Thank you for your question.
You submitted your question without a photo.
And essentially, you are describing your discussion with an aesthetician who said that because
of your middle eastern background that the 1064 YAG laser is the only wavelength safe
for your skin type and for darker skin.
And your primary concern is to improve the pores, the fine lines under the eyes and the
lines in between the eyebrows.
And so you’ve listed several names of different brands and you found that one particular brand
mainly helps pigmentation and redness.
Well I can certainly understand why this can be overwhelming based on that one particular
idea that was presented to you by the aesthetician and I can certainly share with you how I discuss
these issues with my patients.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
In our practice, we offer everything from non-surgical procedures such as Hydrafacial
and multiple different lasers as well as advanced surgical procedures such as lower eyelid blepharoplasty,
eyelid surgery, face lifting surgery, etc.
So it is certainly important for any practitioner to recognize the importance of selecting the
right wavelength or the right laser procedure for the right patient.
But I think that it is understandable why you’re a little overwhelmed and you’re
looking at the information often provided by manufacturers about the things that are
good for light or dark skin.
And I can tell you from decades of using lasers and different devices that many lasers can
be used for dark skin.
It has to do with something called the relative absorption of particular wavelengths to melanin.
And so your aesthetician is somewhat appropriately counseling you in that 1064 YAG is safer for
darker skin types because of that wavelength selectivity.
However, the differences between lasers are too many to describe and there are certain
technologies that have been used at different wavelengths that can also be used on darker
skin.
So it is less about the laser than it is about the doctor who is selecting the laser.
And also, you don't need to just limit yourself when it comes to these treatments by just
laser alone.
For example, if you want to improve the appearance of pores or dilated pores, well you can use
a combination approach.
We have used, for pores, we have used something called 1064 YAG Q Switch laser to help reduce
pores.
We can also use a technique of using Botox®, a neuromodulator injection or the delivery
through a microneedling device to improve the appearance of pores and this is well documented.
And I always believe in synergistic approaches so I’ll often combine two different modalities
together.
When we talk about fine lines under the eyes, there is actually a particular method using
an Erbium laser but that is minimally ablative.
And one of our lasers, we can actually use that in a way to stimulate collagen and improve
the skin quality without getting the classic ablation which means removal of skin with
that same wavelength.
So the wavelength is one part of the equation.
The other part has to do with the longevity of that delivery of that pulse as well as
the energy delivered.
And these are technical issues and certainly not necessarily important for you to fully
understand but when you think of these variables, you can realize that there are a lot of ways
to adjust these variables to maximize the safety.
When it comes to any darker skin type, you can be sure that the biggest concern is getting
a reaction which results in too much pigment or a result where you lose pigment.
So most of the time, these treatments have to be adjusted.
In addition, when it comes to fine lines under the eyes, we have a lot of success using something
like platelet-rich plasma (PRP).
We can also combine that with a neuromodulator and improve the fine lines.
For the lines in the brows, essentially, Botox® or any other neuromodulator is likely to be
a value as well as injectable fillers something like in the hyaluronic acid family.
So I think that one of the things that you might be getting is a little of a bias because
if it’s an aesthetician who is advising you, well they’re only advising you about
laser and they may be only legally limited to only be able to use a laser.
But if you were to go to a physician, you might find that you’ll get more options
which will be more appropriately customized for your issues.
The goal is to get the best treatment and you really ought not be limited.
So you may want to consider combining different modalities.
There are also ways to help improve pores with Hydrafacial or microdermabrasion.
So obviously you are in the right path in asking about lasers.
But laser is only as good as the practitioner who uses that laser and how that practitioner
customizes that treatment.
It is certainly true that lasers that are more recently developed over the past several
years have a lot of intrinsic safety measures placed where you can literally plug in or
enter the person’s skin type and what their problem is and get a range of parameters.
But an experienced physician will also have the experience from doing the previous treatment
and the understanding of the skin to help customize that and I think there is a value
there.
I think it’s worthwhile pursuing that approach.
So meet with a qualified, experienced physician who offers all these different types of treatments
and a get a sense of what their experience is and what their bias is but certainly understand
that anything for skin is often a treatment strategy which requires multiple treatments
as well as some maintenance treatments and that’s very important to understand going
in so that you don't have disproportionate expectations after one treatment.
But I think that you are on the right path.
I think it’s certainly overwhelming and that’s why having an experienced professional
guide you will probably take you to the next step moving forward.
So I hope that was helpful, I wish you the best of luck and thank you for your question.