Written by: Robin Lewallen, MD, FAAD
There is no single “best” laser or skin treatment. Different technologies target different concerns such as wrinkles, pigmentation, acne, redness, scars, or skin laxity. The best treatment depends on your skin type, goals, downtime tolerance, and underlying skin condition.
Fractionated CO2 Laser
Fractionated CO2 is one of the most powerful resurfacing lasers available. It improves deep wrinkles, acne scars, texture, sun damage, and crepey skin by stimulating significant collagen remodeling. This treatment can produce dramatic results, but it also comes with more downtime and temporary redness.
Best for: Wrinkles, acne scars, texture, sun damage, advanced anti-aging
Typical downtime: About 7–14 days of healing with redness that can last several weeks
Ellacor
Ellacor is a newer treatment that removes tiny “micro-cores” of skin without heat or surgery. It helps tighten loose skin and improve wrinkles by physically removing microscopic amounts of excess skin while stimulating collagen production.
Ellacor is especially helpful for crepey skin, lower face aging, and wrinkles around the mouth.
Best for: Skin laxity, lower face aging, wrinkles, collagen stimulation
Typical downtime: About 5–14 days of swelling, redness, and visible healing dots
XF 1540 Fractional Laser
XF 1540 is a fractional non-ablative resurfacing treatment designed to stimulate collagen and improve skin texture with less downtime than aggressive resurfacing lasers like CO2. It creates controlled microscopic treatment zones in the skin to soften fine lines, improve pores, acne scars, and early signs of aging.
Compared with CO2 lasers, XF treatments are gentler and involve less peeling and recovery while still improving overall skin quality.
Best for: Fine lines, texture, pores, mild acne scars, early anti-aging
Typical downtime: About 2–5 days of redness, dryness, and swelling
IPL (Intense Pulsed Light)
IPL uses broad-spectrum light to target brown pigment and redness caused by sun damage. It is one of the most popular treatments for improving uneven skin tone, sun spots, freckles, and diffuse redness on the face, neck, chest, and hands.
IPL is excellent for overall skin brightening and “color correction,” although it is generally not ideal for melasma-prone patients because heat can sometimes worsen pigmentation.
Best for: Sun spots, freckles, diffuse redness, photoaging, uneven tone
Typical downtime: Mild redness for 1–3 days; darkened pigment may flake off over about 5–10 days
PicoSure
PicoSure Pro uses ultra-short pulses of energy to improve pigmentation, acne scars, pores, and fine lines with less heat than traditional lasers. It is often a good option for patients wanting rejuvenation with lower downtime and may be safer for some melasma-prone patients.
Best for: Pigment, mild acne scars, texture, pores, fine lines, melasma-prone skin
Typical downtime: Usually 1–3 days of redness or mild swelling
Excel V+
Excel V+ is a vascular laser designed to treat redness and visible blood vessels. It is one of the best treatments for rosacea, facial redness, broken capillaries, cherry angiomas, and red acne marks.
Excel V+ improves skin clarity by targeting abnormal blood vessels and chronic inflammation.
Best for: Rosacea, redness, broken blood vessels, red acne scars
Typical downtime: Mild redness or swelling for 3-7 days; occasional bruising depending on settings
Sofwave
Sofwave Medical uses ultrasound technology to stimulate collagen and tighten skin without surgery or significant downtime. Unlike resurfacing lasers, Sofwave focuses on lifting and tightening rather than correcting pigment or texture.
Best for: Mild skin laxity, jawline definition, lifting, collagen stimulation
Typical downtime: Minimal to none; mild swelling or tenderness for 1–2 days
Chemical Peels (PRX+, Salmon Facials/PDRN, ZO 3-Step Peel)
Chemical peels and regenerative skin treatments help brighten the skin, improve texture, reduce mild pigmentation, and support collagen production. Some peels focus more on exfoliation, while treatments like PDRN “salmon facials” focus on skin healing and hydration.
Best for: Glow, mild pigmentation, acne, texture, maintenance rejuvenation
Typical downtime: Anywhere from none to about 5–14 days of peeling depending on the peel strength
Microneedling
Microneedling stimulates collagen through controlled micro-injuries in the skin. It is commonly used for acne scars, enlarged pores, fine lines, and texture improvement. It is also considered safer for many darker skin tones compared with some heat-based lasers.
Best for: Acne scars, pores, fine lines, texture
Typical downtime: Usually 1–3 days of redness similar to a sunburn
AviClear
AviClear is a laser treatment designed specifically for acne. It targets oil glands to reduce breakouts and may help patients looking for an alternative to oral acne medications.
Best for: Active acne, oily skin, hormonal acne
Typical downtime: Mild redness and swelling for 1–2 days
TheraClear
TheraClear combines suction and light technology to treat acne and clogged pores. It focuses on reducing active inflammation and oil buildup with little downtime.
Best for: Inflammatory acne, congested pores, oily skin
Typical downtime: Minimal; mild redness for several hours to 1 day
DiamondGlow
DiamondGlow is a resurfacing facial that exfoliates, deep cleans pores, and infuses customized serums into the skin at the same time. It helps improve glow, hydration, congestion, and overall skin texture with little to no downtime.
Best for: Dull skin, mild acne, congestion, hydration, glow
Typical downtime: Minimal; mild redness for several hours
Which Treatment Is Right for You?
A consultation is important because two patients with “aging skin” may need completely different treatments depending on whether the main issue is pigment, redness, texture, acne scars, or skin laxity.
Different concerns require different approaches:
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Wrinkles & texture: Fractionated CO2, XF 1540
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Skin tightening & laxity: Sofwave, Ellacor
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Redness & rosacea: Excel V, IPL
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Sun spots & pigmentation: IPL, PicoSure Pro
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Acne scars: CO2, XF 1540, microneedling, PicoSure Pro
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Active acne: AviClear, TheraClear, DiamondGlow
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Low downtime rejuvenation: IPL, PicoSure Pro, Sofwave, XF 1540, DiamondGlow
Don’t Forget Maintenance
Even the best laser treatments are not permanent if the skin is not maintained properly afterward. Daily sunscreen is one of the most important steps for protecting results, preventing pigmentation, and slowing collagen breakdown from UV exposure. Targeted skincare products such as retinoids, antioxidants, pigment-correcting ingredients, and medical-grade moisturizers can also help extend results and increase the time between treatment sessions.
