The charts below show the chances of developing various side effects from non-ablative fractional laser treatment.1-5 For some side effects, we currently do not have enough data to provide a percentage.
| SHORT TERM Swelling (edema) | up to 100% |
| SHORT TERM Pain | up to 100% |
| SHORT TERM Redness (erythema) | up to 100% |
| SHORT TERM Purplish spots on the skin (purpura) | up to 80% |
| SHORT TERM Crusting | up to 68% |
| SHORT TERM Dryness | up to 60% |
| SHORT TERM Skin darkening (hypopigmentation) | up to 50% |
| LONG TERM Discrete redness (erythema)* | up to 47% |
| LONG TERM Skin darkening (hyperpigmentation) | up to 35% |
| SHORT TERM Heat sensation | up to 20% |
| LONG TERM Visible grid pattern | up to 18% |
| SHORT TERM Flaking | up to 16% |
*Discrete redness (erythema): “Discrete redness” refers to red areas on the skin that are well-defined or clearly separated from the surrounding skin. This type of redness is more localized and can be seen as distinct spots or patches.
Possible/Rare Side Effects
| SHORT TERM Skin tightening | up to 10% |
| SHORT TERM Blistering | up to 5% |
Studies:
Five studies have looked at the side effects of treatment with non-ablative fractional lasers.
- Study 1:
- Authors: Guertler et al.1
- Total # of patients: 16
- # of female patients: 15
- # of male patients: 1
- Age of patients: 18-36
- Laser type: Non-ablative fractional Er:Glass laser
- Laser settings: Energy up to 70 mJ/μbeam; beam density: up to 500 μbeams/cm2
- Duration of treatment and follow-up: 3 treatments, follow-up after 1 and 6 months
- Side effects:
- Redness (erythema): 100%
- Swelling (edema): 100%
- Mild-to-moderate pain: 100%
- Crusting: 68%
- Skin darkening (post-inflammatory hyperpigmentation): 50%
- Study 2:
- Authors: Jang et al.2
- Total # of patients: 21
- # of female patients: 15
- # of male patients: 6
- Age of patients: Average: 44.3
- Laser type: Non-ablative fractional 1,550 nm Er:Glass;
- Laser settings: 100-150 mJ, 120-150 spots/cm2 density
- Duration of treatment and follow-up: 4 treatments, follow-up for 1 month
- Side effects:
- No side effects reported
- Study 3:
- Authors: Guertler et al.3
- Total # of patients: 16
- # of female patients: 16
- # of male patients: 0
- Age of patients: 18-44
- Laser type: Erbium-doped fiber laser
- Laser settings: 150-300 μbeams/cm2, 40-50 mJ
- Duration of treatment and follow-up: 3 treatments, follow-up for 6 months
- Side effects:
- Swelling (edema): 100%
- Redness (erythema): 100%
- Moderate pain: 57%
- Study 4:
- Authors: Toudorf et al.4
- Total # of patients: 20
- # of female patients: 11
- # of male patients: 9
- Age of patients: 24-46
- Laser type: 1,540 nm fractional Erbium:Glass laser
- Laser settings: 70 mJ/microbeam and 15 ms pulse durations
- Duration of treatment and follow-up: 3 treatments, follow-up for 1, 3, and 6 months
- Side effects:
- Redness (erythema) after the treatment: up to 100%
- Swelling (edema) after the treatment: up to 95%
- Purplish spots and patches on the skin (purpura) after the treatment: up to 80%
- Redness 24h after the treatment: up to 100%
- Dryness 24h after the treatment: up to 60%
- Long-term discrete erythema: 47%
- Swelling 24h after the treatment: up to 40%
- Long-term skin darkening (hyperpigmentation): 35%
- Heat sensation 24h after the treatment: up to 20%
- Long-term visible grid pattern: 18%
- Flaking 24h after the treatment: 16%
- Blistering 24h after the treatment: up to 5%
- Study 5:
- Authors: Wang et al.5
- Total # of patients: 30
- # of female patients: 24
- # of male patients: 6
- Age of patients: 21-33
- Laser type: Non-ablative fractional 1440-nm laser
- Laser settings: 390 μm depth, 4.5% coverage, energy of 9 mJ
- Duration of treatment and follow-up: 3 treatments, follow-up for 3 months
- Side effects:
- Heat sensation: (percentage not reported)
- Pain: (percentage not reported)
- Redness (erythema): (percentage not reported)
- Skin tightening: 10%
- Skin dryness: 3.33%
Study 1: In a study published in 2017 in the journal Lasers in Medicine Science, Guertler and colleagues treated 16 patients with hypertrophic scars with a non-ablative fractional laser. Patients received 3 treatments at 1-month intervals and were followed up for 6 months after treatment to discuss side effects. Redness and swelling were reported in all patients immediately after the treatment, while 68% of patients developed crusts, which resolved in 5 days. Half of the patients experienced hyperpigmentation that lasted 7 days on average.1
Study 2: In a study published in 2016 in the journal Archives of Plastic Surgery, Jang and colleagues treated 21 patients with hypertrophic scarring with a non-ablative fractional laser. Patients received 4 treatments in 4-week intervals and were followed up for 1 month. No side effects were reported in the study.2
Study 3: In a study published in 2018 in the Journal of the European Academy of Dermatology and Venereology, Guertler and colleagues treated 16 patients with hypertrophic scars with a non-ablative fractional laser. Patients received 3 treatments at 4-week intervals and were followed up for 6 months. Authors reported swelling and redness in all patients and moderate pain in 57% of treated patients.3
Study 4: In a study published in 2014 in the journal Lasers in Surgery and Medicine, Toudorf and colleagues treated 20 patients with hypertrophic scars with a non-ablative fractional laser. Patients received 3 treatments at 4- to 6-week intervals and were followed up for 1, 3, and 6 months. Authors reported side effects during the treatment, 24h after the treatment, and side effects seen at the 6-month follow-up. All side effects are summarized below:4
| During the treatment | Redness (erythema) after the treatment: 90% to 100% Swelling (edema) after the treatment: 85% to 95% Purplish spots and patches on the skin (purpura) after the treatment: 50% to 80% |
| 24h after the treatment | Redness: 95% to 100% Dryness: 53% to 60% Swelling: 26% to 40% Heat sensations: 15% to 20% Flaking: 15% to 16% Blistering: 0% to 5% |
| 6-months follow-up | Discrete erythema: 47% Skin darkening (hyperpigmentation): 35% Visible grid pattern: 18% |
Note: This study reported side effects in ranges and it is unknown why this was done.
Study 5: In a study published in 2021 in the journal Lasers in Medical Science, Wang and colleagues treated 30 patients with hypertrophic scars with a non-ablative fractional laser. Patients received 3 treatments at 4-week intervals and were followed up for 3 months. No severe side effects were observed. The heat sensation, pain, and post-treatment redness were observed in most patients but the exact percentage was not reported. Three patients (10%) felt skin tightening and one patient (3.33%) reported dryness.5
References
- Guertler A, Reinholz M, Poetschke J, Steckmeier S, Schwaiger H, Gauglitz GG. Objective evaluation of the efficacy of a non-ablative fractional 1565 nm laser for the treatment of deliberate self-harm scars. Lasers Med Sci. 33(2), 241-50 (2018).
- Jang JU, Kim SY, Yoon ES, Kim WK, Park SH, Lee BI, Kim DW. Comparison of the Effectiveness of Ablative and Non-Ablative Fractional Laser Treatments for Early Stage Thyroidectomy Scars. Arch Plast Surg. 43(6), 575-81 (2016).
- Guertler A, Reinholz M, Steckmeier S, Gauglitz GG. Evaluation of a non-ablative, fractional 1565 nm laser for the improvement of striae distensae albae. J Eur Acad Dermatol Venereol. 33(1), 220-6 (2019).
- Taudorf EH, Danielsen PL, Paulsen IF, Togsverd-Bo K, Dierickx C, Paasch U, Haedersdal M. Non-ablative fractional laser provides long-term improvement of mature burn scars–a randomized controlled trial with histological assessment. Lasers Surg Med. 47(2), 141-7 (2015).
- Wang B, Deng YX, Yan S, Xie HF, Li J, Jian D. Efficacy of non-ablative fractional 1440-nm laser therapy for treatment of facial acne scars in patients with rosacea: a prospective, interventional study. Lasers Med Sci. 36(3), 649-55 (2021).