Thank you for your question.
You are asking a question without a photo and you are asking can someone explain the
difference between the different types of lasers and you just write them more of a list
of ablative versus non-ablative.
You name Fraxel®, CO2, Pulsed Dye and a few other lasers.
Well, I can certainly give you a perspective based on similar questions that get asked
of me every day in our practice.
A little bit of 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 beginning with the original fully ablative
CO2 lasers.
Your question really reflects what I feel is an overwhelming information overload that
both consumers and physicians have with the aggressive marketing of lasers.
And it’s remarkable how a brilliant technology which was developed after the innovative concepts
brought to us by famous physicians who really changed the world and when it comes to this
technology , Rox Anderson, on the concept called selective photothermolysis and what
that means is that there are particular pigment types in the body or things that activate
that attract different wavelengths of light and the main ones are water, hemoglobin, protein
in blood and melanin.
And based on those particular affinities of those particular elements, an entire universe
of lasers became introduced and like computers, every year, continues to improve.
Now, the challenge is that the differences between them can really be best explained
based on really what your needs are because the question you are asking is in a way an
academic question that can take hours to explain but what I think is really the point of your
confusion is that everywhere you turn, you are seeing something that claims to be the
best laser and a lot of them claim to 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.
Essentially, like pharmaceuticals companies will promote particular drugs and say, “Ask
your doctor about” and everyone knows about those commercials.
Well, laser companies and equipment companies have done similar things.
They put a technology on a major television program, popular health programs and talk
shows and the consumer now wants that particular service.
Those same companies turn around to the doctor and say get this laser otherwise your competitor
will and it puts doctors in a very strange position.
Now, when you understand basically the principle of what laser does, your doctor is the person
that should really guide you 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.
And 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 the claims were made in the beginning
that they work really 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 and then they pressure the practitioners
to getting that one.
So there is a lot of behind the scenes business that really creates this type of consumer
confusion.
So to understand the differences is first by understanding the problems and what role
lasers have.
Let’s say for example you have a problem with sun exposure where you are a lighter
skin person and this one of the most common issues so let’s use that as an example on
how to choose the right laser.
Well, if you are a lighter skin person and you have brown spots, you have fine lines
and wrinkles, you have some laxity to your skin and you have some fine blood vessels.
Well, for that type of problem, you have choices that include the Q Switch Laser, you have
the resurfacing laser, the CO2, the Erbium laser, you also have the non-ablative technology
such as the Nd:YAG laser.
All of those things can be appropriate but how you apply those technologies, when do
you apply those technologies, depends on a very important concept of a treatment plan
and not just a one of, this is the laser that will solve all these problems.
Back in the early to mid-90’s, we would do laser like CO2 laser as kind of almost
a panacea for that scenario because that basically aggressively ablating the skin, you have prolonged
downtime and healing time but it can work really well.
Unfortunately there are also a lot of challenges with the healing process and complications
which lead to demand for other alternatives.
So, I think that, what you really should do is meet with several doctors.
Get an understanding of what the lasers have in terms of a role in your particular issue
and really 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 what are
the outcomes of those treatments.
And generally, it is understood that you don’t just, especially when it comes to skin, you
don’t just do a single thing.
You have to have a treatment plan and with that comes with a certain amount of maintenance.
So, I think that’s the take home message of what’s the right laser for your situation
and be aware of the incredible amount of messaging that is affecting both your decision and your
physician’s.
So, I hope that was helpful I wish you the best of luck and thank you for the question.