Focused light removes and heats aging, sun-damaged skin, prompting the body to rebuild collagen and grow a fresher surface. The most dependable gains are smoother texture, more even color, softer lines, and improved acne scars. Stronger devices deliver more but need longer healing; gentler ones trade power for less downtime and fewer complications. (Full Review)

Protocol

Device Selection

Matched to goal & skin type

Ablative CO2/Er:YAG for severe photoaging in lighter skin; fractional ablative for acne scars; non-ablative fractional for milder concerns or darker skin

Session Structure

1 ablative, or 3–5 fractional

Fractional and non-ablative courses spaced roughly 3–4 weeks apart

Pre-Treatment Prep

2–4 weeks skin priming

Retinoid (plus hydroquinone for darker skin), antiviral prophylaxis, baseline photography

Time to effect

Wrinkles & Tightening

3–6 months

Collagen-driven benefits develop as new collagen matures

Texture & Pigment

1–4 weeks

Surface improvements visible once redness settles

Recovery

5–10 days

Ablative re-epithelialization; 1–3 days for non-ablative fractional

Benefits

High: Reduction of fine lines, wrinkles, and photoaging; improvement of skin texture and uneven pigmentation; reduction of atrophic acne scars

Medium: Skin tightening and improvement of mild laxity; reduction of actinic keratoses and field cancerization

Low: Improvement of enlarged pores and overall skin quality; improvement of melasma (conflicted)

Speculative: Long-term reduction of non-melanoma skin cancer risk; preventive "prejuvenation" use in younger skin

Contraindications

Gold salts

Active skin infection or herpes outbreak in the treatment area (until resolved)

History of keloids or hypertrophic scarring

Recent isotretinoin (within ~6–12 months)

Fitzpatrick types IV–VI (aggressive ablative settings)

Pregnancy

Recent tanning or sunburn (until resolved)

Connective-tissue or collagen-vascular disease

Key Interactions

Photosensitizing drugs (doxycycline, hydrochlorothiazide, St. John's wort)

Anticoagulants and antiplatelets (warfarin, clopidogrel, aspirin)

NSAIDs and analgesics (ibuprofen, naproxen)

Immunosuppressants (prednisone, tacrolimus, methotrexate)

Blood-thinning supplements (fish oil/omega-3, vitamin E, Ginkgo biloba, garlic)

Topical retinoids, alpha hydroxy acids, benzoyl peroxide

Risk & Side Effects

High: Post-inflammatory hyperpigmentation; prolonged redness; pain, swelling, oozing, and crusting during recovery

Medium: Infection; delayed hypopigmentation; scarring

Low: Ectropion and eyelid complications; acne and milia flares; contact dermatitis and delayed hypersensitivity

Speculative: Disseminated or systemic infection

Monitoring

Marker	Target	Why
Fasting Glucose	75–90 mg/dL	Impaired glucose control slows healing and raises infection risk
HbA1c	< 5.4%	Reflects long-term blood sugar and wound-healing capacity
Vitamin D (25-OH)	40–60 ng/mL	Supports skin barrier repair and immune defense during healing
Ferritin	30–150 ng/mL	Iron status supports tissue repair; very low levels impair healing
Zinc (plasma)	90–110 µg/dL	Cofactor for collagen synthesis and wound repair

Cadence: Wound check at day 3–7, then follow-up at ~4 weeks, 3 months, and 6 months; maintenance visits thereafter

Qualitative Assessment

Resolution of redness on the expected timeline for the device used
Even, predictable re-epithelialization without infection or delayed healing
Improvement in skin texture, smoothness, and tone at follow-up
Even pigmentation without new dark or light patches
Patient-reported satisfaction and improved skin-related confidence

Laser Resurfacing for Skin Rejuvenation

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment