How much do we wish we could actually just stop our skin from aging, or send it in reverse? Well, while we wait for those inventions, we actually have the next-best thing: skin treatments like the Halo Hybrid Fractional Laser that can remove some of the evidence of aging and trick skin into rejuvenating itself. Here, we want to explain exactly how it does that, which we think will help you decide whether you’d want to get a Halo laser treatment for your own skin.
To understand how Halo works, you probably should first understand the problems it’s designed to correct, many of which we can lump into the category of aging skin. We’ve described what happens when skin ages in this blog before, but here is a brief recap: As we age, our outer layer of skin (the epidermis) gets thinner, and the cells regenerate at a slower rate; the cells that produce collagen and elastin get less efficient; and we lose fat and hyaluronic acid in our skin, making it begin to lose volume and bounce, allowing wrinkles to form. Meanwhile, the sun’s rays and other environmental factors damage skin cells, causing sun spots (lentigines) and further depleting collagen, elastin, and hyaluronic acid.
There are some ways we can restore skin’s youthful appearance, however, using two different approaches. The first is to remove the very top layer of the epidermis, eliminating dead skin cells and allowing newer skin cells to grow at the surface. This can be done by dermaplaning, applying peels, using microdermabrasion, or ablative laser (which is one part of the Halo, as we’ll explain below).
The other approach is to go below the epidermis and cause enough small injury to the skin that the wound-healing process is triggered. This causes new cells to grow and replace sun-damaged skin cells, and it also boosts collagen production and elastin, which improves the structure of the skin. You can achieve this through microneedling or a laser that is calibrated to reach slightly deeper, as the Halo is designed to do.
A History of Laser Skin Resurfacing
To understand why we think the Halo is the best option for laser skin resurfacing, it might be helpful to understand the science behind it, and the methods that came before this advanced technology.
The word laser is actually an acronym for Light Amplification by Stimulated Emission of Radiation — and though we’re not going to review the principles of atomic physics here, it’s just helpful to know that a laser involves exciting electrons so that they emit energy in the form of photons, or light. Unlike the light from other sources, the light from a laser is one specific wavelength (color) and a tightly controlled beam. But like all other light, it can either reflect off surfaces, be scattered, or be absorbed, all depending on the light’s wavelength. When it’s absorbed, the energy from the photons turns into heat. This is all to say that the type of laser, the wavelength of the light, and the length of its pulses all determine how it interacts with skin.
In the 1980s and ‘90s, dermatologists began using continuous CO2 lasers to resurface skin. In the same way that microdermabrasion or a chemical peel destroys skin cells on the upper layer of skin, the heat from these lasers does the job by vaporizing the water in skin cells. This stimulates the generation of new skin cells, as well as the production of collagen, improving the texture and appearance of the skin. The problem is that these lasers are so strong, the heat they emit damages more skin cells than necessary. In practical terms, that means that the skin takes longer to recover from a CO2 laser resurfacing treatment, with lasting redness. This kind of treatment sometimes results in scarring and loss of pigment.
The initial solution to this issue was to develop pulsing lasers. In short, controlled pulses of light, the laser would heat smaller areas of skin, and the skin cells would have time to cool between pulses. The result is that the heat wouldn’t damage surrounding skin cells, only the ones targeted. With less damage, healing time is shorter and scarring less severe.
The early laser skin treatments were all ablative, meaning they worked by heating and vaporizing tissue on the outer layer of the epidermis. But the collagen and elastin that maintain skin structure are in the deeper layers of skin, so reaching this area with a laser has a better chance of reducing the appearance of wrinkles and sagging skin. At the right wavelength, the light from a laser isn’t absorbed and turned to heat until it reaches those deeper layers. This kind of treatment is called non-ablative, and it’s able to leave the epidermis intact while instead damaging the deeper skin tissue of the dermis to stimulate wound healing there. (This kind of targeting ability is also the advantage of using light rather than needles, blades, or chemicals.) The advantage of non-ablative treatment is that there’s no open wound that needs to heal, which reduces the risk of complications.
The disadvantage of non-ablative laser treatment is that it’s not quite as effective as an ablative laser, so you’d need more treatments to get the same desired effect.
Another crucial innovation in laser skin treatments is the development of fractional lasers. Those early CO2 lasers worked as a full-field treatment — which means they heated the entire surface to vaporize everything at once. That’s why the downtime to heal from such treatments was so long.
A fractional laser works on the principle that you don’t need to damage the entire surface of the skin to stimulate cell regeneration and wound healing. Instead, the laser targets a grid of microscopic treatment zones (MTZs), leaving the rest of the skin cells untouched. With fewer cells damaged, the undamaged skin cells help the skin heal faster, and downtime is drastically reduced. During this process cells actually even out — in other words you won’t see the grid of treated skin versus untreated skin. But because it’s not as drastic a process, multiple treatments with a fractional laser may be necessary in order to reach the same effect as a full-field treatment.
The Halo Hybrid Model
The Halo Hybrid Fractional Laser combines both ablative and non-ablative fractional lasers to get the best of both worlds. The ablative laser targets the outer epidermis and through that same targeted area the non-ablative laser reaches deeper, creating a column of affected tissues, or MTZs. It’s like removing a lid so you can treat what lies underneath it.
Instead of using CO2 like the earlier skin resurfacing lasers, the Halo uses erbium as its energy source, and nuances between the two sparks never-ending debate. The Halo allows us to control all sorts of variables to treat different kinds of issues on different kinds of skin, with minimal unintended damage. We adjust the wavelength, which affects how deeply the laser penetrates and which types of skin cells it will affect. The laser can be dialed in to change variables. One combo may be better for use on darker skin types, for example, which are more susceptible to discoloration, and another to adjust to thicker skin (this can mean adjustments in different parts of the face).
We can adjust the size and density of the MTZs, so that more or less of the skin is treated — higher density means a stronger effect but requires more time to heal. We might decide to do more than one pass over the skin during one session, or to treat it in more sessions. We can also change the length of the laser pulses, affecting the intensity of the treatment.
Humans have such a variety of skin types and skin concerns, being able to make this many micro-adjustments with a Halo laser broadens how well we can treat more patients.
What Happens to the Skin After Treatment?
You might be curious about more of the mechanics of how Halo laser skin resurfacing actually improves your skin. It’s pretty amazing stuff. First the laser hits the MTZ, vaporizing the water in the affected column. That becomes dead tissue (with the fancy name of microscopic epidermal necrotic debris, or MENDs) that rises out of the column through the stratum corneum (the outermost layer of the epidermis). Next, the undamaged cells surrounding the MTZ begin the wound healing process. After ablation, the epidermis usually heals within 24 hours. But beneath the epidermis, the skin takes a longer time to rebuild itself back, better than before. Eventually, the small wounds stimulate collagen production, making the skin actually thicker by as much as 25 percent. Skin tone also evens out, as melanin from the damaged tissue also leaves through the MTZ, and healthy cells take over.
We do recommend that patients receiving any laser treatment do so in the fall, winter, or spring instead of summer. It’s just better not to have to contend with sun sensitivity during healing.
What to Expect on the Day of Your Halo Laser Treatment
Actually, let’s start before the first day of your treatment. We would have you come in for a complete skin assessment first, because it’s important for us to discuss your desired outcome and the best way we can help you achieve it. We’ll discuss whether Halo is right for you and how many sessions you might need. This way, on the day of your treatment, we’ll know just how to calibrate the machine for your unique skin.
To tell the truth, having lasers pointed directly at your skin can hurt a little. That’s why half an hour before your Halo treatment, we cover your skin in numbing cream. This way, you might feel a bit of discomfort during the procedure, but it should be minimal. Your clinician uses a tool to measure your face to ensure even treatment, before rolling the laser handpiece over your face. The machine helps guide your clinician the entire time and it constantly adjusts the density of MTZs based on how fast they move over your skin, ensuring that you get a steady level of treatment.
When the treatment is finished, you can head straight home, where you may feel heat in your face for the first hour after the topical anesthetic wears off. For a few days, you may experience redness, swelling, and peeling, as the wound healing takes place. That’s how you know it’s working! After a couple of days your skin might appear bronze as the melanin works its way out of the MTZs and evens out. Finally, by the fifth day, you should see some amazing results, and over the following weeks your skin will keep improving.
Depending on your skin issue, we may recommend repeat treatments. Melasma, for example, usually requires two Halo sessions. For other skin issues, we wait for a couple of months, while your skin continues to improve, and then we can tell whether more sessions are necessary. We may also decide on a less-intense “mini” Halo treatment (more on that below).
Will Halo Treat My Skin Issues?
Halo Hybrid Fractional Laser treatment is effective in removing the effects of sun damage (sun spots/lentigines, melasma, lines and wrinkles), other forms of discoloration, enlarged pores, vascular changes, and scarring. Halo laser isn’t the only way to treat these skin concerns, but it is a proven and effective way to make you look your absolute best.
A “Mini” Halo
Sometimes you may not need or want a full-strength Halo Laser treatment. We offer an option we call a Radiant Skin Refresh, using the same Halo technology to improve skin texture, minimize pore size, or treat fine lines. If you’ve seen advertisements for Clear and Brilliant treatments, this is a lot similar, but we prefer to use the Halo system.
For a Radiant Skin Refresh, we set the machine to non-ablative laser treatment, with a much lower density of MTZs, and the treatment takes a shorter time. This means that the targeted damage is more superficial, but we’ve seen great results — improved overall texture, less discoloration, and brighter skin. The recovery time is as little as a day (compared to a week for the full Halo treatment), and you can even wear makeup the next day, though you might find you don’t need to. If you have a big event coming up, or want a refresh after getting a Halo a year ago, a mini Halo is an easier way to bring a lovely glow back to your face.
To find out whether a Halo or mini-Halo treatment is right for you and your skin goals, come in for an assessment soon. We can’t wait to see you!