This winter, let derms help you undo the sins of summer (and the effects of time)—there are in-office treatments that can tend to those brown spots, fine lines, and wrinkles and leave you with smoother, more even skin. Post-laser skin can be especially sensitive to sun exposure, so this is the season for scheduling!

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Fractionated Laser Resurfacing

What does it fix? "It minimizes wrinkles, firms sagging skin, fades brown spots and acne scars, shrinks large pores, and improves the signs of sun damage," says Ellen Marmur, MD, a board-certified dermatologist in New York City and founder of MMSkincare. Fractionated lasers have also been shown to protect against skin cancers: Some research shows that as the skin heals after treatment, the number of precancerous cells decreases.

How does it work? Energy from resurfacing lasers converts to heat deep within the skin, which stimulates collagen production and helps firm skin. While the lasers are penetrating below, their pulses of light are also exfoliating the top layers of skin by pricking hundreds of microscopic pinholes on the surface—unlike microneedling holes, these channels are technically microthermal zones. Some treatments (known as non-ablative) leave the skin intact. Ablative laser treatments slough off the outer layer and tend to be more invasive. All fractionated treatments leave "tiny skipped areas of the skin, so healing is faster," explains Heidi Waldorf, MD, a cosmetic dermatologist in Nanuet, New York. That's howfractionated lasers got their name: They only target a fraction of your skin (almost like latticework); it's also why you may need between two and five visits. Worth noting: If you have darker skin or are prone to hyperpigmentation, it's critical for you to talk to your derm about the appropriate strength of the laser. An experienced doc can adjust the amount of heat and how large a fraction of the surface is treated to make it safest for your skin.

OK, so how painful is it? The pain depends on the strength of the laser. The sensation can vary from feeling like tiny pinpricks to (ouch!) hot needles. But, you'll get a generous slather of numbing cream, Dr. Marmur says. 

What are the side effects and downtime? Depending on the strength and type of the laser you're treated with, your skin can range from red and sandpapery (like a bad sunburn) to swollen and flaky. So you may want to wait until after any big events before starting treatment. It can take up to two weeks for the redness and flaking to completely disappear, explains Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City and Health Advisory Board member. "Keep skin moist with a wound-healing ointment like Aquaphor," Dr. Marmur says. "And avoid sun exposure for a week."

When will I see results? Ingeneral, you'll notice smoother, brighter skin after seven days. But for optimal results—we're talking fewer lines and spots—derms recommend a series of treatments.

How many treatments do I need? Most doctors say at least three, spaced four weeks apart. (Something to consider, budgetwise: "One stronger laser-resurfacing procedure can be equal to—and cheaper than—multiple low-intensity treatments," Dr. Marmur says. But there will be more downtime.) "The results will last forever," says Dr. Marmur, "as long as you try to stay out of the sun and are diligent about daily sun protection to prevent future sun damage." Since it's difficult to avoid the sun completely, many people do a "booster" treatment every year or two for maintenance. 

How much does it cost? A low-intensity treatment, like Clear + Brilliant, done on the face and neck can run $500 to $750 per treatment, while stronger fractionated lasers, such as Fraxel Dual or Halo, are about $1,500 per treatment. 

Colorful lights on woman face
Credit: Liliya Rodnikova/Adobe Stock

Intense Pulsed Light (IPL)

What does it fix? Also known as a "photofacial," IPL works differently than a fractionated laser and is used to reduce sun-induced freckles, broken capillaries, redness from rosacea, and general blotchiness from sun damage without the collagen-stimulating benefits. And although it's technically not a laser treatment—it uses multispectrum light versus a single-spectrum light—you'll often hear it referred to as such since they both use light to address specific concerns.

How does it work? A broad spectrum of light wavelengths is delivered to the skin's surface; the device literally flashes an intensely bright light, like a camera flash, next to your face. "Unlike a true laser that uses only a single wavelength of light, it emits a broad spectrumof light to the skin," explains Dr. Zeichner, who adds that the device is applied to the skin along with a cooling gel to protect the skin from a burn. "BBL [BroadBand Light] and IPL work very well for discoloration," Dr. Marmur says, "but because it isn't as aggressive as fractionated laser, it won't supply the same kind of serious anti-aging benefits, such as firming skin." Though lots of spas offer IPL treatments, this is still a highly energized beam of light and best left to medical professionals. As with any treatment that's targeting color in the skin—in the case of IPL, it homes in on the colors red and brown—you should make sure that your provider is trained in working on all skin tones.

OK, so how painful is it? At worst, it's like a rubber band snapping on your skin. "We offer numbing cream beforehand, but most patients don't find it necessary," Dr. Marmur says.

What are the side effects and downtime? Your skin may be a little bit pink for a few hours afterward; sunspots will get darker and peel off over the next week or so. Intense treatments can cause swelling and redness for a few days.

When will I see results? It takes about a week to see initial improvement. But with several treatments, you can expect to see less redness, fading freckles, and smoother skin after the second or third.

How many treatments do I need? Here's the catch: You'll need multiple treatments to get the best results—say, 5 to 12 weekly sessions. 

How much does it cost? Depending on the size of the area, expect $250 to $750 per treatment with Lumenis M22 or Cynosure Icon. (Many derms offer a slightly discounted price for a prepaid series. It doesn't hurt to ask!) 

This article originally appeared in the January/February 2021 issue of Health Magazine. Click here to subscribe today!

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