Laser Treatments in Austin

Overview

Laser treatments: what they cost, how skin type changes the risk, and what to expect

Lasers and light devices treat unwanted hair, wrinkles, scars, sun damage, pigment spots and blood-vessel concerns (ASPS; Babilas et al., Lasers Surg Med 2010). Each device aims at something different and asks for a different amount of recovery. Darker skin has more melanin in its outer layer, which makes pigment changes and scarring after laser treatment more likely (Alexis, Br J Dermatol 2013).

Mechanism

The science behind lasers

The principle is selective photothermolysis. A target absorbs short pulses of light and is damaged, while nearby tissue is spared. The original study demonstrated this for small blood vessels and for pigment granules in skin (Anderson & Parrish, Science 1983). Wavelength, pulse length and energy determine what gets targeted.

A device or setting that is wrong for your skin type can leave blisters, pigment changes or scars (AAD; Alexis, Br J Dermatol 2013). That is why it matters how much experience the operator has with skin like yours.

“Cleared” and “approved” mean different things. The usual path to market is a 510(k) submission. It shows that a new device is substantially equivalent to a device already on the legal market, and FDA “clears” devices that pass it (FDA). A different route, Premarket Approval (PMA), covers higher-risk Class III devices, and FDA calls it the most stringent device application (FDA). Ask which clearance applies to this device and to the use your provider has in mind.

Types

Common laser and light devices

Intense pulsed light (IPL or BBL)

Uses: Studies describe IPL for acne, sun-damaged skin, pigmented and vascular lesions, and unwanted hair (Babilas et al., Lasers Surg Med 2010).

Mechanism: IPL is not a laser. Flashlamps and filters produce light that is non-coherent and spans a range of wavelengths (Babilas et al., Lasers Surg Med 2010).

Darker skin: In a small randomized split-body study, hair removal was done on both sides of the body in 11 people with skin types IV to VI. Some IPL-treated sides developed pigment changes; none of the 1,064 nm Nd:YAG sides did (Goh, J Dermatolog Treat 2003). If your skin is type IV or darker and IPL is offered, ask why a laser is not.

Halo hybrid fractional laser

Mechanism: Sciton says Halo sends two wavelengths into the same microscopic treatment zone, a non-ablative 1,470 nm and an ablative 2,940 nm (Sciton).

Downtime: According to Sciton, patients can go back to regular activity within 24 hours (Sciton).

Number of treatments: Sciton says 1 to 2 treatments can achieve results (Sciton).

Skin types: Per Sciton, Halo can be used on skin types I to VI (Sciton). That is the manufacturer’s claim, so ask what results your provider has seen in your skin type.

CO2 laser resurfacing

Mechanism: The American Society of Plastic Surgeons describes CO2 lasers as taking off skin in thin layers while doing minimal damage to surrounding tissue (ASPS). One review found the overall complication rate much lower with fractional resurfacing than with traditional ablative resurfacing, although serious complications can still occur (Metelitsa & Alster, Dermatol Surg 2010).

Downtime: ASPS gives about 1 week for erbium and up to about 2 weeks for CO2 resurfacing (ASPS).

Darker skin: ASPS notes that people with darker skin tones are more likely to develop hyperpigmentation after laser resurfacing (ASPS). The most common complication of CO2 laser resurfacing is transient hyperpigmentation (West & Alster, Dermatol Surg 1999).

CoolPeel

Mechanism: CoolPeel is a treatment mode that only DEKA’s Tetra CO2 and Helix devices offer (Cartessa). Cartessa, the US distributor, says it involves “little to no downtime” (Cartessa). We could not find peer-reviewed data on CoolPeel recovery time.

Non-ablative fractional lasers

Research: Fraxel Re:Store, a 1,550 nm non-ablative fractional laser, was tested on skin types IV to VI in one chart review (Clark, Silverberg & Alexis, J Drugs Dermatol 2013).

Darker skin: Across 115 sessions, the 45 patients (types IV to VI) put hydroquinone 4% cream on before and after each treatment. 5 sessions (4%) were followed by post-inflammatory hyperpigmentation, and only one episode went past a month (Clark, Silverberg & Alexis, J Drugs Dermatol 2013).

Laser hair removal

Number of treatments: Most patients need 2 to 6 treatments, usually 4 to 6 weeks apart, according to the American Academy of Dermatology, and some need maintenance treatments (AAD).

Wavelength and skin type: In skin types V and VI, hair has been removed safely with longer-wavelength lasers: the 810 nm diode and the 1,064 nm Nd:YAG (Alexis, Br J Dermatol 2013). AAD warns that hair removal on dark skin has to be done very carefully (AAD).

Side effects: The most common, per AAD, are discomfort, swelling and redness for 1 to 3 days. Less common ones include blistering, infection, scarring, and lighter or darker skin, and some color changes are permanent (AAD).

What “permanent” means: In FDA clearances for hair removal lasers, the wording is permanent hair reduction. It is defined as a long-term, stable cut in the number of hairs that regrow, checked 6, 9 and 12 months after a treatment course (FDA 510(k) K180353). AAD reports that most patients stay free of hair for months, even years, and that any hair that grows back tends to be lighter (AAD).

Skin Safety

Darker skin tones and laser safety

The Fitzpatrick scale groups skin by how it reacts to sun, from type I to type VI (Fitzpatrick, Arch Dermatol 1988). Skin of color carries more melanin in its outer layer, so it is more likely to get pigment changes and scarring from lasers (Alexis, Br J Dermatol 2013). Darker skin types are also more prone to complications after fractional resurfacing (Metelitsa & Alster, Dermatol Surg 2010).

The studies, by treatment:

• Hair removal: Skin types V and VI have a record of safe use with two lasers, the 810 nm diode and the 1,064 nm Nd:YAG (Alexis, Br J Dermatol 2013). A small study in types IV to VI found pigment changes on some IPL-treated sides and none on Nd:YAG-treated sides (Goh, J Dermatolog Treat 2003).
• Resurfacing: Darker skin also has a record of safe treatment with fractional lasers (Alexis, Br J Dermatol 2013). In types IV to VI, PIH followed 4% of 115 sessions with a 1,550 nm non-ablative fractional laser (Clark, Silverberg & Alexis, J Drugs Dermatol 2013).
• Gaps in the research: The published data mostly involve patients of East Asian descent. Few studies cover people of African descent or skin types V and VI (Alexis, Br J Dermatol 2013).

Lightening creams before treatment. The findings point in different directions. In a randomized study, 100 people with skin types I to III had CO2 resurfacing. Those given hydroquinone 4% plus tretinoin beforehand had no less hyperpigmentation than those given no pre-treatment. The authors suggested the creams might do more if applied after treatment (West & Alster, Dermatol Surg 1999). Patients in the Clark study above applied hydroquinone 4% before treatment and again after it (Clark, Silverberg & Alexis, J Drugs Dermatol 2013). According to ASPS, skin care before treatment is matched to your skin type (ASPS). Ask your provider what to use ahead of treatment and afterward, given your skin type, and why.

What to Expect

Your timeline: before, during and after

How long healing takes depends on the device. Where a source names the device, so does the step below.

1. In the weeks before

   For laser resurfacing, skin care often begins at least 6 weeks ahead (ASPS). Tell your provider if you take isotretinoin. A 2017 expert consensus advises against fully ablative laser while you are on it, but found too little evidence to delay fractional laser or laser hair removal (Spring et al., JAMA Dermatol 2017). Mention cold sores as well. Ablative facial resurfacing can set off herpes simplex again, so oral antivirals are used as prevention (Gilbert et al., Herpes 2007).

2. The day of

   Expect resurfacing to take about 30 minutes to 2 hours, with local anesthetic possibly used to numb the skin (ASPS). Skin-treatment lasers fall in FDA Class IV, which FDA describes as an immediate hazard to the eyes from the beam, direct or reflected (FDA), so you and the operator should both wear eye protection.

3. The first few days

   Halo: per Sciton, regular activity can restart within 24 hours (Sciton). Laser hair removal: usually 1 to 3 days of discomfort, swelling and redness (AAD). CO2 and erbium resurfacing: about 5 days to a week in, the skin turns dry and peels (ASPS).

4. Weeks to months later

   Following resurfacing, new skin is pink, fades over 2 to 3 months, and may stay pink for as long as a year. Once healed, skin needs sunscreen daily (ASPS). Following laser hair removal, keep the treated skin out of direct sun and stay away from tanning beds (AAD).

Sun Protection

Planning around the sun

After laser resurfacing, ASPS recommends sunscreen every day (ASPS). After laser hair removal, AAD recommends shielding skin from direct sunlight (AAD).

• Raise timing with your provider. Ask whether to schedule ablative resurfacing for a stretch when you can keep out of the sun while you heal.
• Choose the right sunscreen. AAD advises a sunscreen labeled broad-spectrum and water-resistant, SPF 30 or higher, put on again every 2 hours outside and straight after you swim or sweat (AAD).
• Leave room for healing. CO2 resurfacing can mean up to about 2 weeks of downtime (ASPS).

Tell your provider before you book if treated skin cannot be kept out of the sun while it heals.

Pricing

What lasers cost

We do not publish an Austin price range for laser treatments. The one figure we have is national: the American Society of Plastic Surgeons reports an average of $697 for laser skin treatments such as hair removal (ASPS). It comes from plastic surgeons, it is not an Austin med spa price, and ASPS gives no year for it. ASPS also says the average leaves out other related expenses (ASPS).

Price shifts with the device, the treatment area and how many sessions you need. Get a written quote listing the device, area, session count and everything it includes.

Texas Law

Vetting a laser provider in Austin

With lasers, three things count: the device, the settings, and how much experience the operator has with your skin type.

Texas rules on delegated cosmetic procedures. Delegation of nonsurgical medical cosmetic procedures, including cosmetic use of a prescription medical device, falls under Texas Medical Board rules in 22 TAC Chapter 169, Subchapter E (22 TAC §169.25). The rules became effective January 9, 2025 (TMB). They require the following:

• Before any delegated procedure, you must have a practitioner-patient relationship established by a physician, or by a PA or APRN the physician has delegated to (22 TAC §169.26).
• Delegation needs a written order (22 TAC §169.27). The person doing the procedure also has to sign and date a written protocol (22 TAC §169.26).
• The name and Texas license number of the delegating physician must be posted in every public area and treatment room (22 TAC §169.28).

Laser hair removal has its own license. Laser hair removal staff are certified by the Texas Department of Licensing and Regulation at four levels: Laser Hair Removal Professional, Senior Technician, Technician and Apprentice-in-Training. TDLR defines laser hair removal devices to include both lasers and IPL used for hair removal. Each facility must hold a written contract with a consulting physician, and that physician must audit the facility every quarter (TDLR). The certificates cover hair removal and nothing else.

How to verify credentials:

1. Physician license: use the Texas Medical Board’s license lookup. Confirm the license is active and check for disciplinary actions.
2. Board certification: search abms.org. Among the ABMS member boards are the American Board of Otolaryngology–Head and Neck Surgery, the American Board of Dermatology and the American Board of Plastic Surgery. None of the boards ABMS lists is for aesthetic or cosmetic medicine (ABMS).
3. Nurse license: check the Texas Board of Nursing verification portal. Laser hair removal staff: look up their TDLR certification at tdlr.texas.gov.

Good questions for the consultation:

• Which device will you use, and why does it suit my concern?
• How many people with my skin type have you treated using this device?
• How will you adjust the settings for my skin type?
• Can you do a test spot first, before the full treatment?
• Who is the delegating physician, and what board certification do they hold?
• Can I see before-and-after photos from patients whose skin is like mine?

Red flags:

• No delegating or consulting physician you can identify
• Public areas and treatment rooms without the physician’s name and Texas license number on display (22 TAC §169.28)
• A delegated procedure with no practitioner-patient relationship established first by a physician, PA or APRN (22 TAC §169.26)
• An operator who cannot explain the device, the wavelength or the settings
• Your skin type never comes up
• The same settings offered whatever your skin type
• Pushy sales tactics, particularly for large packages