Everything You Need to Know About Offering Laser Skin Treatments



The use of lasers in esthetics is nothing short of revolutionary, transforming skin by correcting fine lines, wrinkles, loose skin, and pigmentation issues.

Expanding the menu of services you offer in your esthetics practice to include laser skin treatments can take your career in a new, exciting, and profitable direction.

Laser Skin Treatments: What They Are and What They Do for The Skin

Laser skin treatment destroys damaged skin cells, which then stimulates the production of new skin cells and collagen. Today’s advanced laser technologies allow estheticians to achieve precision when treating areas of the face, neck, and chest.

Laser skin treatments may go by a number of names, including:

  • Laser resurfacing
  • Laser skin rejuvenation
  • Laser peels
  • Laser vaporization
  • Lasabrasion
  • Fractional resurfacing
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Lasers are medical devices that produce focused beams of intense light. Depending on the color of the light and its intensity, lasers can interact with the skin and address any number of skin conditions, such as:

  • Acne scars
  • Age spots
  • Crow’s feet
  • Droopy eyelids
  • Sagging jowls
  • Sun damage
  • Scars
  • Wrinkles and fine lines
  • Birth marks
  • Warts

Because different types of skin conditions often require different treatment approaches, it is common for estheticians to perform combination laser therapies using different resurfacing laser devices.

Laser resurfacing is not for everyone. Patients with active acne lesions, dark skin, and active herpes infections are not candidates for laser skin treatments. Potential side effects include:

  • Swelling
  • Burning sensation
  • Itching
  • Irregular pigmentation
  • Infection
  • Scarring

There are many types of devices for laser skin resurfacing, and many more being introduced every year. However, regardless of the technique, device, or machine, laser skin treatments are classified into three, main groups of lasers:

Ablative Lasers

Ablative lasers work by using high-intensity pulses of light that essentially heat the water in the skin and vaporize targeted skin cells via a controlled burn. When this occurs, it is called ablative because the outer layers of the skin are being ablated, or destroyed. As the wound heals, new skin and collagen are formed and the dermis and epidermis thicken as a result.

There are two types of ablative lasers: CO2 lasers and Erbium lasers:

  • CO2(far infrared, 10600 nm)
  • Erbium: YAG(mid infrared, 2940 nm)

The healing time for traditional CO2 lasers can take months. CO2 lasers carry a high risk of scarring and red skin. Erbium ablative lasers are less invasive and take just 2-3 weeks of recovery time.

Ablative lasers remove layers of skin and create uniform injury to the skin. Ablative lasers produce results that are similar to chemical peels or dermabrasion, although many providers prefer using the laser because it allows them to maintain greater control regarding the depth of injury to the skin. Ablative lasers smooth and tighten the skin and corrects wrinkles, acne scars, and pigmentation problems.

Ablative lasers are intense, usually requiring anesthesia/sedation and downtime. However, they produce the most dramatic results. Ablative lasers can only be performed by board-certified physicians trained in laser therapy.

Individuals can expect raw, uncomfortable, weeping skin following an ablative laser treatment. Healing ointments and bandages are used for the first few days following the procedure.

Non-Ablative Lasers

Non-ablative lasers target only the skin’s deeper layers, leaving the epidermis intact. They are therefore non-wounding and less invasive than ablative lasers.

Non-ablative lasers were developed as an alternative to ablative treatments, offering a shorter recovery time and mild adverse side effects. Benefits are dramatic with non-ablative lasers, although it takes a number of treatments (two to five) to achieve the best results.

The light energy emitted targets the water in the skin, vaporizing the skin cells. Laser treatments considered non-ablative include:

  • Visible Light Lasers
    • Argon(blue-green, 488-514 nm)
    • KTP (green, 532 nm)
    • Pulsed Dye (yellow, 577-585 nm)
    • Ruby (red, 694 nm)
  • Near Infrared Lasers
    • Alexandrite(near infrared, 755 nm)
    • Diode(near infrared, 800-900 nm)
    • Nd: YAG(near infrared, 1064 nm)

Fractional/Fractionated Lasers

Fractional lasers are the newest addition to laser skin resurfacing.

Fractional laser resurfacing is more gentle than traditional laser resurfacing because only a part of the skin’s surface is ablated. This type of laser resurfacing creates tiny holes deep in the layers of the skin. The laser beam is fractionated into a pattern (often resembling a grid) that allows specific areas of the skin to be destroyed while leaving the surrounding areas intact, thus reducing the healing time.

Although fractional lasers create less surface injury, they are able to create a greater depth of injury as to address skin issues such as deep wrinkles, sun damage, brown spots, and acne scarring.

Fractional lasers can be either ablative or non-ablative. The first fractional laser was Fraxel, which was a fractionated CO2 laser. Some ablative lasers can be fitted with a pixelated tip for fractional resurfacing purposes.

Esthetic Laser Skin Treatment Licensing Requirements

The role of estheticians in laser skin treatments varies depending on the type of laser therapy, the state in which they work, and the type of education and training they receive.

Ablative Laser Therapies

Ablative laser therapies can only be performed by licensed physicians trained in laser therapies.

However, in addition to providing patients with pre- and post-laser skincare, estheticians often work alongside physicians performing these laser skin treatments.

Laser equipment manufacturers, schools that teach cosmetic procedures, dedicated laser institutes and certification bodies, technical schools and schools of esthetics may offer courses that provide licensed estheticians with training that covers the methods and physiology behind ablative laser treatments, and the skincare treatments that can safely be performed both before and after these procedures.

Non-Ablative Laser Therapies

As is the case with many advanced cosmetic procedures, the waters tend to be murky when it comes to which non-ablative laser resurfacing procedures estheticians are allowed to perform—if any. In most states, estheticians must perform laser procedures under the supervision of a licensed physician. Additional training in laser skin treatments or certification as a laser technician must often accompany the esthetician license.

In states with two-tier esthetician licensing, which currently includes Washington State, Washington D.C., Utah, and Virginia, master estheticians are permitted to perform laser resurfacing procedures.

Although many states, such as California and New Jersey, view lasers as medical procedures and therefore limit their use to only medical professionals, a number of states have made strides to clarify the use of cosmetic lasers and to protect the public and those performing laser procedures.

For example, Georgia implemented the Georgia Cosmetic Laser Services Act, which highlights a set of competencies required to perform cosmetic laser procedures and become licensed as a cosmetic laser practitioner. Estheticians in Georgia may apply for an assistant laser practitioner license if they (1) hold a current esthetician license in Georgia, and (2) hold three or more certificates from approved laser/IPL continuing education courses. Estheticians performing laser services must work in a facility that has a consulting physician trained in laser modalities and must work under the supervision of a senior laser practitioner or physician trained in laser modalities.

Similarly, the Texas State Medical Board implemented the Texas Laser Rule, which specifies that laser practitioners must perform cosmetic laser procedures under the supervision of a physician or mid-level practitioner. This means that patients must receive a pre-op exam by a physician or physician assistant prior to receiving a cosmetic laser procedure by an esthetician or nurse.

Esthetic Laser Treatment Training and Certification Courses

If you are allowed to perform non-ablative laser skin treatments under your esthetician license, or if you must obtain additional training in laser resurfacing to begin offering these services, there is a host of laser skin programs that will provide you with the necessary training.

Esthetic laser training programs include both classroom and hands-on training and can range from intensive 2-day workshops to comprehensive 8-week programs that cover everything from hair removal to skin care treatments. These courses are available through:

  • Laser equipment manufacturers
  • Cosmetic surgery schools
  • Dedicated laser aesthetics institutes and certification bodies
  • Technical schools
  • Esthetics schools

Topics covered in laser skin treatment programs include:

  • Skin physiology and histology
  • Disorders and diseases
  • Client consultation, analysis, and skin classification
  • Laser and light physics and modalities

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