Yes, laser skin resurfacing is generally safe for appropriately selected patients when performed by an experienced provider and followed by proper aftercare. Safety depends on several factors, including your skin type and tone, medical history, the type and depth of laser treatment, the area being treated, and the provider’s experience.
Non-ablative lasers generally involve less downtime and a lower risk of complications, while deeper fractional and fully ablative treatments may produce more noticeable changes but require more careful patient selection and a longer recovery.
How Safe Is Laser Skin Resurfacing for Different Skin Types?
Laser skin resurfacing may be appropriate across Fitzpatrick skin types I–VI, but the safest treatment approach varies by skin tone, medical history, treatment goals, and the type of laser being used. According to the American Academy of Dermatology, lasers can be used on all skin types, although darker skin is more prone to burns and dark marks after treatment. Patients with Fitzpatrick types IV–VI generally have a higher risk of post-inflammatory hyperpigmentation or hypopigmentation, so treatment often requires more conservative parameters and a provider experienced in treating skin of color. Non-ablative fractional wavelengths in the approximately 1440–1550 nm range and 1927 nm are among the options clinicians may consider for darker skin types, depending on the indication and device. Lower treatment density or energy, careful skin preparation, and strict sun protection may also help reduce pigment-related complications.
What Are the Pros of Laser Resurfacing?
Laser skin resurfacing benefits include:
- Improved skin texture by reducing fine lines and wrinkles.
- Improvement in the appearance of acne scars and certain pigmentation concerns.
- Collagen remodeling, which can contribute to smoother, firmer-looking skin over time.
- Nonsurgical, with most treatments performed as outpatient procedures.
- Gradual skin improvement, with some changes becoming visible within weeks and continuing as the skin remodels.
- Targeted treatment, allowing providers to adjust the treatment area and depth based on the concern being addressed.
What Are the Cons of Laser Resurfacing?
Laser skin resurfacing’s potential drawbacks may include:
- Potential side effects include redness, swelling, and temporary sensitivity.
- Risk of pigmentation changes, particularly in people with darker skin tones.
- Downtime, which can range from a few days to several weeks, depending on intensity.
- Possible discomfort or mild pain during and immediately following treatment.
- Multiple treatments may be required for optimal results, increasing costs and recovery time.
- Sun sensitivity post-treatment requires diligent sun protection to prevent complications.
Laser Resurfacing Gone Wrong: What Can Happen?
Laser resurfacing causes controlled injury to the skin, so some temporary reactions are expected. More serious complications are less common but can occur.
Common Expected Side Effects
- Redness and swelling
- Sensitivity, warmth, or itching
- Peeling, dryness, or crusting
- Temporary changes in skin color
Less Common Complications
- Burns or blistering
- Post-inflammatory hyperpigmentation
- Infection, including cold sore or HSV reactivation
- Prolonged redness or sensitivity
- Uneven texture or patchy results
Rare or Long-Term Complications
- Persistent hyperpigmentation or hypopigmentation
- Hypertrophic or atrophic scarring
- Long-lasting texture changes
- Ectropion following aggressive resurfacing around the lower eyelid
Who May Need Extra Caution With Laser Resurfacing?
In addition to understanding risks, it’s equally important to know whether you’re a good candidate for treatment. Certain medical conditions, skin types, and external factors can increase the risk of complications or limit the effectiveness of the treatment. If you fall into any of the following categories, you may need to consider alternative treatments or consult with a qualified professional to determine the best course of action.
1. You Have Darker Skin or a History of Pigment Changes
Having darker skin does not automatically rule you out for laser resurfacing. However, people with more melanin in their skin may have a greater risk of post-inflammatory hyperpigmentation (darkening) or hypopigmentation (lightening) after treatment. That makes the choice of laser, treatment depth, energy settings, and aftercare especially important. If you have a darker skin tone or a history of pigmentation problems, look for a provider with experience treating a wide range of skin tones. Depending on the device and your individual risk factors, your provider may recommend a more conservative treatment approach, additional skin preparation, or a different type of resurfacing procedure.
2. You Have a Cold Sore
If you have the herpes simplex virus, laser resurfacing can trigger a flare-up, leading to painful cold sores after treatment. To reduce this risk, your provider may prescribe an antiviral medication before your procedure. Preventive antiviral treatment can help reduce the risk of an outbreak in appropriate patients. If you have a history of frequent cold sores, be sure to inform your doctor so they can tailor your treatment plan accordingly.
3. You Are Prone to Keloid Scars
If your skin tends to form keloid scars, raised, thickened scars that extend beyond the original wound, laser resurfacing may not be the best option for you. The laser creates controlled damage to the skin to stimulate healing, but in individuals prone to keloids, this can result in excessive scarring instead. Since keloids can be difficult to treat once they form, it’s crucial to discuss your medical history with your provider. They may recommend alternative treatments that minimize your risk.
4. You’re Having an Acne Breakout
If you have an active acne breakout, it may be best to delay laser resurfacing. Some lasers are designed to treat acne, but undergoing treatment while experiencing severe breakouts can increase the risk of infection. Additionally, acne can interfere with the laser’s effectiveness, making results less predictable. Certain acne medications can also make the skin more sensitive and slow down healing. If you’re treating acne, consult your provider about safer alternatives or the best timing for laser resurfacing.
5. You’re Pregnant or Breastfeeding
If you’re pregnant, elective cosmetic laser resurfacing is generally postponed because there is limited safety data on its use during pregnancy. Although lasers use non-ionizing energy, that does not mean elective resurfacing has been proven safe for pregnant patients. Pregnancy-related hormonal changes can also affect pigmentation and skin sensitivity, and medications or skincare products used around the procedure may require additional consideration.
If you’re breastfeeding, laser resurfacing is not automatically off-limits, but treatment should be considered individually. The main considerations may include medications, anesthetics, antivirals, antibiotics, pain relievers, and post-treatment skincare products used as part of the procedure. Tell your provider that you’re breastfeeding so they can review the treatment plan and determine whether it makes sense to proceed or wait.
6. You Currently Take or Recently Took Isotretinoin
Taking isotretinoin (commonly known by the former brand name Accutane) does not automatically mean you must wait 6–12 months before every type of laser treatment. The American Society for Dermatologic Surgery’s consensus recommendations found insufficient evidence to justify delaying non-ablative laser treatments, including non-ablative fractional procedures, solely because of current or recent isotretinoin use.
However, more aggressive procedures, particularly fully ablative resurfacing, generally require greater caution because of concerns about healing and scarring. Tell your provider about current or recent isotretinoin use so they can evaluate the type and depth of treatment, your skin condition, and your individual risk factors. Do not stop or change isotretinoin without discussing it with the clinician who prescribed it.
7. An Autoimmune Disease or a Weak Immune System
If you have an autoimmune disease or a weakened immune system, laser resurfacing may not be the best option for you. Since the procedure works by creating controlled damage to stimulate healing, individuals with compromised immune systems may struggle with prolonged recovery times and an increased risk of infection. Conditions like lupus, rheumatoid arthritis, or immunosuppressive treatments can affect how well your skin heals. It’s crucial to consult with your doctor to determine if laser resurfacing is safe or if an alternative treatment would be better suited for your skin.
8. Your Skin Hasn’t Fully Healed From a Recent Procedure
If you’ve recently had laser resurfacing, a chemical peel, surgery, or another procedure that affects the skin, you may need to wait until your skin has fully healed before undergoing laser resurfacing. Treating skin too soon can increase irritation and may interfere with normal healing. Your provider should review what procedure you had, when it was performed, and how your skin recovered before recommending another treatment. Be sure to mention any history of facial radiation therapy as well, since it may affect healing and treatment planning.
Considering laser resurfacing?
Schedule a consultation to discuss your skin, treatment options, expected recovery, and potential risks.
How to Reduce the Risk of Complications from Laser Resurfacing
The risk of many laser resurfacing complications can be reduced with appropriate treatment planning and aftercare. A few key steps can significantly improve safety and results:
- Choose an experienced, qualified provider who regularly performs laser treatments
- Avoid sun exposure before and after treatment to reduce the risk of pigmentation changes
- Follow all pre- and post-treatment instructions carefully
- Disclose your full medical history, including medications and skin conditions
- Avoid picking, scratching, or irritating the skin during healing
Taking these precautions helps minimize risks and can support a smoother recovery.
So, Is Laser Skin Resurfacing Worth It?
For the right candidate, laser resurfacing can provide meaningful improvement in concerns such as fine lines, sun damage, uneven texture, and acne scars. Whether it’s worth it for you depends on your skin type, treatment goals, tolerance for downtime, and the type and depth of resurfacing needed.
Non-ablative treatments generally involve less downtime but may produce more gradual results and require multiple sessions. Ablative resurfacing can create more noticeable changes but typically involves a longer recovery and greater risk of side effects. An experienced provider can help you compare these tradeoffs with other treatment options and determine which approach best fits your goals.
Patient Results
* All patients are unique and individual results may vary.
Who Should Perform My Laser Resurfacing Treatment?
While laser skin resurfacing is a safe and effective procedure for many patients, choosing an experienced and skilled provider is key to minimizing risks and achieving the best results. A board-certified facial plastic surgeon or dermatologist with expertise in laser treatments can assess your skin type, medical history, and goals to determine if laser resurfacing is right for you.
Dr. Ran Y. Rubinstein, a double-board-certified facial plastic surgeon, is an expert in laser skin resurfacing and non-surgical skin rejuvenation. With his extensive experience, he can recommend an appropriate treatment approach based on your skin, goals, and risk factors. Whether you’re a candidate for laser resurfacing or a better alternative, Dr. Rubinstein will guide you through the process. Call us today at (845) 863-1772 to schedule a consultation and find the best solution for your skin concerns.
