Laser Surgery
Which skin conditions can be treated with lasers and what types of lasers are used?

Lasers permit the treatment of a wide variety of skin concerns through the carefully calibrated application of targeted light energy. I perform a high volume of laser treatments and have access to a range of advanced lasers across a number of central London locations. The following are the most frequent conditions that I treat:-
- Redness and broken blood vessels: Pulsed-dye lasers are effective in treating spider veins and redness caused by conditions like rosacea. They target the blood vessels, causing them to shrink and be reabsorbed by the body. Long-pulsed Nd:YAG lasers are used for larger or more resistant blood vessels.
- Scars: Atrophic (dipped) scars can be improved by non-ablative or ablative fractional lasers that promote collagen production. Red scars and keloid scars can be improved by pulsed dye lasers.
- Pigmentation: Sunspots, freckles and post-inflammatory hyperpigmentation can be treated with Q-switched Nd:YAG lasers.
- Wrinkles and Fine Lines: Ablative fractional lasers, such as carbon dioxide lasers can improve the appearance of moderate to deep wrinkles and fine lines. They work by causing microscopic columns of thermal injury in the skin, promoting collagen production and skin resurfacing without damaging the surrounding tissue. Non-ablative fractional lasers can achieve an improvement with less downtime.
- Hair removal: I use the Elite laser which has both alexandrite and NdYAG wavelengths permitting the safe treatment of pigmented and non-pigmented skin types.
I use the following types of lasers and these are discussed below:-
Vascular lasers
Vascular lasers such as pulsed dye lasers are used for the following indications:-
- Rosacea and facial redness
- Spider veins (telangiectasias)
- Port-wine stains
- Cherry angiomas
- Venous lakes
- Poikiloderma of Civatte
- Scars
I will most commonly use Pulsed-Dye Lasers. These emit a yellow light, which is absorbed by the haemoglobin in blood vessels. This light energy causes the blood vessels to coagulate and eventually be reabsorbed by the body. PDLs are particularly effective for treating rosacea, facial redness, spider veins, and port-wine stains.
Long-Pulsed Nd:YAG Lasers: Nd:YAG lasers have a longer wavelength, allowing them to penetrate deeper into the skin. This makes them suitable for treating larger blood vessels, such as those found in varicose veins and deeper vascular lesions, however as they target larger blood vessels, they are associated with a slightly higher risk of complications such as scarring.
Advantages of vascular laser treatments
- Minimally invasive: Lasers offer precise targeting of blood vessels, minimizing damage to surrounding tissue and reducing the risk of scarring.
- Quick: Vascular laser treatments are typically quick, with many procedures taking less than an hour to complete.
- Minimal downtime: Most patients can return to their normal activities soon after treatment, with only minor side effects, such as temporary redness or swelling.
- Long-lasting results: Vascular laser treatments often provide long-lasting improvement in the appearance of vascular skin conditions.
Risks and Side Effects
As with any medical procedure, vascular laser treatments do carry some risks and potential side effects:
- Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical anesthetics or cooling devices.
- Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolve within a few days.
- Pigmentary change: In rare cases, vascular laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones.
- Scarring: Although rare, scarring is a potential risk of vascular laser treatment, particularly if the skin's outer layers are damaged during the procedure.
- Incomplete clearance: Some vascular lesions may require multiple treatment sessions for optimal results, and in some cases, complete clearance may not be achievable.
Questions about vascular lasers
What is pulsed dye laser treatment?
Pulsed dye laser (PDL) treatment uses a specific type of laser, emitting light at a wavelength that targets blood vessels in the skin. PDL is primarily used to treat vascular skin conditions, such as rosacea, port-wine stains, spider veins, and red scars.
How does pulsed dye laser treatment work?
The pulsed dye laser emits light at a specific wavelength that is absorbed by the blood vessels in the targeted area. The absorbed energy heats the blood vessels, causing them to shrink or collapse. Over time, the body naturally reabsorbs the damaged vessels, reducing the appearance of redness or prominent blood vessels.
Is pulsed dye laser treatment painful?
Some patients may experience mild discomfort during the treatment, often described as a sensation similar to a rubber band being snapped against the skin. Anaesthetic is not required, however cooling is used during the procedure.
How many treatments are needed for optimal results?
The number of treatments required varies depending on the specific skin condition being treated, its severity, and the individual's response to the treatment. On average, most patients require 4-6 sessions, spaced 6 weeks apart, to achieve optimal results.
What should I expect during the recovery period?
After a pulsed dye laser treatment, patients may experience temporary redness, swelling, and mild bruising in the treated area. These side effects usually resolve within a few days to a week. It is essential to avoid sun exposure and use sunscreen, to minimize the risk of complications such as pigmentation.
Are there any risks or side effects associated with pulsed dye laser treatment?
As with any medical procedure, pulsed dye laser treatment carries some risks and potential side effects. These may include temporary or permanent changes in skin pigmentation, scarring, blistering, or, in rare cases, infection. Dr Lynch will discuss these risks with you in detail prior to the procedure.
How long do the results of pulsed dye laser treatment last?
The longevity of the results depends upon the condition being treated and the response to the treatment. For some patients, the results can be long-lasting or even permanent, while others may require maintenance treatments to maintain the desired appearance.
Is pulsed dye laser treatment suitable for all skin types?
Pulsed dye laser treatment is generally safe for most skin types but more caution is required in darker skin types.
Can pulsed dye laser treatment be combined with other treatments?
Yes, pulsed dye laser treatment can be combined with other treatments such as steroid injection for scars, Q-switched laser for pigmentation and non-ablative fractional laser for scarring and fine lines.
How much does pulsed dye laser treatment cost?
Pulsed dye laser treatments will generally cost several hundred pounds per treatment (including the cost of the laser usage). A guide to prices is available
here. You will be provided with a detailed quotation for treatment following your initial consultation.
Pigment lasers
I use Q-switched (532nm and 1064nm) lasers to treat a variety of skin conditions. Some common indications for pigment laser treatment include:
- Age spots (solar lentigines)
- Freckles
- Post-inflammatory hyperpigmentation (PIH)
- Café-au-lait spots
- Nevus of Ota
- Hori's nevus
- Becker's nevus
- Melasma
Benefits of Pigment Laser Treatment
- Targeted treatment: Pigment lasers offer precise targeting of pigmented lesions, minimizing damage to surrounding tissue and reducing the risk of scarring.
- Minimally invasive: Pigment laser treatments are non-surgical and less invasive compared to other treatment options, such as cryotherapy, chemical peels or electrocautery.
- Quick procedure: Most pigment laser treatments can be completed within half an hour, depending on the size and complexity of the area being treated.
- Minimal downtime: Patients can typically return to their normal activities soon after treatment, with only minor side effects, such as temporary redness or swelling.
- Long-lasting results: Pigment laser treatments often provide long-lasting improvement in the appearance of pigmentation issues.
Risks and Side Effects
As with any medical procedure, pigment laser treatments do carry some risks and potential side effects:
- Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical anesthetics or cooling devices.
- Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolve within a few days.
- Pigment changes: Pigment laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
Due to the potential for complications it is always advisable to attend for a small test patch of treatment prior to treating a larger area.
Questions about pigment lasers
What is pigment laser treatment?
Pigment laser treatment targets pigment, such as melanin – the natural pigment responsible for skin coloration, within the skin. The treatment is effective for conditions such as sun spots, age spots and certain birth marks. It can be helpful in some cases for post inflammatory hyperpigmentation and melasma.
How does pigment laser treatment work?
The Q-switched Nd:YAG laser emits short pulses of light at specific wavelengths that target the pigment, such as melanin, in the skin. The pigments absorb the laser energy, causing them to break down into smaller particles, which are then naturally removed by the body's immune system.
Is pigment laser treatment painful?
Some patients may experience mild to moderate discomfort during the treatment, often described as a sensation similar to a rubber band being snapped against the skin. Topical anesthetics can be used to minimize discomfort during the procedure, however this is rarely necessary.
How many treatments are needed for optimal results?
The number of treatments required varies depending on the nature of the lesion being treated and the individual's response to the treatment. On average, most patients require a test patch and 1-2 treatment sessions, spaced 4-8 weeks apart, to achieve optimal results.
What should I expect during the recovery period?
Immediately after the treatment the skin may appear whitish grey. Occasionally there will be bruising, blistering or crusting. temporary redness, swelling, and mild crusting in the treated area. These side effects usually resolve within a few days to a week. It is essential to avoid sunlight exposure and to use a sunblock cream for several months after treatment and not to attend for treatment with a suntan due to the increased risk of complications.
Are there any risks or side effects associated with pigment laser treatment?
As with any medical procedure, pigment laser treatment carries some risks and potential side effects. These may include temporary or permanent changes in skin pigmentation, scarring, blistering, or, in rare cases, infection. Dr Lynch will discuss these risks with you in detail prior to treatment and will perform a test patch on a smaller area first to assess the response to treatment and any side effects.
How long do the results of pigment laser treatment last?
The longevity of the results varies depending on the specific condition being treated. Often the results can be long-lasting or permanent.
Is pigment laser treatment suitable for all skin types?
Pigment laser treatment can be used in all skin types, however it is safer in lighter skin types and the risks are greater in pigmented skin types since the natural pigmentation can be damaged by the laser light or inflammation from the laser can cause post-inflammatory hyperpigmentation. For this reason greater caution is required when treating pigmented skin types.
Can pigment laser treatment be combined with other treatments?
Yes, pigment laser treatment can be combined with other dermatological treatments such as pulsed dye laser and non-ablative fractional resurfacing.
How much does pigment laser treatment cost?
The cost of pigment laser treatment varies depending on factors such as the size of the treatment area and the number of sessions required and you will be provided with a quotation following your initial consultation. A guide to prices is available
here.
Laser hair removal
Hair removal lasers are a widely used and generally safe method of removing unwanted hair growth. They can cause a long lasting reduction in hair growth, however they are not a permanent treatment and repeat treatments are usually required.
Please note:
- Laser hair removal is only effective for dark hairs and will not work for grey or blond hairs.
- When patients come to me for laser hair removal, it is generally for relatively small areas of treatment since it is much more cost efficient to attend high street laser clinic where large areas need to be treated over multiple session.
- Alternatives to hair removal lasers include electrolysis and topical eflornithine (Vaniqa) cream.
- If you are attending for laser hair removal it is essential that you do not have a tan and are not wearing makeup or anything else on the skin as this increases the risks of treatment. It is important that the hairs to be treated should be shaved close to the skin surface to reduce discomfort and risks during the procedure.
Indications for Laser Hair Removal
Laser hair removal is primarily used to reduce unwanted hair growth on various areas of the body. Some common indications for laser hair removal include:
- Facial hair, such as upper lip, chin, and sideburns
- Underarms
- Bikini line and Brazilian area
- Arms and legs
- Chest and back
- Treatment of ingrown hairs and razor bumps
Types of Hair Removal Lasers
Various types of hair removal lasers are used, each with its specific strengths and target areas. The most common hair removal lasers include:
- Nd:YAG Lasers: Nd:YAG lasers have a long wavelength and are suitable for treating all skin types, including darker skin tones. They are often used for hair removal on larger body areas and for treating ingrown hairs.
- Alexandrite Lasers: Alexandrite lasers have a shorter wavelength, making them more effective for treating lighter skin tones. They offer rapid hair removal on large areas, such as the legs and back.
- Diode Lasers: Diode lasers have a longer wavelength, making them effective for treating a wider range of skin types, including darker skin tones. They are commonly used for hair removal on larger areas of the body, such as the back and legs.
- Intense Pulsed Light (IPL): While not a true laser, IPL devices emit a broad spectrum of light that targets melanin in hair follicles. IPL is often used for hair removal on various body areas and is suitable for treating a wide range of skin types.
I use the Cynosure Elite device which has both Nd:YAG and Alexandrite lasers enabling treatment of both lighter and darker skin types.
Benefits of Laser Hair Removal
- Long-term hair reduction: Laser hair removal provides long-term hair reduction by targeting the hair follicle, resulting in slower regrowth and thinner, finer hair.
- Precision: Lasers offer precise targeting of hair follicles, minimizing damage to surrounding tissue and reducing the risk of scarring or pigmentation changes.
- Speed: Laser hair removal treatments are relatively quick, with most sessions taking less than an hour to complete, depending on the size of the area being treated.
- Minimal downtime: Most patients can return to their normal activities soon after treatment, with only minor side effects, such as temporary redness or swelling.
Risks and Side Effects
- Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with cooling devices.
- Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolves within a few days.
- Pigment changes: Laser hair removal may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
- Burns or blisters: In rare cases, burns or blisters may occur.
- Incomplete hair removal: Some patients may require multiple treatment sessions for optimal hair reduction and may not fully respond to treatment.
Fractional ablative lasers
Ablative lasers such as the carbon dioxide laser were a major advance in dermatology providing new treatment options for scars, sun damage, fine lines and wrinkles. Ablative lasers remove the surface layer of the skin allowing the natural healing process of the skin to regenerate the skin. I use the Lumenis Ultrapulse (available either at OneWelbeck or Skin55). I will use the laser in full ablative mode for conditions such as keloid scars, rhinophyma or for removal of harmless skin growths however generally for superficial resurfacing and acne scarring I will use in fractional mode.
Fractional mode has faster recovery and significantly lower risks of scarring and pigmentary change. The Lumenis Ultrapulse permits precise control of fractional energy delivery. Fractional ablative lasers have revolutionized the treatment of become an integral part of dermatological treatments, offering impressive results for scarring, fine lines and rejuvenation.
Indications for Fractional Ablative Laser Treatment
Fractional ablative lasers are primarily used to treat skin conditions that require resurfacing or collagen stimulation. Some common indications for this treatment include:
- Fine lines and wrinkles
- Acne scars
- Surgical or traumatic scars
- Sun damage and age spots
- Skin texture irregularities
- Enlarged pores
- Skin tightening and rejuvenation
What to Expect During Treatment
- Pre-treatment preparation: Your skin will be cleansed, and a topical anaesthetic may be applied to minimize discomfort during the procedure.
- Laser treatment: Dr Lynch will use the fractional laser device to deliver controlled pulses of energy to the targeted areas. This creates microscopic columns of thermal injury in the skin, stimulating collagen production and promoting skin resurfacing.
- Post-treatment care: We will apply a soothing ointment to your skin and provide you with specific aftercare instructions to optimize healing and results.
- Recovery period: The healing process typically takes 1-2 weeks, during which your skin may appear red, swollen, or crusty. It's essential to follow aftercare instructions, such as avoiding sun exposure and using gentle skincare products, to minimize the risk of complications.
Benefits of Fractional Ablative Laser Treatment
- Collagen stimulation: The treatment promotes collagen production, which can help improve skin elasticity, reduce the appearance of wrinkles, and tighten the skin.
- Skin resurfacing: Fractional ablative laser treatment effectively removes damaged outer layers of the skin, revealing a smoother and more youthful complexion.
- Precision: Fractional ablative lasers minimize damage to surrounding skin reducing the risk of scarring.
- Long-lasting results: Fractional ablative laser treatment often provides long-lasting improvement in the appearance of scars and skin rejuvenation.
Risks and Side Effects
- Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical or injected anaesthetic. Pain can persist for a number of days.
- Redness and swelling: Immediately following the treatment, the surface of the skin will appear red, swollen and inflamed. Some bleeding and crusting may occur.
- Pigment changes: Fractional ablative laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
- Infection: Although rare, there is a risk of bacterial or viral infection after the treatment particularly if aftercare instructions are not followed.
- Scarring: In rare cases, scarring may occur as a result of the treatment.
Questions about fractional ablative laser treatments
What is ablative fractional laser treatment?
Ablative fractional laser treatment is a laser treatment that targets skin concerns, such as deep wrinkles, scars, sun damage, and skin texture irregularities. The treatment removes the outer layers of the skin, promoting skin regeneration and stimulating collagen production.
How does ablative fractional laser treatment work?
The carbon dioxide laser emits controlled pulses of light that create microscopic columns of thermal injury in the skin, removing the outer layers and promoting collagen production. This process stimulates skin resurfacing, improving the appearance of the skin.
Is ablative fractional laser treatment painful?
Topical or injected anaesthetic is used, however some patients may experience moderate discomfort during the treatment, often described as a sensation of heat or burning. Pain medication can be prescribed for post-treatment discomfort.
How many treatments are needed for optimal results?
The number of treatments required varies depending on the specific skin concern and the individual's response to the treatment. On average 1-2 treatments are required
What should I expect during the recovery period?
After an ablative fractional laser (carbon dioxide) treatment, patients may experience redness, swelling, oozing, and crusting in the treated area. These side effects usually resolve within 1-2 weeks, but the redness may persist for several months. It is essential to follow aftercare instructions, such as avoiding sun exposure, using sunscreen, and keeping the area moisturized, to minimize the risk of complications.
Are there any risks or side effects associated with ablative fractional laser treatment?
As with any medical procedure, ablative fractional laser treatment carries some risks and potential side effects. These may include infection, scarring, temporary or permanent changes in skin pigmentation, and delayed healing. Dr Lynch will discuss these risks with you in detail prior to the procedure and will advise that a small test area is treated first to assess healing.
How long do the results of ablative fractional laser treatment last?
The longevity of the results varies depending on the specific condition being treated and the individual's response to the treatment. For some patients, the results can be long-lasting or even permanent.
Is ablative fractional laser treatment suitable for all skin types?
Ablative fractional laser treatment can be performed in all skin types but is safer in lighter skin types due to the higher risk of pigmentation changes in darker skin tones. Dr Lynch will help you to weigh up the risks and benefits of treatment during your consultation.
Can ablative fractional laser treatment be combined with other treatments?
Yes, ablative fractional laser (carbon dioxide) treatment can be combined with other treatments such as subcision or punch excision for acne scars.
How much does ablative fractional laser treatment cost?
The cost of ablative fractional laser (carbon dioxide) treatment varies depending on factors such as the size of the treatment area and the number of sessions required. You will be provided with a quotation for treatment after your consultation. A guide to prices is available
here.
Fractional non-ablative lasers
Whilst fractional ablative lasers were a major advance in skin resurfacing and the treatment of scars, the recovery time and risks meant that they were not suitable for all patients. This led to the development of non-ablative fractional lasers, such as the erbium glass laser. Whilst these generally will not achieve the same degree of improvement as fractional ablative lasers they can cause significant improvement with minimal downtime and low risks – even in pigmented skin types. I use the Palomar ICON laser – a 1540nm erbium glass laser available at Skin55 Ltd.
Indications for Fractional Non-Ablative Laser Treatment
Fractional non-ablative erbium glass lasers are primarily used to treat skin conditions that require collagen stimulation or skin resurfacing with minimal downtime. Some common indications for this treatment include:
- Fine lines and wrinkles
- Acne scars
- Surgical or traumatic scars
- Mild to moderate sun damage and age spots
- Skin texture irregularities
- Enlarged pores
- Skin tightening and rejuvenation
What to Expect During Treatment
- Pre-treatment preparation: Your skin will be cleansed, and a topical anesthetic may be applied to minimize discomfort during the procedure.
- Laser treatment: Dr Lynch will use the fractional non-ablative laser to deliver controlled pulses of energy to the targeted areas. This creates microscopic columns of thermal injury in the skin while leaving the outer layers intact, stimulating collagen production and promoting skin resurfacing. Several passes may be required in each area.
- Post-treatment care: We will apply a soothing ointment or gel to your skin and provide you with specific aftercare instructions to optimize healing.
- Recovery period: The healing process for fractional non-ablative laser treatment is typically shorter than that of ablative lasers, with most patients experiencing only mild redness and swelling for a day or two.
Benefits of Fractional Non-Ablative Laser Treatment
- Collagen stimulation: The treatment promotes collagen production, which can help improve skin elasticity, reduce the appearance of wrinkles, and tighten the skin.
- Minimal downtime: Fractional non-ablative erbium glass lasers offer skin resurfacing and collagen stimulation with minimal downtime, making them an attractive option for those seeking effective results without the extended recovery time associated with ablative laser treatments.
- Long-lasting results: Fractional non-ablative laser treatment often provides long-lasting improvement in appearance.
Risks and Side Effects
As with any medical procedure, fractional non-ablative erbium glass laser treatments do carry some risks and potential side effects:
- Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical anesthetics or cooling devices.
- Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolve within a day or two.
- Pigment changes: Rarely, fractional non-ablative erbium glass laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
- Infection can occur but is rare.
Questions about non-ablative fractional lasers
What is non-ablative fractional laser treatment?
Non-ablative fractional laser treatment is a laser procedure that targets skin concerns, such as fine lines, wrinkles, acne scars, sun damage, and skin texture irregularities. The treatment stimulates collagen production and promotes skin resurfacing without removing the skin's outer layers.
How does non-ablative fractional laser treatment work?
The erbium glass laser emits controlled pulses of light that create microscopic columns of thermal injury in the deeper layers of the skin while leaving the outer layers intact. This process stimulates collagen production and promotes skin resurfacing, improving the appearance of the skin.
Is non-ablative fractional laser treatment painful?
Some patients may experience mild to moderate discomfort during the treatment, often described as a sensation of heat or prickling. Topical anesthetics or cooling devices can be used to minimize discomfort during the procedure.
How many treatments are needed for optimal results?
The number of treatments required varies depending on the specific skin concern and the individual's response to the treatment. On average, most patients require 3-6 sessions, spaced 4-6 weeks apart, to achieve optimal results.
What should I expect during the recovery period?
After a non-ablative fractional laser treatment, patients will generally experience temporary redness and swelling in the treated area. These side effects usually resolve within a day or two. It is essential to follow aftercare instructions, such as avoiding sun exposure and using sunscreen, to minimize the risk of complications.
Are there any risks or side effects associated with non-ablative fractional laser treatment?
As with any medical procedure, non-ablative fractional laser (erbium glass) treatment carries some risks and potential side effects. These are uncommon but may include temporary or permanent changes in skin pigmentation, scarring, blistering, or, in rare cases, infection.
How long do the results of non-ablative fractional laser treatment last?
The longevity of the results varies depending on the specific condition being treated and the individual's response to the treatment. For some patients, the results can be long-lasting, while others may require maintenance treatments to maintain the desired appearance.
Is non-ablative fractional laser treatment suitable for all skin types?
Non-ablative fractional laser treatment is safe and effective for most skin types.
Can non-ablative fractional laser treatment be combined with other treatments?
Yes, non-ablative fractional laser treatment can be combined with other treatments such as pulsed dye laser treatment.
How much does non-ablative fractional laser treatment cost?
The cost of non-ablative fractional laser treatment varies depending on factors such as the size of the treatment area and the number of sessions required. You will be provided with a quotation for treatment after your consultation. A guide to prices is available
here.