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Lasers, in plain light.

From gentle IPL to full resurfacing — matched to your skin tone, your concern, and your downtime budget.

Updated · ~9 min full read · 24 sections

The case in five lines

If you read nothing else

  1. 1. Only ablative resurfacing (CO₂/erbium, full-field or fractional) has strong evidence for meaningful wrinkle removal that lasts years — at the price of real downtime and real risk.
  2. 2. IPL is a colour treatment: excellent for sun spots, redness, and mottled tone; the best randomized trial found no effect on wrinkles, whatever "photorejuvenation" marketing implies.
  3. 3. Every technology has a downtime-for-results exchange rate — from IPL (hours) through Fraxel-class lasers (days) to full resurfacing (weeks). Decide your downtime budget first.
  4. 4. Skin tone changes the map: melanin-targeted devices (IPL, KTP) burn dark skin, while 1064 nm and non-ablative fractional lasers treat Fitzpatrick IV–VI safely with conservative settings.
  5. 5. Melasma is the trap: lasers can lighten it temporarily, recurrence is the rule, and aggressive "laser toning" has caused permanent confetti-white spots. Sunscreen and topicals stay the backbone.

The basics

How lasers and IPL actually work

Every device in this guide is a variation on one idea — selective photothermolysis: pick a wavelength and pulse duration absorbed preferentially by one chromophore, so that target heats and is destroyed while surrounding tissue survives. Water is the target for resurfacing lasers (they heat skin itself), melanin for pigment lasers, haemoglobin for vascular lasers. IPL is not a laser at all — a filtered flash-lamp hitting melanin and haemoglobin at once, which is why it treats "colour".

The second big idea, fractional delivery (2004), treats only microscopic columns of skin and leaves bridges of intact tissue between them — turning brutal resurfacing into something that heals in days. Most modern "laser facials" are fractional variants at different depths and aggressiveness.

The downtime ladder — deciding how much result you're buying

Reading laser menus becomes simple once you see the exchange rate:

  • Hours of redness: IPL, vascular lasers, "laser genesis" — colour and glow, no change to established wrinkles.
  • 1–3 days + a week of flaking: non-ablative fractional (Fraxel-class) — texture, fine lines, pigment, over 3–6 sessions.
  • About a week raw: fractional ablative CO₂/erbium — significant wrinkle and scar remodelling in 1–3 sessions.
  • Two weeks of wound care, months of pink: full-field ablative — the deepest result available without surgery, lasting years.

There is no cheat code: every "ablative results with no downtime" claim is selling the middle of the ladder with the top's vocabulary. Decide your downtime budget first, then pick the strongest tool inside it.

Before you book

Darker skin: the safety map

Melanin-targeted platforms cannot tell tan or constitutive pigment from the lesion they're aimed at — which is why IPL and 532 nm KTP are generally avoided in Fitzpatrick V–VI and used cautiously in IV, and why full-field ablative resurfacing (with its ~8% permanent light-spot risk even in fair skin) is off the menu for most darker phototypes.

The safe lane is real, though: non-ablative fractional lasers (1550/1927 nm) produced post-inflammatory hyperpigmentation after only 4% of sessions in Fitzpatrick IV–VI — all resolving — with conservative settings and hydroquinone priming, and long-pulsed/picosecond 1064 nm is the classic dark-skin-safe wavelength. Ask any clinic: "how many patients of my skin type have you treated, and on what settings?" — then ask for a test spot.

Prep, aftercare & the rules that changed

The no-tan rule: melanin-targeted devices treat only untanned skin — four-plus weeks from real sun or self-tanner, with strict SPF before and after everything.

Cold-sore cover: facial resurfacing reactivates herpes in ~7–9% without prophylaxis; antiviral tablets from the day before reduced reactivation to zero in a controlled study. Routine for ablative work; sensible for anyone with a cold-sore history before fractional treatments.

Isotretinoin: the old "wait 6 months" rule is obsolete — the ASDS consensus found insufficient evidence to delay vascular lasers, non-ablative and fractional treatments during or shortly after treatment. The wait survives only for full-face fully ablative resurfacing.

Who fires the laser: regulation is patchy — parts of the EU restrict Class 4 lasers to physicians; England is only now building a licensing scheme. Practical rule: ablative resurfacing with a dermatologist or equivalent physician; for IPL/vascular/pigment work insist on medical supervision, a named complication pathway, and device transparency.

The full breakdown

Laser & IPL — what the evidence says

Part 01

Resurfacing lasers

Strong evidence

Full-field ablative resurfacing (CO₂ / Er:YAG)

The deepest wrinkle result available without surgery, lasting years — bought with weeks of recovery and an ~8% light-spot risk.

The heavy artillery: the entire outer skin layer is vaporised and the dermis heated, triggering massive collagen remodelling. Three decades of controlled series and a systematic review of split-face trials agree it delivers the largest, most durable wrinkle improvement of any device — with long-term follow-up showing improvement persisting for years. CO₂ resurfaces deeper; erbium heals faster with less tightening.

The price is written in the risk column: 1–2 weeks of open wound care, erythema for up to months, and delayed permanent hypopigmentation in ~8% of a large series. For deep perioral lines and severe photoaging in fair skin, nothing non-surgical matches it; for everyone else, the fractional versions below exist precisely to avoid this trade.

Sessions
1
Downtime
2 wks + months pink
Cost
€2,500–5,000+
Strong evidence

Fractional ablative (CO₂ / Er:YAG)

The workhorse for real wrinkle and scar remodelling — most of full-field's effect at a fraction of its downtime.

The same ablative wavelengths delivered as microcolumns covering 5–40% of the surface, healing from the intact bridges between. Reviews position it as the better efficacy-to-risk ratio for fine-to-moderate photoaging — and it extends to neck, chest, and hands, where full-field is unsafe. It doesn't quite match full-field on the deepest lines, and results build over 3–6 months as collagen matures.

In darker skin it's possible with conservative density and priming, but carries meaningfully more pigmentation risk than the non-ablative class.

Sessions
1–3
Downtime
~5–7 days
Cost
€600–2,000/session
Moderate evidence

Non-ablative fractional (Fraxel-class, 1550/1927 nm)

Texture, fine lines, and pigment over 3–6 sessions with days of downtime — and the preferred fractional class for darker skin.

Heat without vaporisation: microcolumns of coagulated tissue under an intact surface. The 1550 nm wavelength remodels deeper (texture, fine lines, scars); 1927 nm works superficially (pigment, tone, actinic damage). RCTs support periorbital wrinkle improvement — 1550 nm beat focused ultrasound in one randomized trial — and a pooled analysis found small-sample outcomes statistically comparable to ablative, though per-session change is clearly subtler.

Its quiet superpower is safety in Fitzpatrick IV–VI (see the darker-skin section). Expect 25–50% improvement in texture/fine lines across a series, maintained with an annual top-up.

Sessions
3–6
Downtime
1–3 days + flaking
Cost
€500–1,000/session
Emerging evidence

Hybrid fractional (Halo)

Ablative + non-ablative in one pass — popular, clever, and supported by a single sponsor-linked trial so far.

Halo fires a shallow erbium ablative component and a deeper 1470 nm coagulative one simultaneously — chasing "ablative-like results with non-ablative downtime". The published base is one multi-center manufacturer-linked trial (~80% significantly improved, makeup next day) with no independent comparison against fractional CO₂ or Fraxel. Clinically loved; evidence hasn't caught up with popularity — a classic "emerging".

Sessions
1–3
Downtime
2–5 days
Cost
€900–1,800/session
Emerging evidence

Low-energy fractional (Clear + Brilliant, Moxi)

"Prejuvenation" lasers — lighter versions of the 1927 nm class, with sparse device-specific published outcomes.

The lunchtime tier: low-energy 1440/1927 nm diodes marketed for glow, early pigment, and "prevention". Their plausibility rides on the full-strength 1927 nm class evidence at lower doses — device-specific peer-reviewed outcomes are thin, with sponsor trials registered rather than published. Think "a lighter Fraxel, more sessions, less result per session": pleasant maintenance, honest expectations.

Sessions
4–6, ongoing
Downtime
~1 day
Cost
€250–400/session
Limited evidence

Long-pulsed 1064 nm ("laser genesis")

No-downtime glow with small, unblinded studies and transient effects — its real niche is being safe in dark skin.

Gentle bulk heating of the dermis with a wavelength melanin barely notices. Small prospective studies report modest wrinkle-grade and laxity improvements after a series of sessions, fading without maintenance — no large or blinded trials exist. Its genuine value: a polish-and-glow option for Fitzpatrick IV–VI, where most other devices carry pigment risk. As a wrinkle treatment, it's a candle next to the fractional class.

Sessions
4–6+, repeated
Downtime
None
Cost
€150–350/session

Part 02

Light, colour & pigment

Strong evidence

IPL for sun spots, redness & tone

The colour eraser: RCT-plus-systematic-review support for lentigines, visible vessels, and mottled tone in 3–6 sessions.

IPL's proven lane is colour. A Danish randomized split-face trial with blinded evaluation found it improved pigmentation, visible vessels, and texture, and a 16-study systematic review (637 patients, average ~4 sessions) supports efficacy across lentigines, redness, and global photoaging scores. Treated spots darken and flake within a week; new sun makes new spots, so maintenance 1–2× a year is the norm.

Skin-tone caveat: melanin is a target — IPL is for lighter phototypes, on untanned skin, with conservative settings toward Fitzpatrick IV and generally not beyond.

Sessions
3–6 + upkeep
Downtime
Hours; spots flake ~1 wk
Cost
€120–400/session
Strong evidence

Vascular lasers (pulsed-dye, KTP)

The redness specialists: 75–85% telangiectasia clearance in ~3 sessions, meta-analysis-backed for rosacea flushing.

Haemoglobin-targeted lasers photocoagulate visible vessels and diffuse flushing. A 2024 meta-analysis found pulsed-dye and IPL comparably effective for rosacea erythema, and a split-face trial cleared 85% of discrete vessels with KTP vs 75% with PDL after three sessions. Treated vessels are gone for good; rosacea grows new ones, so expect top-ups every year or two. KTP suits fair skin; PDL stretches cautiously to Fitzpatrick IV.

Sessions
1–4 + upkeep
Downtime
None–mild (purpura opt.)
Cost
€200–500/session
Strong evidence

Pigment lasers (Q-switched & picosecond) for sun spots

The precision tools: 68–93% lentigo clearance in 1–2 sessions across a 41-trial systematic review.

Nanosecond and picosecond pulses shatter melanin photoacoustically — the right tool for discrete sun spots. A 2025 systematic review of 41 trials (3,234 patients) reports clearance of 67.9–93% for picosecond and up to 90% for IPL, with lasers causing less post-treatment pigmentation than cryotherapy. Spots crust and flake for about a week. In darker skin, 1064 nm is the safe wavelength; 532/755 nm are the risky ones.

Sessions
1–2 per spot
Downtime
~1 wk crusting
Cost
€120–350/area
Moderate evidence

Same-session combinations (IPL + fractional)

Controlled split-face studies show additive benefit without added downtime — colour first, texture second.

Stacking a colour pass and a texture pass in one visit is evidence-backed, not just upselling: split-face studies found IPL plus non-ablative fractional synergistic with downtime similar to either alone, and a comparative study found the combination beat either monotherapy. Sequencing logic: vascular/IPL passes first (so the optical targets aren't disturbed), fractional second; big resurfacing procedures stand alone; melasma gets the least aggressive plan first.

Sessions
Per plan
Downtime
As per strongest part
Cost
Bundled
Emerging evidence

Lasers for melasma

Temporary lightening with recurrence as the rule — and "laser toning" schedules have caused permanent confetti-white spots.

Melasma is a chronic, hormonally driven pigment disorder — not a sun spot — and lasers are adjuncts at best. Meta-analysis of picosecond treatment shows real short-term MASI reductions (best at 1064 nm) with recurrence in ~7–13% even within short trial windows — and real-world relapse is widely considered higher. The specific hazard to know: frequent low-fluence "laser toning" has produced permanent confetti-like hypopigmentation.

The backbone of melasma care remains strict photoprotection and topicals ± tranexamic acid, with cautious low-energy laser as a supporting act. Distrust any "laser cure".

Sessions
Adjunct courses
Downtime
Minimal
Cost
€300–600/session
Emerging evidence

At-home laser & IPL devices

The home 1440 nm fractional laser has one manufacturer trial (modest periorbital gains); home IPL's evidence is for hair removal.

Two very different products share the drawer. The Tria-class home fractional laser (1440 nm) is FDA-cleared for periorbital wrinkles on a manufacturer-run study of 90 users showing modest improvement — real, small, earned by months of daily stinging. Home IPL units are hair-removal hardware whose "rejuvenation" modes run at fluences far below clinical photorejuvenation, with essentially no supporting trials — and skin-tone lockouts that exclude darker users by design.

Think "maintenance toy between clinic visits", and mind your eyes with any of them.

Sessions
Months of use
Downtime
Stinging, mild redness
Cost
€250–600 (device)
Limited evidence

IPL as "anti-aging" (wrinkles, Forever Young claims)

The best RCT found no wrinkle effect, and the "genetically younger skin" story rests on a tiny uncontrolled pilot.

Here the marketing outruns the data. The same blinded RCT that validated IPL for colour found no efficacy on wrinkles. The "Forever Young BBL" narrative — that maintenance sessions keep skin "functionally younger" — extrapolates from a small uncontrolled gene-expression pilot on forearm skin plus retrospective series. Regular IPL keeps tone genuinely fresher; buy it for the colour, not for the collagen story.

Part 03

Safety

Complications, honestly ranked

Transient redness and PIH are the common ones; scarring and permanent light spots are the rare ones that scale with aggressiveness.

Ranked by how much they should influence your choice:

  • Post-inflammatory hyperpigmentation (PIH) — the everyday risk, rising with skin tone, sun exposure, and device aggressiveness; usually months-long, usually reversible; minimized by settings, priming, and SPF discipline.
  • Prolonged redness, milia, acne flares — common after resurfacing; annoying, self-limited.
  • Herpes reactivation — ~7–9% after facial resurfacing without antivirals; near zero with them.
  • Permanent hypopigmentation — the signature late risk of aggressive full-field ablation (~8% in older series) and of repetitive "laser toning" for melasma.
  • Scarring and burns — rare, and overwhelmingly operator-dependent: wrong settings, tanned skin, wrong device for the skin type. This is what the consultation questions in "Before you book" are for.

Eye safety is absolute: proper shields for every facial treatment, no exceptions around the orbit.

Part 04

Frequently asked questions

Which laser actually removes wrinkles?

Ablative

Full-field or fractional CO₂/erbium resurfacing is the only class with strong evidence for major, years-long wrinkle reduction. Non-ablative fractional freshens texture and fine lines over several sessions; IPL improves colour, not lines. Match the tool to the wrinkle depth — and to your downtime budget.

Is IPL "anti-aging" or just spot removal?

Colour only

Its proven effects are on sun spots, redness, and overall tone — which reads as "younger" in the mirror. The best randomized trial found no wrinkle change, and the gene-expression "Forever Young" story is a pilot-study extrapolation. Buy IPL for colour; buy resurfacing for lines.

I have olive/brown/black skin — what's safe?

1064 + Fraxel-class

Safest: long-pulsed or picosecond 1064 nm, and 1550/1927 nm non-ablative fractional with conservative settings and priming — PIH ran ~4% per session and self-resolved in a careful Fitzpatrick IV–VI series. Risky to avoid: IPL and KTP in V–VI, and full-field ablative beyond type III. Always ask for a test spot and for the provider's experience with your exact skin type.

How long is the downtime really?

Hours to weeks

IPL/vascular: hours of redness, spots flaking a week. Non-ablative fractional: 1–3 swollen pink days plus bronzed flaking. Hybrid: 2–5 days. Fractional ablative: about a week raw, then weeks of pink. Full-field: two weeks of wound care and up to months of erythema. Plan events accordingly — and count the "pink but presentable" phase, not just the raw one.

Can lasers cure my melasma?

No

Lasers can lighten melasma temporarily; recurrence is the rule, and aggressive weekly "toning" schedules have caused permanent white spotting. The foundation remains fanatical photoprotection plus topicals ± tranexamic acid, with gentle laser as an adjunct. Any clinic promising a permanent laser cure has told you what you need to know about them.

I took isotretinoin — must I wait 6 months?

Mostly no wait

Consensus guidance found insufficient evidence to delay vascular lasers, non-ablative and fractional treatments, or hair removal during or shortly after isotretinoin. The six-month wait survives for full-face fully ablative resurfacing. Discuss timing rather than assuming the old blanket ban.

Interactive

Find your light

Open your main concern to see where the evidence points — each link jumps to the graded section.

Deep, etched wrinkles
Full-field ablative resurfacing the only class that removes rather than softens — read the downtime first Fractional ablative most of the effect at a fraction of the recovery

Fine lines, rough texture, big pores
Non-ablative fractional (Fraxel-class) 3–6 sessions, days of downtime, well-tested Clear + Brilliant / Moxi the gentle maintenance version

Sun spots & mottled tone
Q-switched / picosecond lasers 1–2 sessions clear most lentigines IPL photorejuvenation the full-face colour reset, 3–6 sessions

Redness, flushing, visible vessels
Pulsed-dye / KTP lasers 75–85% vessel clearance in ~3 sessions IPL comparable for diffuse rosacea redness in meta-analysis

Melasma
Lasers for melasma adjunct only — read the recurrence and toning-risk story first

Deeper skin tone (Fitzpatrick IV–VI)
The safety map which devices are safe, risky, and off the menu Non-ablative fractional the preferred class — ~4% transient PIH per session in careful series

Minimal downtime, please
IPL hours of redness, real colour results Same-session combinations colour + texture in one visit without added downtime

The trade

The downtime ladder

Results scale with recovery — pick your rung deliberately.

strong

IPL & vascular

Colour correction — spots, redness, tone. No change to established wrinkles.

Downtime: Hours
moderate

Non-ablative fractional

Texture and fine lines over a series — the maintenance workhorse.

Downtime: 1–3 days + flaking
strong

Fractional ablative

Real wrinkle and scar remodelling in 1–3 sessions.

Downtime: ~1 week
strong

Full-field ablative

The deepest non-surgical result, lasting years — and the biggest risks.

Downtime: 2 wks + months pink

References & further reading

All claims cite peer-reviewed studies, systematic reviews, or consensus statements, linked inline within each section. Primary sources: PubMed/PMC, Lasers in Surgery and Medicine, JAMA Dermatology, ASDS consensus documents.

Educational content, not medical advice. Device selection depends on your skin, history, and goals — assess them with a qualified practitioner, and insist on a test spot when skin tone or tan is in play.