Laser Treatments
"Laser" covers several different technologies that do entirely different things. Choosing correctly matters more than choosing the newest device. This page sorts our energy-based treatments by the problem they solve — sun damage, redness, pigment, unwanted hair, veins, laxity, tattoos and sweating — so you can find the right one. All are performed at our Bellevue office without general anesthesia.
Which treatment do I need?
| What you want treated | Treatment | Technology |
|---|---|---|
| Sun damage, fine lines, texture, acne scarring | Laser Resurfacing | CO2, erbium and fractional lasers |
| Brown spots, redness, flushing, overall photodamage | Fotofacial (IPL) | Intense pulsed light |
| Precancerous sun damage and actinic keratoses | Intensive Fotofacial | Levulan photodynamic therapy |
| Isolated brown spots and freckles | Freckles and Spots | Targeted pigment treatment |
| Facial capillaries and spider veins | Face Vein Laser | Vascular laser |
| Leg veins | Leg Vein Laser or sclerotherapy | Vascular laser or injection |
| Unwanted hair | Laser Hair Removal | Hair-targeting laser |
| Skin laxity and crepiness | Thermage or Ultherapy | Radiofrequency or micro-focused ultrasound |
| Unwanted tattoo | Laser Tattoo Removal | Q-switched Nd:YAG |
| Excessive underarm sweating | miraDry | Microwave energy |
Resurfacing, light, or energy? The three categories
Nearly every device we use falls into one of three groups, and understanding which is which explains why one treatment cannot substitute for another.
| Ablative resurfacing | Light-based (IPL) | Energy tightening | |
|---|---|---|---|
| What it does | Removes or fractionally injures the skin surface so it regrows | Targets colour — brown pigment and red vessels | Heats deeper layers to contract and build collagen |
| Best for | Texture, lines, scarring, sun damage | Spots, redness, tone | Laxity |
| Downtime | Days to weeks, by depth | Little to none | None |
| Sessions | Often one | A series | Usually one, repeated periodically |
| Examples | CO2, erbium, fractional | Fotofacial, Levulan PDT | Thermage, Ultherapy |
Skin tone matters, and we take it seriously
Treatments that work by targeting pigment — IPL, many hair and vein lasers, and pigment-specific lasers — carry a real risk of burns and pigment change in darker skin, because the device cannot always distinguish the pigment you want treated from the pigment in your skin.
We exercise particular caution in Fitzpatrick type IV and rarely perform ablative resurfacing in types V to VI. Radiofrequency treatments such as Thermage are not affected by pigment and are safe across all skin types. If you have a deeper skin tone, this is worth discussing directly at consultation rather than assuming a treatment is suitable.
Who is not a good candidate?
- Recent sun exposure or a tan. Most light-based treatments are deferred until the tan fades.
- Current or recent isotretinoin (Accutane), which affects healing after resurfacing.
- Active infection or cold sore outbreak in the treatment area.
- Unrealistic expectations about laxity. No laser lifts sagging tissue. If your jawline or neck has descended, a facelift or neck lift is the appropriate procedure, and we will say so.
- Volume loss. Hollowing needs filler, Sculptra or fat grafting, not resurfacing.
What does it cost?
Fees vary widely by treatment and area — laser resurfacing runs from $3,000 to $6,000 depending on modality and depth, while a single IPL session costs considerably less. Current pricing for every treatment is published on our non-surgical pricing page.
Frequently asked questions
Which laser is best for sun damage?
It depends what the damage looks like. Brown spots and redness respond well to IPL with no downtime. Texture, fine lines and deeper photodamage need resurfacing, which achieves considerably more in exchange for real recovery time. Many patients benefit from both.
How much downtime should I expect?
From none at all with IPL and radiofrequency, to one to two weeks with deeper ablative resurfacing. Downtime scales with how much change the treatment produces.
Can lasers tighten loose skin?
Only modestly. Resurfacing improves skin quality and produces mild tightening; Thermage and Ultherapy do more for laxity. None of them lifts descended tissue the way surgery does.
Are laser treatments safe for darker skin?
Some are, some are not. Radiofrequency is safe across all skin types. Pigment-targeting treatments require caution and sometimes are not appropriate at all. This is assessed individually.
How many sessions will I need?
IPL, hair removal and vein treatment are typically a series. Ablative resurfacing is often a single treatment. Thermage and Ultherapy are usually one session repeated every one to two years.
Can I combine laser treatments with injectables?
Yes, and it is common. Lasers treat skin quality; injectables treat movement and volume. They address different problems and are frequently planned together.
What time of year should I have laser treatment?
Autumn and winter are preferable for anything light-based or ablative, because sun exposure before and after treatment increases the risk of pigment change.
Next steps
The most valuable part of a consultation is identifying which of these categories your concern actually falls into. Choosing the wrong technology is the most common reason patients are disappointed with laser treatment.
Schedule a consultation or ask us a question. You can also view our before and after gallery.
Medically reviewed by Sam Naficy, MD, FACS, board-certified facial plastic surgeon and medical director, Naficy Plastic Surgery & Rejuvenation Center, Bellevue, Washington.
