Aesthetic Applications of Laser and Light-Based Energy Devices
Wilhelmina Lam, Alexandra DeVries, Aysham Chaudry, Alec Lawson, Mark S. NestorLaser and light-based energy devices have become integral to modern dermatologic practice, offering versatile, minimally invasive solutions for both clinical and aesthetic indications. This narrative review synthesizes current evidence on laser and light technologies, focusing on skin resurfacing, vascular and pigmented lesions, scar modulation, and adjunctive therapeutic roles. Foundational principles such as selective photothermolysis have evolved into advanced modalities, including fractional, nonablative, picosecond, and hybrid systems, enabling improved efficacy with reduced downtime and enhanced safety across diverse skin phototypes. While ablative lasers, particularly CO 2 and Er:YAG, remain the gold standard for advanced photoaging and scar remodeling, nonablative and fractional devices offer comparable outcomes with improved tolerability. Vascular-specific lasers, such as the pulsed dye laser and Nd:YAG, demonstrate high efficacy in treating superficial and deep vascular lesions. Pigment-targeting technologies, including Q-switched and picosecond lasers, provide effective treatment for dyschromia and tattoo removal, with emerging evidence favoring picosecond platforms for improved safety and patient comfort. Multimodal approaches, including combination laser therapies, integration with radiofrequency, microneedling, platelet-rich plasma, and laser-assisted drug delivery, enhance clinical outcomes by targeting multiple tissue layers and pathophysiologic processes. Careful patient selection, parameter optimization, and attention to phototype-specific risks remain critical for minimizing complications such as postinflammatory hyperpigmentation. Advances in laser engineering and combination strategies continue to expand therapeutic capabilities. An individualized, evidence-based approach incorporating these technologies is essential for optimizing outcomes in dermatologic practice.