this on the phone before you go in.
- "How long have you been doing this?" This gives you an idea of their experience level -- but people have been known to lie. This is another question to ask on the phone. You can say you only want someone who has been doing it for at least two years.
- "Do you have insurance?" This applies to the spa that is giving the service and the individual.
If You See This -- Run!
The esthetician doesn't put goggles over your eyes before starting a treatment.
The operator can't answer your questions about the treatment or the equipment.
The place looks dirty or the staff acts unprofessional.

