After the Summer Sun: Matching the Laser to the Damage
By October, summer has left a record on the skin and it is easy to read: new freckles and brown patches, a rougher surface, a few more fine red vessels, and less of the clarity the skin had in spring. Most of it can be treated, but not with one device, and autumn is the season in which treatment is easiest to do well.
By October, summer has left its mark on your skin, and it is easy to see: new freckles and brown patches, a rougher feel, a few more tiny red veins, and less of the clear, even look you had in spring. Most of it can be treated, but not with one single laser, and autumn is the easiest time of year to do it properly.
Summer skin damage: the essentials
The short version
Brown spots and freckles, uneven tone, rougher texture, fine red vessels and a dull, tired surface
Brown spots and freckles, patchy colour, a rougher feel, tiny red veins and skin that looks tired.
Less ultraviolet light, less sun on healing skin, and a tan that has faded back to your true baseline
The sun is weaker, healing skin stays out of it more easily, and your tan has faded, so the laser meets your real skin.
A pigment-selective laser, or Fraxel FTX using its 1927 nm wavelength for surface pigment
A laser aimed at brown colour, or Fraxel FTX on its gentler surface setting.
VBeam, a vascular laser whose light is absorbed by the blood inside the vessel
VBeam, a laser that is taken up by the blood in the tiny vein and leaves the skin around it alone.
Fraxel FTX for gentler resurfacing, erbium or CO2 for deeper work with a longer recovery
Fraxel FTX for a gentler reset, or erbium or CO2 when more is needed, with a longer recovery.
Work back from the event: a series takes months, healing takes days to weeks, and results keep maturing afterwards
Count back from the event. A course takes months, each visit needs days or weeks to heal, and the results keep improving afterwards.
What summer actually does to skin
What summer really does to your skin
Ultraviolet exposure over a summer is a dose, and the skin answers it in three ways you can see. Melanocytes make more pigment, which appears as freckles, sun spots and darker patches. The surface thickens and roughens as it tries to protect itself. And small vessels near the surface widen or break under heat and ultraviolet light, leaving fine red lines on the cheeks, nose and chest.
Over a whole summer the sun gives your skin a dose, and the skin answers in three ways you can see. The cells that make colour produce more of it, which shows up as freckles, sun spots and darker patches. The surface thickens and turns rougher as it tries to protect itself. And tiny blood vessels near the surface widen or break in the heat and sun, leaving fine red lines on the cheeks, nose and chest.
None of this appears from nothing. Most of what shows in autumn is the accumulated record of years of exposure, brought into view by one more season, which is why a spot can seem to arrive overnight in August when it had been forming for years below the surface. The mechanism is described in Why Your Skin Has a Memory for Sunlight.
None of this comes from nowhere. Most of what you see in autumn is the built-up record of many summers, brought into view by one more season. That is why a spot can seem to arrive overnight in August when it had been forming for years under the surface. The reason is explained in Why Your Skin Has a Memory for Sunlight.
Heat and visible light add to the picture, particularly for melasma, which can darken in summer and ease a little in winter. That pattern is one reason melasma is managed rather than removed, and it is covered in Melasma Is Managed, Not Cured. A new or changing dark spot is a different matter, and it is examined before anything is treated.
Heat and visible light make things worse for some people, especially those with melasma, which can darken in summer and ease a little in winter. That is one reason melasma is managed rather than wiped out, and it is covered in Melasma Is Managed, Not Cured. A new or changing dark spot is a different matter, and it gets looked at before anything is treated.
Why autumn is the season for it
Why autumn is the season for it
Lasers that treat pigment and texture work by injuring the skin in a controlled way, and the skin then needs several weeks without much sun while it heals. In October and November that is simple. In July it is a daily struggle.
Lasers that treat colour and texture work by injuring the skin in a controlled way, and the skin then needs several weeks away from strong sun while it heals. In October and November that is easy. In July it is a daily fight.
Tanned skin is the second reason. A tan is extra melanin in the upper layers, and most pigment lasers are absorbed by melanin, so treating tanned skin makes uneven results and pigment change more likely. Recent tanning or sunburn is a standard reason to postpone treatment. By autumn the tan has faded and the skin shows its true baseline, which is what a treatment plan should be built on.
A tan is the second reason. A tan is extra colour in the top layers of skin, and most laser treatments for colour are taken up by that colour. Treating tanned skin makes patchy results and unwanted darkening more likely, so a recent tan or sunburn is a normal reason to wait. By autumn the tan has faded and the laser meets your real skin, which is what a plan should be based on.
Time is the third. Most of these treatments are a series, and pigment and collagen keep improving for weeks to months after the last session. Starting in October means the skin is at its best across the winter events, rather than only on the day of one of them. Lower autumn sun does not remove the need for protection, because UVA is present all year and passes through cloud and window glass, so sunscreen stays part of every plan.
Time is the third. Most of these treatments come as a series, and colour and firmness keep improving for weeks or months after the last visit. Starting in October means your skin looks its best through the winter events, not only on one day. The autumn sun is weaker, but it is not harmless: UVA is there all year and passes through cloud and window glass, so sunscreen stays part of every plan.
Matching the laser to the damage
Choosing the right laser for each problem
Summer damage is not one problem. It is brown pigment, red vessels, rough texture and loss of firmness, and each absorbs light differently. A laser works when its wavelength is taken up by the thing being treated and by little else around it, the principle of selective photothermolysis set out by Anderson and Parrish in 1983. The first decision is therefore which target matters most, and the device follows from that.
Summer damage is not one problem. It is brown colour, red veins, rough texture and loss of firmness, and each one takes up light in a different way. A laser works when its light is absorbed by the thing you want to treat and by very little else. Scientists described this idea in 1983, and it is why the first question is always which problem matters most. The laser follows from the answer.
| What you see | What it is | Typical approach here | What recovery is usually like |
|---|---|---|---|
| Brown spots and freckles | Concentrated pigment from sun exposure | A pigment-selective laser such as the Pico laser or the 755 nm wavelength of GentleMax Pro, or Fraxel FTX | Hours to several days of redness; treated spots can darken and flake away |
| Patchy tone and early sun damage across the face | Widespread, shallow pigment and an uneven surface | Fraxel FTX, usually a series about a month apart | Several days of redness, swelling, bronzing and flaking |
| Redness and fine vessels | Widened vessels close to the surface | VBeam | Hours to a day or two of redness and swelling; some settings leave a bruise for several days |
| Rough texture and deeper lines | A thickened, uneven surface and lost collagen | Erbium YAG or fractional CO2 resurfacing | About a week to several weeks, depending on depth; redness can last longer |
| Loosening and loss of firmness | Collagen change building over years | Thermage FLX, with RF microneedling for some texture concerns | Little or no downtime; results build over two to six months |
| What you see | What is going on | The usual laser here | What healing is like |
|---|---|---|---|
| Brown spots and freckles | Small patches of extra colour from the sun | A laser aimed at colour, such as the Pico laser or GentleMax Pro, or Fraxel FTX | A few hours to several days of redness; treated spots may darken and flake off |
| Patchy colour and early sun damage across the face | Shallow, widespread colour change and a rough surface | Fraxel FTX, usually a few visits about a month apart | Several days of redness, swelling and flaking |
| Redness and tiny veins | Small blood vessels near the surface that have widened | VBeam | Redness and swelling for a day or two; some settings leave a bruise for several days |
| Rough skin and deeper lines | A thickened, uneven surface and lost collagen | Erbium or CO2 laser resurfacing | About a week to several weeks to heal, depending on depth |
| Loosening and less firmness | Slow loss of collagen over years | Thermage FLX, sometimes with RF microneedling | Little or no downtime; results build over two to six months |
Choosing the device is a diagnostic decision before it is a technical one. Brown marks can be sun spots, melasma, pigment left by inflammation or, occasionally, something that needs a biopsy rather than a laser, so the skin is examined first and any new or changing lesion is assessed before it is treated. In this practice Dr. Gallacher carries out every laser treatment herself, so the person who makes the diagnosis is the person who sets the energy. The wider reasoning is in Why One Laser Cannot Do Everything.
Choosing the laser is a diagnosis first and a technical choice second. Brown marks can be sun spots, melasma, colour left behind by inflammation, or occasionally something that needs a biopsy and not a laser. So your skin is examined first, and any new or changing spot is checked before it is treated. At this practice Dr. Gallacher performs every laser treatment herself, so the person who makes the diagnosis is the person who sets the laser. The bigger picture is in Why One Laser Cannot Do Everything.
Some treatments suit several concerns at once. Fraxel FTX, for instance, has a 1927 nm setting that works near the surface for pigment and a 1550 nm setting that reaches deeper for texture, so a single course can address both. Others are chosen precisely because they do one thing and leave everything else alone.
Some treatments can help with more than one thing. Fraxel FTX has a gentle surface setting for colour and a deeper setting for texture, so one course can cover both. Others are chosen exactly because they do one job and leave everything else alone.
Working back from the holidays
Counting back from the holidays
The practical question is rarely which laser. It is how long before a date to begin. Work backwards from the event and allow for three things: the number of sessions, the days of visible healing after each, and the weeks over which the result matures.
The practical question is usually not which laser but how early to start. Count back from the date and allow for three things: how many visits you need, how many days of visible healing follow each one, and how many weeks the result takes to settle.
This is a rough guide, not a promise. A vascular laser such as VBeam settles in a day or two for most people, so a session can sit fairly close to an event, although settings that bruise need up to a week. Fraxel FTX leaves several days of redness and flaking and is usually a series, so beginning two months or more ahead of an important date is sensible. Erbium and CO2 resurfacing need from about a week to several weeks to heal, so they belong at the start of the window, not the end. Thermage FLX has no downtime, but its effect builds over two to six months.
This is a rough guide, not a promise. After a VBeam visit most people settle in a day or two, so it can sit fairly close to an event, although settings that bruise need up to a week. Fraxel FTX leaves several days of redness and flaking and usually comes as a series, so starting two months or more before an important date makes sense. Erbium and CO2 resurfacing need about a week to several weeks to heal, so they go at the start of your window, not the end. Thermage FLX has no downtime, but its effect builds over two to six months.
Starting in the first half of October leaves room for two or three monthly sessions before mid-December, and for the skin to calm between the last one and the party. If the date is closer than that, a shorter plan is often still possible, and being honest about what can be done in the time is part of the consultation.
Starting in the first half of October leaves room for two or three monthly visits before mid-December, and a few weeks for your skin to calm down before the party. If your date is closer, a shorter plan is often still possible, and being honest about what can be done in the time is part of the consultation.
Protecting what you have treated
Looking after the result
The same sun that caused the damage is the main threat to the result. Treated skin is more sensitive for a while, and new pigment can form quickly if it is exposed too soon.
The same sun that caused the damage is the biggest threat to the result. Treated skin is more sensitive for a while, and new colour can form quickly if it is out in the sun too soon.
The plan afterwards is dull and effective: a broad-spectrum sunscreen every morning, a hat for long days outdoors, no tanning of any kind including sunbeds, and gentle skin care while the surface heals. Flaking and crusting should not be picked, because that can leave marks the laser did not. The history of why this advice took so long to arrive is in Sunscreen Was Invented Twice.
The plan afterwards is dull but it works: a broad-spectrum sunscreen every morning, a hat for long days outdoors, no tanning of any kind including sunbeds, and gentle skin care while the surface heals. Do not pick at flaking or crusting, because that can leave marks the laser did not. The story of why this advice took so long to arrive is in Sunscreen Was Invented Twice.
None of this is a reason to avoid the sun for ever. It is a reason to treat the skin you have now as the skin you will be keeping, and to expect new brown spots to form again with new exposure. Treatment resets the picture, and protection decides how long it stays reset.
None of this means avoiding the sun for ever. It means treating the skin you have now as the skin you will be keeping, and expecting new brown spots to form again if you get new sun. Treatment resets the picture, and protection decides how long it stays reset.
Questions patients ask
Can I have a laser treatment if I still have a tan?
Can I have a laser treatment if I still have a tan?
Usually not until the tan has faded. A tan is extra pigment that competes with the laser’s target, and recent tanning or sunburn is a standard reason to postpone. The skin is assessed at the consultation, and a short wait often gives a better and safer result.
Usually not until it has faded. A tan is extra colour that gets in the way of the laser, so a recent tan or sunburn is a normal reason to wait. Your skin is checked at the consultation, and a short wait often gives a better and safer result.
How far ahead of an event should I start?
How early should I start before an event?
It depends on the treatment. Fractional lasers such as Fraxel FTX are usually a series about a month apart, so two months or more is sensible. Deeper resurfacing needs about a week to several weeks to heal. Redness lasers and Thermage FLX need little or no downtime but still take time to show their effect. The plan is set at the consultation.
It depends on the treatment. Fraxel FTX is usually a series of visits about a month apart, so two months or more is sensible. Deeper resurfacing needs about a week to several weeks to heal. Redness lasers and Thermage FLX need little or no downtime, but they still take time to show their effect. The plan is set at your consultation.
Will treated brown spots come back?
Will the brown spots come back after treatment?
A treated spot can clear, but the skin that made it is still sun-sensitive, and new spots form with new exposure. Daily sunscreen and sensible sun habits decide how long the result lasts. Melasma behaves differently and tends to recur, which is why it needs ongoing care.
A treated spot can clear, but your skin is still sensitive to the sun, and new spots form if you get new sun. Daily sunscreen and sensible sun habits decide how long the result lasts. Melasma is different and tends to come back, which is why it needs ongoing care.
Are these lasers safe for darker skin?
Are these lasers safe for darker skin?
They can be, when the wavelength and settings are chosen for the skin being treated. The margin for error is smaller in darker skin because inflammation more readily leaves pigment behind, so the device, energy and cooling are individual decisions and some treatments are avoided. Suitability is assessed at the consultation.
They can be, when the laser and settings are chosen for your skin. There is less room for error in darker skin, because inflammation is more likely to leave dark marks behind. So the device, the energy and the cooling are chosen for you, and some treatments are avoided. Whether a treatment suits you is decided at the consultation.
Do I have to treat everything at once?
Do I have to treat everything at once?
No. Most people have two or three concerns, and the usual approach is to treat the one that bothers them most first and then reassess. Some treatments can be combined in a plan, but the order and the spacing are chosen to protect the skin, not to fit as much as possible into one visit.
No. Most people have two or three concerns, and the usual way is to treat the one that bothers you most first and then look again. Some treatments can be combined in a plan, but the order and the gaps between them are chosen to protect your skin, not to cram as much as possible into one visit.
- Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220(4596):524-527. Source
- Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426-438. Source
Where to go next
Talk it through with a physician first.
Every plan starts with an assessment of your skin, your anatomy and what you actually want to change.
This page is general health information, not medical advice. It cannot tell you whether a treatment is right for you. Approved uses, risks and results differ from person to person, and product labelling changes. Ask us at Dermatology and Laser Centre about your own situation, or make an appointment, and seek urgent care for any serious symptom.
