Better, Faster, Stronger
Lasers that perforate skin with microscopic holes, such as the Fraxel (which treats uneven skin tone, wrinkles, and scarring; average price: $1,161 per treatment) and Clear + Brilliant (Fraxel's gentler cousin, which shrinks pore size and brightens skin), use light energy that travels through the epidermis and dermis underneath to prod skin into creating new youthful cells. "Combining Clear + Brilliant with a topical antioxidant is like 1 + 1 = 4," says Frank. "Using a little bit of both allows us to get more results with less trauma." By producing thousands of tiny channels, the lasers essentially open skin for up to two days while it repairs, allowing active ingredients to pass through its protective layers.
To further improve absorption, Clear + Brilliant recently introduced Perméa, an attachment that lengthens the laser's wavelength to a level that allows for up to 17 times more product penetration. (Treatment prices start at $250 for both Clear + Brilliant and Perméa.) "This is the sweet spot to make skin more receptive, but not so much that it causes irritation," explains New York City dermatologist Dr. Anne Chapas.
"Lasers also stimulate inflammation in skin," she continues. "Sometimes that's beneficial — collagen grows and scars are healed. But sometimes inflammation can stimulate pigmentation and cause prolonged redness and swelling, so we're always trying to figure out how far to go." During the 20-minute Perméa treatment, SkinCeuticals C E Ferulic serum is applied so it's immediately absorbed.
"The laser allows the antioxidant serum to get where it needs to go and helps speed healing time," says Chapas. Since antioxidants also reduce inflammation, patients will notice a shorter recovery time — less than a day in some cases. "Instead of needing multiple treatments, after one session, patients are seeing improvements in pigmentation, fine lines, and texture," adds Chapas, who also finishes the procedure with a Skinceuticals Biocellulose Restorative Masque to further reduce sunburn-like redness and irritation.
Beyond what laser and skincare companies are packaging together, dermatologists have started exploring the two-pronged approach on their own. Frank adds antioxidant therapy during Fraxel Dual laser treatments (which target hyperpigmentation; average price: $1,161) to cut repair time from five days to three. He also applies salicylic acid products during acne-clearing Isolaz laser sessions (starting at $200) to help minimize oil production. New York City dermatologist Dr. Ellen Marmur chases Fraxel laser resurfacing procedures with an antiaging StriVectin eye cream on crow's-feet or StriVectin neck cream to treat the décolletage. "The laser gets rid of brown spots and crepiness, while the cream tightens. You want just the right level of moisturizer to accelerate healing without causing a rash and to deliver extra ingredients under the skin as it's repairing," says Marmur, who sends patients home with these nonirritating products.
In Beverly Hills, dermatologist Dr. Lisa Chipps maximizes collagen production to smooth and firm skin by applying DNA EFG Renewal Growth Factor Serum along with a retinol lotion right after Pellevé radio-frequency treatments, which heat the deeper layers of skin to increase firmness (from $500 to $1,250 per session; Chipps recommends two to three). "By feeding the skin growth factors to help it build more collagen after the treatment, your results will look good longer," she explains.
For years, dermatologists have targeted precancerous skin conditions like actinic keratosis (which looks like thick, scaly patches of skin) with photodynamic therapy (activating light-sensitive chemotherapy drugs like Levulan and Photofrin with lasers or intense pulsed light), but Frank is experimenting with combining the therapeutic drugs with the Clear + Brilliant laser to treat cosmetic sun damage, like spots.
"There's a huge growing market in at-home devices, too," adds Frank. "Although they will never replace what we do in a doctor's office, at-home lasers have potential as performance enhancers."
Also on the horizon is the pairing of Botox-like neurotoxin creams and radio-frequency devices to freeze wrinkles. "Right now, we're pretreating patients a week or two in advance with Botox injections," Chipps explains. "If you paralyze the muscle, it can't form creases in the dermis while the skin is healing from laser treatment, so you're building new collagen without lines." Sound too good to be true? The jury's still out: Topical neurotoxins are still in clinical trials right now and need FDA approval before dermatologists can start prescribing them for combination therapy. Real Housewives, stand by.