The Risks of Laser Skin Resurfacing: What You Need to Watch Out For

By Deana D.| Last updated on April 24, 2023
risks of laser skin resurfacing
⏱️ 6 min read

Laser skin resurfacing is a type of laser skin care also known as lasabrasion, laser peel, and laser vaporization. It can reduce or eliminate various blemishes, and help address several skin conditions as well.

The laser peel is a safe procedure, as long as it’s performed in a clinical environment, at an accredited facility, by a board-certified, licensed plastic surgeon.

That said, it does have some possible unwanted side effects that you should watch out for. Read this article to learn everything you need to know about the potential risks of laser skin resurfacing.

General Laser Skin Resurfacing Risks

Being a form of plastic surgery, laser skin resurfacing does have some associated risks.

You should discuss any concerns during consultations with your surgeon. They’ll assess the chances of you experiencing any of these unpleasant side effects and decide on a strategy to avoid or minimize them.

Some common laser resurfacing risks include:

  • Prolonged redness
  • Swelling
  • Scarring (rarely happens, but is possible)
  • Milia
  • Hyperpigmentation (more likely)
  • Hypopigmentation (less likely)
  • Acne flare-up
  • Cold sore flare-up
  • Bacterial infection

In addition, you might be more prone to unpleasant complications of laser resurfacing if you have:

  • Very dark skin
  • Very deep wrinkles
  • Sagging skin
  • Excess skin
  • An ongoing herpes viral infection
  • Active acne
  • A history of frequent laser treatments

These risk factors don’t necessarily forbid you from having the treatment at all, but they will adversely affect it.

At best, you simply won’t get any noticeable improvement. At worst, you will be much more susceptible to the negative side effects we listed above.

That’s why it’s essential to be transparent and thorough in your consultations. Tell your provider all about your medical history and lifestyle, even if you think something isn’t that important.

Especially be honest about any underlying conditions, ongoing medication courses, any supplements you might be taking, and any allergies or sensitivities that you have (or even suspect you have).

Image source: Instagram @medreinhealth

Ablative CO2 Laser Risks

Ablative laser treatments can be considered the most aggressive form of laser skin care, in that they remove the skin cells in the entire targeted area at once. As such, they carry the following risks:1
  • Redness, skin fragility, and peeling for up to 3 months post-treatment
  • Acneiform dermatitis (acute acne-like rash)
  • Milia formation
  • Cold sore outbreak
  • Post-treatment infection
  • Hyperpigmentation (more common)
  • Hypopigmentation (less common, but still more likely with ablative CO2 than with other lasers)
If your surgeon determines that your skin type is too sensitive for ablative CO2 treatment, they may recommend an erbium laser instead or a non-ablative treatment.

Fractional CO2 Laser Risks

Although less severe on the skin than traditional ablative CO2 lasers, fractional carbon dioxide laser treatments do still pose some risks. Potential complications include:2
  • Post-treatment infection (due to broken skin barrier)
  • Scarring
  • Drooping of the lower eyelids
  • Secondary skin lesions (e.g. psoriasis, vitiligo)
  • Hyper- or hypopigmentation
  • Contact dermatitis post-procedure
  • Prolonged redness (uncommon, but possible)
  • Milia or acne
These risks can mostly be avoided if the surgeon is skilled and experienced and the laser is used at proper energy settings.

Image source: Instagram @skinworksmedspa

Erbium Laser Risks

Erbium lasers (Er:YAG) can be used both ablatively and non-ablatively. They’re generally considered gentler than CO2 lasers and with lower chances of undesirable side effects.

However, they do still carry some risks3, including:

  • Prolonged redness
  • Cold sore outbreak
  • Post-treatment infection
  • Hyper- and hypopigmentation
  • Appearance of milia, acne, and dermatitis
  • Surface bleeding
  • Burns
  • Scarring
  • Eye injury

Most of these are standard laser skin care side effects. They can be managed just like the potential complications after CO2 laser treatments.

The more serious adverse effects – burns, scarring, bleeding, and eye damage – can be entirely avoided with adequate preparation.

The surgeon must be qualified and experienced in working with Er:YAG lasers, and know how to adapt the laser settings to each client’s unique condition and skin type.

They must give the patient appropriate protective equipment, i.e. corneal shields (special protective goggles) and use ocular lubricant if necessary.

Pulsed Dye Laser Risks

Pulsed dye lasers work by targeting specific pigment molecules, so their side effects are mostly different types of pigmentation issues. They include:

  • Increased sensitivity to sunlight
  • Hyper- or hypopigmentation
  • Temporary whitening or crusting in the treated area (goes away in a couple of weeks)
  • Temporary bruising (goes away in 3-10 days)
  • Scarring (rare on the face, mostly around ankles with varicose veins)

The side effects of pulsed dye laser skin care tend to resolve themselves within a few days or weeks. The most important thing is to follow your surgeon’s aftercare instructions and skincare product recommendations.

Image source: Instagram @celibre

Alexandrite Laser Risks

Alexandrite lasers are versatile in targeting pigment cells. They can be used either on brown pigment (melanin), which dictates skin color in general, or red pigment (hemoglobin), which specifically determines skin redness in certain areas.

The possible side effects of alexandrite laser treatments are usually minor and not very intense. They include:

  • Pain during treatment
  • Redness, swelling, and itching post-treatment
  • Temporary blistering
  • Hyper- or hypopigmentation
  • Temporary bruising
  • Bacterial infection post-treatment

Pain and discomfort are easily alleviated by topical anesthetics and cooling during the treatment. Bacterial infections occur due to improper aftercare and can be treated with prescription antibiotics.

The potential redness, swelling, itching, bruising, and blistering settle on their own within a few days. They might occur if the pigment cells absorb too much laser energy, and spontaneously go away as the excess energy is released while healing.

IPL Treatment Risks

IPL (Intense Pulsed Light) isn’t technically a laser, but it does get grouped into the same skin care category. It uses short pulses of light over a broad spectrum of wavelengths. Potential risks when undergoing IPL treatment include:4
  • Excessive redness
  • Swelling
  • Blistering
  • Burns
  • Pain
  • Hyper- or hypopigmentation
  • Whitened hair in the area
  • Overstimulated hair growth
  • Crusting
  • Scarring
  • Keloid scarring
  • Infection
  • Eye damage
  • Blood clots
This list might seem intimidating, but remember that IPL is much milder than traditional laser skin resurfacing. The greatest risk is having your treatment done by an untrained or inexperienced IPL technician. Always research the facility, the service provider, their area of expertise, portfolio, and credentials. You can also read our guide on IPL photofacials for more information.

Image source: Instagram @nurse.gigi

How Can You Manage the Risks of Laser Skin Resurfacing?

There are a few steps you can take to minimize the chances of laser skin resurfacing risks in your specific case. The first is to be transparent with your doctor during consultations.

If there’s any factor that makes your chosen resurfacing treatment a bad idea, your provider might suggest an alternate procedure. This could be a different type of laser, or a different category of collagen induction skin care, such as skin microneedling or nanoneedling.

If you are prone to cold sores, your doctor will put you on a course of antiviral meds for a few days before and after your laser skin treatment. This will help prevent cold sore outbreaks and make your recovery process much easier.

Minor side effects can be mitigated with at-home strategies such as ice packs, suitable cleansers, hydrating facial care products, and wearing good SPF. Outbreaks of acne or cold sores, as well as bacterial infections, can be managed with prescribed medication.

In Conclusion

Laser skin resurfacing is a widely used procedure to improve various skin conditions, but it does carry some risks.

Different types of lasers, such as ablative CO2, fractional CO2, erbium, pulsed dye, alexandrite, and IPL have their own set of potential complications.

The three key ways to mitigate them and have a safe and successful treatment are choosing a qualified and experienced surgeon, using proper laser settings, and adhering to protective measures.

Most importantly, be open and honest in communication with your skin expert. Disclose all your medical history, and follow aftercare instructions to the letter.

If you’d like to learn more about the treatment as a whole, check out our Ultimate Guide on Laser Skin Resurfacing.

Cover image source: Freepik



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