Now that fall is looming, it's time to take inventory of what's going on with your skin. If you spent too much time lying out this summer, you may see some new dark spots or fine lines that weren't there in April.
While there are tons of (questionably efficacious) topical creams on the market, nothing can rejuvenate your skin like a laser treatment. And it's one of the treatments (unlike Botox) that celebs will admit to indulging in. Gwyneth Paltrow has done Thermage, Kim Kardashian does Fraxel, and Jennifer Aniston did some sort of laser therapy that made her look like a "battered burn victim." Temporarily, obviously.
The technology is changing constantly, and it's easy to be overwhelmed when you start researching. I got Dr. Gervaise Gerstner, L’Oréal Paris Consulting Dermatologist and laser treatment expert, on the phone and picked her brain about the different types of lasers, what they do, how much they cost, and what kind of side effects you can expect. From the "gateway drug" laser to the big guns, there's a treatment for everything that ails you. They're definitely not cheap and there are some risks, so you need to know what you're getting yourself into. Click through and learn.
Clear + Brilliant:
"This is my starter laser, my gateway," Dr. Gerstner said. "It’s good for pores, texture, and fine lines. I do it on my own skin every three weeks." It requires a 30 minute time commitment. You sit with some numbing cream on your face for 15 minutes, then the doctor will treat your whole face (while you wear protective goggles), after which you're given an ice pack and sent back to work. It's a cumulative treatment, meaning the more times you do it, the better results you get. Results don't wear off (well, unless you go to Hawaii, don't wear sunscreen, and burn your face off). "It can be part of your maintenance routine, just like a glycolic peel or a microdermabrasion would be," Dr. Gerstner said.
Side Effects/Down Time: You'll be a bit pink for about an hour, but you can put makeup on right away. "There are no telltale signs," Dr. Gerstner said. "This is something you can do the day before your wedding or a black tie event."
This pulsed dye laser treats anything pink or red, like scars, rosacea, and broken capillaries. "This one is quick and easy," Dr. Gerstner said. It usually requires more than one visit, though, depending on what you're treating.
Side Effects/Down Time: If your scar is pink, it may look purple for a few days, but that's temporary. Otherwise, there are no side effects or down time.
Price: $300-$350/treatment. Insurance will often cover it.
This is the workhorse of lasers. "It’s my gold standard laser for texture, pore size, fine lines, and brown spots," Dr. Gerstner said. "The 1550 wavelength is a general resurfacing wavelength. It also has a 1927 wavelength which is for hyperpigmentation, melasma, and brown spots." This is a treatment that Dr. Gerstner doesn't recommend in the summer, because you need to stay out of the sun for four or five days afterwards.
Like the Clear + Brilliant, Fraxel is cumulative. Dr. Gerstner recommends monthly treatments for about five months. But if, say, you get pregnant and need to stop for nine months, the treatments you already did won't wear off the way Botox and fillers do.
Side Effects/Down Time: "You can immediately go back to work, but you definitely look like you went to St. Bart’s and forgot your sunscreen," Dr. Gerstner said. "You’re pink for two days." There can potentially be some minor swelling. Fraxel is also the treatment of choice for acne scars, in which case your down time may be a little longer. "If a 25-year-old has ice pick acne scars on her cheek I'm gonna knock the hell out of her with the Fraxel," Dr. Gerstner said. That's a good thing for the scars, but possibly a bad thing for your social life for a few days, so plan accordingly. Great time to catch up on Orange Is the New Black!
Thermage is often lumped in with laser treatments, but it's actually a radio frequency tightening device, not a laser. It's commonly used on the jowls and lower abdomen. In Japan, women start doing Thermage at age 30 every three years as a preventive measure, according to Dr. Gerstner. In the US, patients generally start turning up at her office at age 40, to have slack jaw lines corrected with the treatment.
Side Effects/Down Time: You can be slightly pink or swollen and have some temporary tingling in the area, but immediate side effects are minimal.
Price: $3,500/treatment. One treatment lasts about three years.
Like many medical treatments, it's often better to tackle an issue with more than one modality. Lasers are frequently used in combination with other therapies.
• Raised scars: If your scar is red and raised, Dr. Gerstner likes to treat it every two weeks. She'll first inject it with a steroid (which helps to shrink it), then will alternate Fraxel and V-Beam to soften and lighten the scar. (I'm about to go through this process. I have scarring from laser tattoo removal gone bad, back when lasers weren't quite up to the task. Is it weird to hope that the very thing that scarred me in the first place can fix it? Expect a report back.)
• Topical treatment immediately post-laser: Clear + Brilliant and Fraxel work by making microscopic "cuts" in the skin, and "you’re rallying the body’s own collagen to spackle in there," Dr. Gerstner explained. So it's potentially an ideal time to add topical therapy, because it will be more easily absorbed. Several studies are ongoing, including ones by skin care companies Skinceuticals and Lifeline.
• Botox/Fillers: Botox gets rid of deeper wrinkles, fillers plump skin up, and lasers resurface. It's very common to use two or more of these to get better results. No single modality can do everything. (And this is why so many women fall down the rabbit hole of never-ending treatments.)
I've had laser therapy (see my tattoo story on the previous slide, plus I've done laser hair removal), and they make you sign the scariest waiver you will ever see prior to receiving treatment. Just know that doctors have to tell you every single thing that could possibly happen--most are incredibly rare.
Dr. Gerstner recommends going to an experienced doctor. "I wouldn’t go to a spa for laser treatments. I’ve inherited people who were burned in a spa setting," she told me. "I do every laser treatment myself, even though by New York state law I could have medical assistants do some of it."
Here are the absolute worst possible things that can happen (again, they're rare, especially when an experienced practitioner is doing your treatment):
• Scarring • Blindness (wear the weird-looking goggles they give you!) • Raw, weepy skin • Pain during treatment (but the topical numbing creams really work)
So now you've been duly warned. Personally, I think the benefits of laser treatments outweigh the risks--especially now since many doctors have been performing these procedures for years.