Overview
Laser treatments: costs, skin-type safety, and what to expect
Laser and light treatments are used for wrinkles, scars, sun damage, pigment spots, blood-vessel concerns and unwanted hair (ASPS; Babilas et al., Lasers Surg Med 2010). Devices differ in what they target and how much recovery they need. Skin type matters: darker skin has more epidermal melanin and a higher risk of pigment changes and scarring from laser treatment (Alexis, Br J Dermatol 2013). This page covers what the main device types do, what published studies show for darker skin, and how to check a provider in Houston.
| Attribute | Range |
|---|---|
| Cost | $697 national average for laser skin treatments like laser hair removal, from plastic surgeons; not a Houston med spa price (ASPS) |
| Procedure time | 30 minutes to 2 hours for laser skin resurfacing (ASPS) |
| Downtime | About 24 hours for Halo (Sciton) to up to about 2 weeks for CO2 resurfacing (ASPS) |
| Sessions needed | 1–2 for Halo (Sciton); 2–6 for laser hair removal (AAD) |
| Anesthesia | Topical for Halo (Sciton); local anesthetic, sedation or, for extensive resurfacing, general anesthesia (ASPS) |
Mechanism
How laser treatments work
Lasers work by selective photothermolysis: short pulses of light that a target absorbs damage that target while sparing nearby tissue. The original study showed selective damage to small blood vessels and to pigment granules in the skin (Anderson & Parrish, Science 1983). The wavelength, pulse length and energy decide what is targeted.
Using a device or setting that is wrong for your skin type can cause pigment changes, blistering or scarring (AAD; Alexis, Br J Dermatol 2013). This is why the operator’s experience with your skin type matters.
FDA cleared vs. approved. Most devices reach the market through a 510(k), which shows a device is substantially equivalent to one already legally marketed; FDA “clears” these devices (FDA). Premarket Approval (PMA) is a separate pathway for higher-risk Class III devices, which FDA calls its most stringent device application (FDA). Ask which clearance covers the device and the use planned for you.
Types
Types of laser treatments
IPL / BBL — Intense Pulsed Light
What it treats: IPL is used for unwanted hair, vascular lesions, pigmented lesions, acne and sun-damaged skin (Babilas et al., Lasers Surg Med 2010).
How it works: IPL is not a laser. It uses flashlamps and filters to emit non-coherent light across a range of wavelengths (Babilas et al., Lasers Surg Med 2010).
Skin-type safety: In a small randomized split-body study of 11 people with skin types IV to VI having hair removal, pigment changes occurred on some IPL-treated sides and on none of the sides treated with a 1,064 nm Nd:YAG laser (Goh, J Dermatolog Treat 2003). If you have type IV or darker skin, ask why IPL is recommended over a laser.
Halo — Hybrid Fractional Laser
How it works: Sciton says Halo delivers a non-ablative 1,470 nm wavelength and an ablative 2,940 nm wavelength to the same microscopic treatment zone (Sciton).
Downtime: Sciton says patients can resume regular activity within 24 hours (Sciton).
Sessions: Sciton says results can be achieved in 1 to 2 treatments (Sciton).
Skin-type safety: Sciton says Halo can be used on skin types I to VI (Sciton). That is the manufacturer’s statement; ask your provider about their own results in your skin type.
CO2 laser resurfacing
How it works: The American Society of Plastic Surgeons says CO2 lasers remove thin layers of skin with minimal damage to surrounding tissue (ASPS). A review found the overall complication rate with fractional resurfacing much lower than with traditional ablative resurfacing, though serious complications can occur (Metelitsa & Alster, Dermatol Surg 2010).
Downtime: ASPS gives downtime of up to about 2 weeks for CO2 resurfacing and about 1 week for erbium (ASPS).
Skin-type safety: ASPS says patients with darker skin tones have a greater risk of hyperpigmentation after laser resurfacing (ASPS). Transient hyperpigmentation is the most common complication after CO2 laser resurfacing (West & Alster, Dermatol Surg 1999).
CoolPeel
How it works: CoolPeel is a treatment mode available only on DEKA’s Tetra CO2 and Helix devices (Cartessa). The US distributor describes it as having “little to no downtime” (Cartessa). We found no peer-reviewed data on CoolPeel recovery times.
Non-ablative fractional
What has been studied: A chart review in skin types IV to VI used a 1,550 nm non-ablative fractional laser (Fraxel Re:Store) (Clark, Silverberg & Alexis, J Drugs Dermatol 2013).
Skin-type safety: In a retrospective review of 115 sessions in 45 patients with skin types IV to VI, with hydroquinone 4% cream before and after treatment, post-inflammatory hyperpigmentation followed 5 sessions (4%); only one episode lasted longer than a month (Clark, Silverberg & Alexis, J Drugs Dermatol 2013).
Laser hair removal
Sessions: The American Academy of Dermatology says most patients need 2 to 6 treatments, usually every 4 to 6 weeks, and may need maintenance treatments (AAD).
Wavelengths and skin types: Longer-wavelength lasers (810 nm diode and 1,064 nm Nd:YAG) have been used safely for hair removal in skin types V and VI (Alexis, Br J Dermatol 2013). AAD says laser hair removal in dark skin must be performed very carefully (AAD).
Side effects: AAD says the most common side effects are discomfort, swelling and redness lasting 1 to 3 days; less common effects include blistering, infection, scarring and skin lightening or darkening, and some color changes are permanent (AAD).
About “permanent”: FDA clearances for hair removal lasers use the term permanent hair reduction, defined as a long-term, stable reduction in the number of hairs regrowing, measured at 6, 9 and 12 months after a treatment course (FDA 510(k) K180353). AAD says most patients stay hair-free for months or even years, and regrowth tends to be lighter (AAD).
Skin Safety
Laser safety for darker skin tones
The Fitzpatrick scale classifies skin into sun-reactive types I to VI (Fitzpatrick, Arch Dermatol 1988). Skin of color has more melanin in the outer layer of skin and a higher risk of pigment changes and scarring from laser treatment (Alexis, Br J Dermatol 2013). Complications after fractional resurfacing are more likely in darker skin types (Metelitsa & Alster, Dermatol Surg 2010).
What the evidence shows:
- Hair removal: 810 nm diode and 1,064 nm Nd:YAG lasers have been used safely in skin types V and VI (Alexis, Br J Dermatol 2013). In one small study in types IV to VI, IPL caused pigment changes on some treated sides and Nd:YAG caused none (Goh, J Dermatolog Treat 2003).
- Resurfacing: Fractional lasers have been used safely for resurfacing in darker skin (Alexis, Br J Dermatol 2013). One review of 115 sessions of 1,550 nm non-ablative fractional laser in types IV to VI found PIH after 4% of sessions (Clark, Silverberg & Alexis, J Drugs Dermatol 2013).
- Limits of the evidence: Most published data come from patients of East Asian descent, with few studies in people of African descent or with skin types V and VI (Alexis, Br J Dermatol 2013).
Pre-treatment with lightening creams. The evidence is mixed. In a randomized study of 100 CO2 resurfacing patients with skin types I to III, pre-treatment with hydroquinone 4% and tretinoin did not reduce hyperpigmentation compared with no pre-treatment; the authors suggested these creams may help when used after treatment (West & Alster, Dermatol Surg 1999). The Clark study above used hydroquinone 4% both before and after treatment (Clark, Silverberg & Alexis, J Drugs Dermatol 2013). ASPS says pre-treatment skin care is customized for your skin type (ASPS). Ask your provider what they recommend before and after treatment for your skin type, and why.
What to Expect
What to expect before, during, and after treatment
Recovery depends on the device. The phases below note the device where the source is specific.
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Weeks before treatment
Pre-treatment skin care for laser resurfacing often begins 6 weeks or more before the procedure (ASPS). Tell your provider about isotretinoin use: a 2017 expert consensus does not recommend fully ablative laser during isotretinoin treatment and found insufficient evidence to delay laser hair removal or fractional laser (Spring et al., JAMA Dermatol 2017). Tell your provider if you get cold sores; ablative facial resurfacing can reactivate herpes simplex, and oral antivirals are used to prevent it (Gilbert et al., Herpes 2007).
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Day of treatment
Laser resurfacing usually takes 30 minutes to 2 hours; the skin may be numbed with local anesthetic (ASPS). Skin-treatment lasers are FDA Class IV lasers, an immediate eye hazard from the direct or reflected beam (FDA), so both you and the operator should wear eye protection.
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First days
Halo: regular activity within 24 hours, per Sciton (Sciton). Laser hair removal: discomfort, swelling and redness usually last 1 to 3 days (AAD). CO2 and erbium resurfacing: skin dries and peels about 5 days to a week after treatment (ASPS).
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Weeks to months after
After resurfacing, new skin is pink and lightens over 2 to 3 months; pinkness can take up to a year to fade. ASPS advises daily sunscreen once the skin has healed (ASPS). After laser hair removal, keep treated skin out of direct sunlight and do not use tanning beds (AAD).
Houston Climate
Houston climate considerations
ASPS advises daily sunscreen after laser resurfacing (ASPS), and AAD advises keeping skin out of direct sunlight after laser hair removal (AAD). Plan for sun protection before you book:
- Ask whether timing matters. Ask your provider whether to schedule ablative resurfacing for a time when you can stay out of the sun while you heal.
- Use sunscreen correctly. The American Academy of Dermatology recommends broad-spectrum, water-resistant sunscreen with SPF 30 or higher, reapplied every 2 hours outdoors and right after swimming or sweating (AAD).
- Plan around recovery. If you are having CO2 resurfacing, plan for up to about 2 weeks of downtime (ASPS).
If you cannot keep treated skin out of the sun during healing, raise that with your provider before booking.
Houston Pricing
Houston pricing: what to expect
This site does not publish a Houston price range for laser treatments. Nationally, the American Society of Plastic Surgeons gives an average cost of $697 for laser skin treatments like laser hair removal (ASPS). That is a national figure from plastic surgeons, not a Houston med spa price, and ASPS does not give a year for it. ASPS notes the average does not include other related expenses (ASPS).
Price depends on the device, the area treated and the number of sessions. Ask for a written quote that lists the device, the area, the number of sessions and what is included.
Texas Law
How to choose a laser provider in Houston
For lasers, the device, the settings and the operator’s experience with your skin type matter.
Texas rules for delegated cosmetic procedures. Texas Medical Board rules in 22 TAC Chapter 169, Subchapter E cover delegation of nonsurgical medical cosmetic procedures, including the use of a prescription medical device for cosmetic purposes (22 TAC §169.25). These rules took effect January 9, 2025 (TMB). Under them:
- Before a delegated procedure, a physician, or a PA or APRN acting under the physician’s delegation, must establish a practitioner-patient relationship with you (22 TAC §169.26).
- The delegation requires a written order (22 TAC §169.27). The person performing the procedure must also sign and date a written protocol (22 TAC §169.26).
- The delegating physician’s name and Texas license number must be posted in each public area and treatment room (22 TAC §169.28).
Laser hair removal is licensed separately. The Texas Department of Licensing and Regulation certifies four levels of laser hair removal personnel: Apprentice-in-Training, Technician, Senior Technician and Laser Hair Removal Professional. TDLR’s definition of laser hair removal devices covers both lasers and IPL used to remove hair. Each facility must have a written contract with a consulting physician, who must audit the facility quarterly (TDLR). These certificates cover hair removal only.
Credential verification:
- Physician license on the Texas Medical Board Look Up a License page. Check that the license is active and look for disciplinary actions.
- Board certification at abms.org. ABMS member boards include the American Board of Dermatology, the American Board of Plastic Surgery and the American Board of Otolaryngology – Head and Neck Surgery. ABMS lists no aesthetic or cosmetic medicine board (ABMS).
- Nurse license on the Texas Board of Nursing license verification portal. For laser hair removal staff, check TDLR certification at tdlr.texas.gov.
Questions to ask at the consultation:
- What device will be used, and why is it appropriate for my concern?
- How many patients with my skin type have you treated with this device?
- How will the settings be adjusted for my skin type?
- Will you do a test spot before the full treatment?
- Who is the delegating physician, and what is their board certification?
- Can I see before-and-after photos of patients with skin like mine?
Warning signs:
- No identifiable delegating or consulting physician
- No posted physician name and Texas license number in public areas and treatment rooms (22 TAC §169.28)
- No practitioner-patient relationship established by a physician, PA or APRN before a delegated procedure (22 TAC §169.26)
- Operator cannot explain the device, wavelength or settings
- No discussion of your skin type
- The same settings proposed regardless of your skin type
- High-pressure sales, especially for large packages
Treatment Areas