What it is
A laser is a focused beam of light delivered at a specific wavelength. Different wavelengths are absorbed by different targets in the skin — water in soft tissue, hemoglobin in blood vessels, melanin in pigment, the protein matrix of the dermis. Pick the right target and you treat the problem precisely while leaving the surrounding tissue alone.
There is no single laser that does everything. Practices that own one device tend to recommend that device. Esvie maintains a library of modalities so the answer to “which laser” can be the honest one for your skin.
The lasers offered here:
- Fractional CO₂ at 10,600 nm — ablative resurfacing for true photodamage, fine lines, and atrophic scarring. The most aggressive single-treatment option. See CO₂ Skin Resurfacing.
- Intense pulsed light (IPL) — broadband light targeting pigment and superficial vessels. Minimal downtime, multiple sessions. See Intense Pulsed Light.
- 1064 nm Nd:YAG (Laser Genesis protocol) — non-ablative dermal heating for tone, texture, redness, and pore appearance. No downtime. See Laser Genesis.
- Long-pulse hair-removal lasers — multiple wavelengths to safely treat hair across all skin types. See Laser Hair Removal.
- Infrared skin tightening — deep dermal heating for jawline and neck laxity without surgery. See Titan XL Skin Tightening.
- Vascular laser — wavelengths absorbed by hemoglobin to treat rosacea, facial vessels, and diffuse redness. See Vascular Laser.
How Dr. Brown approaches it
Laser physics is part of dermatology residency. Four years of post-graduate training is the floor — not the ceiling — for what a physician should know before delivering energy into your skin. At Esvie, every laser consult starts with a conversation about Fitzpatrick skin type, recent sun exposure, medications (isotretinoin, photosensitizing drugs), history of cold sores, history of pigmentary problems, and what kind of downtime your calendar will tolerate.
Settings — wavelength, fluence, pulse duration, spot size, cooling — are the work. The same device set conservatively for a skin type V patient is a different treatment than the same device set aggressively for a skin type II patient. Dr. Brown selects the device and the settings; she does not delegate the decision.
For most concerns, the right plan combines modalities. Pigment from sun damage may want IPL. The redness underneath may want a vascular laser. The texture may want Laser Genesis or fractional CO₂. None of these are competitors — they are tools.
What to expect
Every laser visit at Esvie begins with a consult. If you are a candidate, you receive a written plan: which device, how many sessions, what spacing, what downtime to budget, what pre- and post-care to follow.
Day-of routines vary by modality and are detailed on each treatment page. Across the board: clean skin, no makeup, no recent retinoid use unless instructed, protective eyewear during the pulse, and a clear post-care handout before you leave.
Candidacy
Almost everyone is a candidate for at least one laser modality. The question is which one.
You are not a candidate for any laser today if you have an active skin infection or herpes outbreak at the site, are pregnant or nursing, are within six to twelve months of isotretinoin therapy, have an active tan, or have recent unprotected sun exposure on the area to be treated.
Skin types IV–VI are absolutely treatable, but the menu is different. 1064 nm Nd:YAG, certain longer-wavelength hair-removal lasers, and conservative IPL or non-ablative protocols are the safer starting points. Aggressive ablative resurfacing in deeply pigmented skin carries real risk of post-inflammatory hyperpigmentation and is approached with caution, longer pre-treatment, and conservative settings — or not at all.
If you are unsure where to start, the consult is the start. Dr. Brown will tell you honestly what will help, what will not, and what you can skip.