Ablative vs Non Ablative laser

Ablative laser treatments remove the outermost layer of the skin to stimulate collagen production and cellular renewal, and non-ablative lasers target deeper levels of the skin without disrupting the skin’s outer barrier. HALO combines both types of lasers into one treatment giving patients the best of both worlds with beneficial collagen remodeling, skin resurfacing, and pigmentation correction below the surface. 

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What are the advantages and disadvantages of HALO?

The dual-action wavelength technology in HALO means it’s one of the most common treatments at my clinic. In one treatment, patients are able to address several concerns at once, including sun damage, hyperpigmentation, fine lines, rough skin texture, mild acne scars, and general skin dullness. Many of my patients book a HALO once or twice every year to maintain a healthy glow. 
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As for what it’s not the best choice for, HALO isn’t the ideal choice for skin tightening, as there are other options including BBL Skintyte, that better target skin laxity. For deeper wrinkles, I generally recommend a more aggressive treatment, using a fully ablative laser, like Contour TRL Erbium. 

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Are there any skin types HALO isn't ideal for?

HALO is safe on most Fitzpatrick skin types but I am very cautious in darker skin patients. Patients with melasma can do a HALO for resurfacing, but generally I recommend a “clean up” MOXI treatment a couple weeks later to take care of pigment that has risen to the surface as well as concurrent oral tranexamic acid and lower energy settings. 

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Why can HALO cause swelling?

With two different wavelengths of energy being put into the skin simultaneously, HALO is more intense than purely non-ablative laser treatments, like MOXI, which causes more swelling, especially around the eyes. This happens because the skin is getting “double zapped”, disrupting the outermost skin barrier and heating targets below the surface. 

The treatment creates a strong inflammatory response, activating local immune cells and recruiting additional immune mediators to the treatment area, leading to a cytokine-driven response that helps stimulate fibroblast growth factor production and skin renewal. While this inflammation is necessary for the regenerative process, it also causes temporary swelling for a few days post-procedure.

Most patients see peak swelling at days 2-3 post-procedure. To minimize discomfort, I recommend using ice, potentially steroids and keeping the head elevated. 

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What are the potential side effects?

Side effects can vary depending on the patient and the treatment settings, but generally what most people feel immediately is heat, similar to a bad sunburn. This heat subsides in a couple hours post treatment. From there, the next step is swelling for 2-3 days, along with the appearance of coffee-ground-like spots, called MENDS (Microscopic Epidermal Necrotic Debris). These tiny brown spots last about 4-7 days as the skin sloughs off. You may also experience an “acne phase” as the baby skin is regenerating on days 7-10. After that, you should be close to fully healed from the treatment, although full benefits of the collagen remodeling take several months to see the benefits. 
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NEVER pick at flaking skin or exfoliate after a HALO treatment as that can lead to PIH (hyperpigmentation), and avoid hot showers/baths/saunas for several weeks post treatment to avoid melasma flares. 

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For personalized recommendations, schedule a consultation at SOM Aesthetics to learn how the HALO laser can revitalize your complexion.

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To learn more about the hybrid ablative/nonablative lasers, check out this study from the National Institute of Health.