Richard Fitzpatrick, M.D.; Dermatologist, GBK Cosmetic Laser Dermatology, San Diego, California; Founder, SkinMedicaI met my first laser in 1962 as a freshman at Princeton University, and as soon as I started playing with the then-brand-new argon laser in physics class, I was instantly fascinated by the fact that you could concentrate a beam of energy so perfectly. Although no one had any idea how to use this innovation at the time, I immediately saw the potential for such a device, and vowed to work with it some day.In the late 1970s, chemical peels and dermabrasion were popular anti-aging treatments, but they were fraught with problems—the main issue being that they were so uncontrollable. I began to look at the carbon dioxide (CO2) laser and eventually developed the protocol for skin treatment, and from there much attention began to focus on laser skin resurfacing and rejuvenation. Among the innovations that stemmed from the principles associated with my work with the CO2 laser were the use of the erbium laser for skin resurfacing and the whole field of non-ablative, no-downtime laser treatments for improving texture and tightening skin. But the innovation that really started today’s laser revolution as we know it was the fractional laser. By taking original laser treatment principles and delivering the energy in pixels as opposed to all in one spot, we are now able to do things with light-based energy that we weren’t able to do before in a much safer manner.With today’s menu of laser offerings, we can smooth surface texture, eliminate premalignant cells, address redness caused by broken capillaries, tighten skin and improve wrinkles. Since all of these skin concerns are associated with aging, combining different laser modalities can have a profound anti-aging effect.Although lasers haven’t replaced the need for surgical procedures that eliminate excess skin (yet), the two work hand in hand to obtain optimal anti-aging outcomes. The main thing that lasers can do that surgery cannot is improve the quality of the skin, and no matter how good a surgeon is, he or she cannot reverse the damage on the surface of the skin that speaks volumes in terms of visible aging. Even more, we’ve found that laser resurfacing can actually improve the longevity of surgical results. The beauty of laser treatment is that just about everyone is a candidate, although some skin types do require greater expertise. Someone with fair skin is an “easier” candidate since there’s minimal pigment to complicate treatment, but dark skin can respond very well in the hands of an experienced doctor. Anti-aging results from laser treatments are long lasting, provided the patient takes the proper steps to protect their skin from further damage. With diligent use of sunscreen and skincare products, improvement can last up to 10 years. The key is using clinically tested (and proven) ingredients such as growth factors, retinol and antioxidants. Growth factors maintain results by stimulating the skin to repair the damage caused by incidental sun exposure (more than 5 minutes of sun each day incurs too much damage for the skin to repair itself naturally). Retinoids help eliminate irregular cells, keep pigment in check, and stimulate new collagen, and antioxidants shield skin from free radicals that cause aging changes. Vitamin C is an especially important antioxidant since it’s also necessary for collagen production, which is a primary way that laser treatment helps improve the appearance of the skin. In fact, laser treatments prompt the skin to produce new collagen for up to a year after the treatment is performed. While the anti-aging benefits of laser treatment for the face are indisputable, many patients don’t realize the potential improvement they can get on other areas of the body. The neck, chest, arms and backs of the hands can see profound improvement as well, which goes a long way to “match” the rejuvenated skin on the face—and deliver an overall more youthful appearance.