Are Laser Facials Good for Boosting Collagen?

Laser facial spas are popping up all over the internet, claiming a host of cosmetic and skin health benefits with just a few zaps of high-powered light.

These facial treatments, also called laser resurfacing, can remove old, damaged skin and boost collagen production. The result is often plumper, firmer, more even skin.

There are many laser resurfacing options. Skin Laundry, one of the most popular laser facial companies of the moment, offers $75 treatments that claim to deep clean, stimulate collagen, reduce fine lines and wrinkles, blend discoloration, and kill acne-causing bacteria. The company encourages clients to buy a monthly membership and return for multiple visits.

Meanwhile, laser resurfacing done by plastic surgeons tends to be more expensive and requires days to weeks of recovery time. But the more intense clinical procedures typically require just one treatment and the results can last for years.

"It helps the 3 Ts—tone, tighten, texture," Sonia Badreshia, MD, FAAD, said a board-certified dermatologist and CEO and medical director of Elite MD Advanced Dermatology, Laser and Plastic Surgery Institute. "People generally do it once and then do maintenance as needed depending on the security of sun damage."

Resurfacing lasers are designed to tighten the skin and get rid of brown spots, fine lines, pre-cancerous growths, acne scars, and even keratosis. Other kinds of laser treatments target skin care needs such as removing hair, tattoo pigmentation, dark spots from sun damage, and dilated blood vessels or red blotches.

Ablative lasers vaporize the top layer of the skin, called the epidermis, to remove aged and damaged cells. They also penetrate deeper into the dermis, where it stimulates collagen formation.

Gentler nonablative lasers reach the underlying skin tissue without damaging the surface. Ablative lasers tend to be more effective, while nonablative options allow for quicker healing.

There are some types of laser that can treat an entire area, while fractional lasers only target a portion of the skin. Fractional lasers can be either ablative or nonablative. Fractional lasers are the most popular for enhancing collagen production and each comes with a different level of intensity.

"Compared to fully ablative laser, fractional laser treatment has several advantages, including faster healing time, fewer side effects, and less discomfort during the procedure. Fractional laser treatment also produces less thermal damage to the skin and reduces the risk of post-treatment complications, such as scarring and infection," said Cameron Rokhsar, MD, FAAD, FAACS, a double board-certified dermatologist and plastic surgeon at the New York Cosmetic Skin & Laser Surgery Center.

Carbon dioxide and Er:YAG fractional lasers are the two most popular styles. CO2 lasers can be more effective at boosting collagen than Er:YAG lasers, and they’re particularly well-suited for older adults, according to Rokhsar.

However, CO2 lasers also carry a greater risk of causing pigmentation. Er:YAG lasers can achieve similar results, but it usually requires a few more passes of the laser. Still, the Er:YAG tends to be more targeted, which is useful for treating skin at risk of scarring, such as the skin around the eyes.

Harmon said most laser treatments will cost between $500 and $6,000. More intensive laser treatments, like CO2 lasers, are usually one-and-done, while more mild ones may require repeat visits.

Fractional laser therapy is so-called because the surgeon penetrates certain parts of the skin with microscopic beams while leaving others undamaged.

Christopher Harmon, MD, FAAD, a board-certified dermatologist at the Surgical Dermatology Group in Alabama, said you can think of fractional lasers as the bristles on a brush. Just as the spaces between the bristles leave sections of the scalp untouched, fractional lasers can pinpoint specific areas of the skin without damaging all the skin.

Fractional laser blasts short bursts of light into the skin, causing small, targeted injuries. After the surgery, the skin will produce more collagen or rearrange existing collagen networks to aid with wound healing while tightening the skin.

"You’re stimulating the production of collagen by creating a very controlled injury. And the healing process of that injury is really what gives the rejuvenation," Harmon said.

Skin contraction is part of the wound-healing process. That skin-tightening "pulls the fine lines out of the skin," Harmon said. As collagen regenerates, it can also smooth discoloration and acne scarring.

Fractional laser therapy has the advantage of a relatively quick recovery time because the wounds can heal with help from the untreated skin around them.

During the procedure, the provider will give the patient a local anesthesia, either as a topical numbing cream or an injection. Some of the more aggressive laser types, such as CO2 lasers, can cause enough discomfort that surgeons may sedate patients.

Nonablative laser treatment may take just a couple days to heal. Superficial laser resurfacing can take five to seven days, while deep laser resurfacing can take a few weeks.

After a laser treatment session, a patient may experience pain, redness, swelling, peeling, and crusting. These typically go away within a few days or weeks, Harmon said.

The treated area of the skin can become discolored with exposure to the sun. Harmon recommends staying out of the sun until the redness has disappeared. Wearing a broad-spectrum sunscreen will help protect the skin and ensure it heals correctly.

Because the procedure involves ablating tissue, it can sometimes leave a patient with scars. For some people with medium-toned skin, the pigmentation and scarring that can sometimes occur from the procedure may be more visible than on other skin tones.

"I’m not saying that it's an absolute contraindication, because it's not. But it's something that you have to be aware of and you have to be sure that who's treating you has experience treating that kind of skin tone," Harmon said.

Badreshia also said that the treatment won't alleviate all types of pigmentation, and that people with melasma should be especially careful.

"Less commonly, treatment may also cause acne-like eruptions, HSV flares, bacterial skin infections, erosions, prolonged redness, and post-inflammatory hyperpigmentation," Badreshia said.

Gentle, nonablative lasers are likely the best choice for most patients, she added.

Laser resurfacing treatments can come in a variety of intensities and styles. The best way for a patient to find the right laser for their needs is to consult a provider with lots of experience, Harmon said.

Some surgeons will give a consultation before the procedure and share which products to use and how to prepare. They may recommend their patients stop using active skincare ingredients like retinol and vitamin C before the laser treatment.

Badreshia said to let your provider know if you have a history of cold sores or fever blisters, as laser skin resurfacing can trigger breakouts. They can prescribe antibiotics or antivirals to ward off such infections.

Additionally, people who smoke or take blood thinners can experience excess bruising and slower recovery from the procedure. Badreshia recommends patients stop smoking and taking these medications 10 days in advance.

Badreshia recommends scoping out several plastic surgery offices to find a provider that works on all skin types and tones and will provide the safest experience. Any kind of laser treatment can have adverse events if given by the wrong provider.

"The most important thing is to do your research—evaluate the office, the experience of the provider, and the before and afters in order to have realistic expectations, comfort, and trust with your provider," Badreshia said.

As with any medical procedure, it's best to receive laser resurfacing treatment from an experienced and well-trained provider. You can check if a provider is certified by the American Board of Plastic Surgery here.

American Society of Plastic Surgeons. Laser skin resurfacing.

Heidari Beigvand H, Razzaghi M, Rostami-Nejad M, et al. Assessment of laser effects on skin rejuvenation. J Lasers Med Sci. 2020;11(2):212-219. doi:10.34172/jlms.2020.35

Preissig J, Hamilton K, Markus R. Current laser resurfacing technologies: a review that delves beneath the surface. Semin Plast Surg. 2012;26(3):109-116. doi:10.1055/s-0032-1329413

By Claire BugosClaire Bugos is a health and science reporter and writer and a 2020 National Association of Science Writers travel fellow.