Laser resurfacing is a fairly common anti-aging procedure and most of us have probably given a passing thought as to whether it’s appropriate for us. Personally, I try to postpone procedures for as long as possible, but that doesn’t mean succumbing to sagging and sun damaged skin. For me it means looking for gentler alternatives to laser treatments. But to know what else to turn to, first we need to understand what laser resurfacing is, how it works and what it does.

What is laser resurfacing?

There are two types of laser: A wounding (ablative) laser, which removes thin layers of skin and a nonwounding (nonablative) laser, which stimulates collagen growth and tightens underlying skin. Typically, laser resurfacing treatments treat wrinkles, uneven skin tone or texture, sun-damaged skin and dark spots, acne or other scars.

Ablative laser skincare treatment: An ablative laser directs an intense beam of light energy (that’s the laser) at your skin. The laser destroys the outer layer of skin (epidermis) and, at the same time, heats the underlying skin (dermis), which causes collagen fibers to shrink. As the wound heals, new skin forms that's smoother and tighter.

Nonablative laser skincare treatment: With nonablative laser a water-based gel is typically used. The laser damages collagen beneath the skin and stimulates the growth of new collagen, tightening underlying skin and improving skin tone and appearance. The epidermis is not removed.

Fractional laser resurfacing: A word about fractional laser resurfacing, also known as fractional photothermolysis. This targets areas of the skin that are precisely spaced out at a microscopic level and heats some skin zones while others are left undisturbed. Instead of emitting a solid beam, the laser puts out clusters of minuscule beams that punch invisible holes in the skin. In creating a grid-like pattern of micro-wounds, fractional laser resurfacing stimulates fresh collagen production beneath the skin’s surface and allows the untreated areas of tissue to remain stable for quicker recovery.

Side effects from all types of laser treatment can include itchiness, redness and swelling, blistering, irritation, change of the skin’s color (darker skins can become darker, and lighter skins abnormally light – hypopigmentation).

Alternatives to Laser Skincare Treatments

Being gentler and causing less wounding, my alternatives may not give the same results as laser treatments, but in combination with good serums and a good diet they will incrementally improve the skin and reduce signs of aging.

Microdermabrasion: For improving skin tone, giving it a smoother surface and eliminating some fine wrinkles, microdermabrasion is an option. It is a powerful exfoliating treatment that uses aluminum oxide crystals or diamond tips to buff away the surface layer skin. There are two microdermabrasion devices that work well at home and can be used to save on trips to the esthetician or maintenance in between visits: the PMD Personal Microderm System ($179); and Riiviva Microderm ($299). The PMD uses aluminum oxide crystals and there are three interchangeable tips available based on skin tolerance. I use it weekly and find it a useful addition to my anti-aging arsenal. The Riiviva Microderm ($299 in the shop) device is considered top-of-the-line with medical grade diamond tips – it also has three tips for different skin types.

LED Light Therapy (LLT). LED uses red light and infra-red (which you can’t see). It doesn’t get very hot and is basically a gentle treatment that lasts about 20 minutes. For a time no one really knew how it worked. But researchers have concluded that “by targeting water layers on elastin, facial wrinkle levels could be significantly reduced by irradiation of the skin with visible light”. Read more on LED. Salon treatments can cost around $130 per session. At home devices make a real difference but only if used regularly. There are some great LED devices for use at home including the Rolls Royce of them, the Quasar MD Plus ($795), the Facial Secret ($329), which is a panel large enough for full face treatment,  and Ultra Renew Plus ($159) which has three LED lights, plus ultrasound and ionic.

Laser at home: If you are intrigued by laser, consider the PaloVia - the first-ever FDA-cleared laser for reducing fine lines that can be used at home. PaloVia uses fractional technology and there are impressive results from clinical trials ($499). It has accolades from members of the Truth In Aging community (see Dennis’ review). PaloVia was cleared by the FDA for periorbital wrinkles, but between you and me, it can be used wherever needed.

Face masks: Although no substitute for tooling up, a good face mask will leave your skin vibrant and refreshed looking. Indeed, our Riiviva tester, Kim, went to far as to say “I get similar results (although definitely more short-lived) when I use the Royal Nectar Face Mask with bee venom ($65 in the shop). I concur that the bee venom mask makes skin look radiant. Glycolic masks are another good option and Michael Todd True Organics Pumpkin Mask ($34) combines pumpkin enzyme with glycolic acid to dissolve skin's impurities. PureCeuticals’Cherry Glycolic Peel ($42 in the shop) is pretty turbo charged with glycolic at 15%, lactic acid (15%), and salicylic acid (15%) – as good as a doctor’s office peel, according to our reviewer.

Topical skin brighteners: There are several active ingredients that will go a long way to evening out skin and lightening sun damage (patience is required for serious dark spots). Kojic acid is one such ingredient and Medik8 White Balance Click ($80 in the shop) has formulated it with six others to tackle all aspects of hyperpigmentation. Sweetsation Therapy Lumi*Essence Body Organic Advanced Brightening Repair Treatment ($48 in the shop) has kojic acid, alpha arbutin and tons of plant oils and extracts, some of which, such as pineapple, contribute to skin brightening. M.A.D Spot On Targeting Skin Brightening Serum ($38/0.50 oz in the TIA shop) has interesting actives in the whitening department. B-White is a combination of amino acids derived from a growth factor. There is also Lumiskin, extracted from the bark of the Chilean Boldo tree and an inhibitor of melanin production.