Treatments You May Not Know About

Laser and related technologies have advanced far beyond basic applications. Today’s sophisticated treatments can address the following:

1. Redness and Blood Vessels Associated with Rosacea

Rosacea affects over 16 million Americans, causing persistent redness, visible blood vessels, and sometimes bumps that resemble acne. If you have been relying solely on topical treatments or oral medications, you might be missing out on one of the most effective approaches available.

How Lasers Can Help

The comprehensive vascular laser collection includes state-of-the-art technologies like Vbeam® Pro; Excel-V®, Clear-V®, and BBL devices that precisely target the dilated blood vessels and telangiectases (spider veins) that cause rosacea’s characteristic redness. These advanced treatments work by delivering specific wavelengths of light that are absorbed by the hemoglobin in blood vessels, causing them to collapse and be naturally reabsorbed by the body. Each system offers unique benefits and can be precisely calibrated to your skin tone and condition severity, ensuring safe, effective treatment with minimal downtime and discomfort.

What You Can Expect

• Visible improvement after the first session
• 1-5 treatments are typically needed for optimal results
• Minimal downtime with possible mild swelling for 24-48 hours
• Long-lasting results

Treatment Approach

Lasers and related devices are typically used in combination with one another to achieve optimal results. Doctors Geronemus and Hashemi may recommend combining different laser technologies based on your specific presentation of symptoms associated with rosacea.

2. Port Wine Birthmarks: Early Intervention Makes All the Difference

Why Timing Matters

Port wine birthmarks affect about 3 in 1,000 children and tend to darken and thicken over time if left untreated. Many parents do not realize that laser treatment can be remarkably effective—especially when started early with the techniques developed by Dr. Geronemus. 

The Science Behind Treatment

Port wine stains consist of dilated capillaries near the skin’s surface that create the characteristic red or purple discoloration. Laser treatment works by delivering specific wavelengths of light that are readily absorbed by the hemoglobin in these abnormal blood vessels. This targeted energy heats the blood, causing the vessel walls to coagulate and collapse. Over time, the body naturally reabsorbs these damaged vessels, gradually lightening the birthmark.

The laser’s precision allows it to selectively target the abnormal capillaries while leaving surrounding healthy tissue largely unaffected. Multiple treatment sessions are typically required because not all vessels can be effectively treated in a single session, and new capillaries may develop over time.

In infants, the capillaries are smaller and closer to the skin surface, making them more responsive to laser energy. Early treatment during infancy typically produces better outcomes than treatment begun later in childhood or adulthood.

Advanced Treatment Options

For thicker port wine stains, combination therapy using AVAVATM Miria laser or radiofrequency with microneedling provides enhanced results. This innovative approach targets deeper vascular lesions more effectively by pairing the precision of laser or RF energy with the collagen-stimulating benefits of microneedling.

Treatment Considerations

• Safe for all ages, including newborns
• Faster results when treatment begins early
• Typically requires multiple sessions
• Can prevent psychological distress later in childhood

Dr. Geronemus’ pioneering research has demonstrated that starting treatment in infancy leads to the best long-term outcomes, making early consultation crucial.

3. Acne Scarring: More Effective Than You Think

The Reality of Acne Scars

Acne scars can persist long after breakouts have cleared, affecting both skin texture and confidence. While they will not disappear overnight, laser treatments can achieve significant improvement that many people do not realize is possible.

How Different Lasers Target Different Scars

Not all acne scars respond the same way to treatment:

For Deep Scars (Ice Pick and Boxcar): Advanced fractional lasers create microscopic channels within depressed scars, stimulating bottom-up collagen production. Fractional CO2 and Erbium lasers gradually lift deep scars by rebuilding from within, while Sciton® ProFractional® uses customizable energy settings to precisely target scar tissue at various depths. Fractional Erbium Lasers break up dense scar tissue while promoting structural repair. These treatments require more downtime (about 7 days) but deliver dramatic results for severe scarring.

For Moderate Scarring: Non-ablative lasers target less severe damage with minimal downtime. Fraxel® Dual creates precise micro-wounds that prompt targeted collagen production, effectively smoothing shallow boxcar and rolling scars. AVAVA Miria delivers gentle, deep energy penetration to promote fresh collagen growth while improving red discoloration. Recovery time is typically 1-7 days with excellent texture improvement and minimal discomfort.  Dr. Geronemus has developed techniques utilizing combination therapy with various devices in the same treatment session.

Realistic Expectations

• Improvement in texture and appearance
• Multiple sessions are usually required
• Results are typically permanent due to collagen remodeling
• Best outcomes are often achieved with combination therapy developed by Dr. Geronemus

4. The Challenge with Pigmentation

Whether you are dealing with sun spots, melasma, or post-inflammatory hyperpigmentation, topical treatments often provide limited results. Laser treatments can target pigmented lesions with the precision that topical treatments cannot achieve.

How Lasers Address Pigmentation

Different wavelengths target different types of pigmentation:

For Surface Pigmentation: Lasers like LaseMD Ultra, Fraxel Dual, and our three picosecond lasers target melanin in the upper skin layers, breaking up pigmented cells that are then naturally shed by the body.

For Deeper Pigmentation: Q-Switched and Picosecond lasers can reach deeper pigmentation (Nevus of Ota, traumatic tattoos, and some birthmarks), promoting cellular turnover and revealing clearer skin underneath.

What Makes Laser Treatment Superior

• Precise targeting of pigmented areas
• Minimal impact on surrounding healthy skin
• Can treat areas that are difficult to reach with topical products
• Often more effective than chemical peels for stubborn pigmentation

Important Considerations: Darker skin tones require specialized laser settings and careful treatment planning to avoid complications.

5. Aging Skin

While good skincare is essential, topical products can only do so much for deeper signs of aging, like fine lines, wrinkles, and loss of skin firmness. Laser treatments work from within to actually remodel your skin’s structure.

How Lasers Turn Back the Clock

Fractional Resurfacing: Fractional CO2 and Sciton ProFractional create controlled micro-injuries that stimulate your body’s natural healing response, producing new collagen and elastin. This leads to firmer, smoother skin with improved texture and tone.

Non-Ablative Treatments: Fraxel Dual and AVAVA Miria heat the deeper layers of skin without damaging the surface, promoting collagen production with minimal downtime.

Combination Approaches: Many patients benefit from combining different laser types—for example, using fractional CO2 for deeper resurfacing alongside gentler lasers like AVAVA Miria for maintenance.

The Aging Issues Lasers Address

• Fine lines and wrinkles
• Loss of skin firmness and elasticity
• Uneven skin tone and texture
• Large pores
• Sun damage and age spots
• Broken blood vessels
• Festoons

Timeline for Results: While you may see some immediate improvement, the best results develop over 3-6 months as new collagen forms.

What You Need to Know Before Treatment

The Consultation Process

Every effective laser treatment begins with a thorough consultation. Dr. Geronemus or Dr. Hashemi will assess your skin type, the specific issues you want to address, and your goals to recommend the most appropriate laser technology and treatment plan.

Key Questions to Ask

• Which laser technology is best for my specific skin type and concerns?
• How many treatments will I need, and what is the timeline?
• What are the potential risks for my skin type?
• What does the recovery process look like?
• How can I optimize my results?

Preparing for Treatment

• Avoid sun exposure for several weeks before treatment
• Follow any specific pre-treatment instructions

Managing Expectations

While laser and related technology treatments can achieve remarkable results, it is important to have realistic expectations. Many times, multiple sessions are required, and results develop gradually as your skin heals and regenerates. The investment in professional laser treatment often provides results that far exceed what is possible with at-home or over-the-counter alternatives.

Why Expertise Matters

The Technology is Only as Good as the Person Using It

Advanced laser systems require extensive training and experience to use safely and effectively. Dr. Geronemus has pioneered most of the laser technologies and treatment protocols used today, while Dr. Hashemi brings Harvard-trained expertise and dual fellowship training in laser/cosmetic dermatology, bringing decades of combined expertise to every treatment.

What Sets Expert Treatment Apart

• All treatments performed by Dr. Geronemus and/or Dr. Hashemi
• Precise laser selection for your specific needs
• Customized treatment parameters for your skin type
• Comprehensive aftercare planning
• Access to the most advanced laser technologies

Schedule Your Consultation

If you have been struggling with any of these skin concerns, laser treatment might offer the solution you have been looking for. The key is working with experienced specialists who can evaluate your specific situation and recommend the most appropriate treatment approach.

Ready to discover what laser technology can do for your skin? Call our office today at 212.663.0400 to schedule a consultation with Dr. Geronemus or Dr. Hashemi.