What Is PDL?
Before diving in, let's quickly classify the two main types of lasers: ablative and non-ablative. "A fractionated ablative laser vaporizes small columns of skin from the exterior in, so all skin layers are effected," said Dr. Herrmann. "Non-ablative lasers and energy-based devices target deeper structures and spare the skin's surface." An ablative laser is the more "intense" of the two (think: Fraxel) and requires a lot more downtime in order to heal, as well as specific ointments.
PDL is a non-ablative laser.
So how does PDL work? "The laser light targets hemoglobin, a protein which is in red blood cells," Dr. Herrmann said. "It heats it up, and this heat collaterally damages the blood vessel walls surrounding it, which causes them to collapse and disappear. Because we have so many extra vessels in the skin, removing a few doesn't have any negative health consequence."
Does PDL Hurt?
I have a pretty high pain tolerance and have subjected my skin to many a non-surgical procedure (ablative lasers, fillers, Botox, and the like), and to me this laser is not painful. When going in for PDL, you likely won't need to get numbed — each zap of the laser feels like a little snap of a rubber band.
The most annoying part of the process, in my opinion, is the cold burst of air that the machine spurts out to offset the heat from the laser. I wouldn't say the whole thing is particularly painful — rather it takes you by surprise every time it fires. Plus, it only takes about five minutes depending on how many vessels you need to take care of.
What You Can Expect For Downtime
Full transparency: the photos above are from my second round of getting PDL. The first time I got the treatment, Dr. Herrmann used a lower setting on the laser, which unfortunately didn't do the trick. So the second time, she used a higher setting, which did leave me a bit red immediately after and gave me some small red bruises that faded over about a week. This is normal, according to Dr. Herrmann.
"Vessels may also turn darker purple and fade over a couple of weeks," she said. "If redness is stubborn, sometimes we purposefully use higher energy to create small bruises, which usually is more effective at reducing redness." She also noted that you should be careful to only get a laser treatment from a qualified MD or laser specialist, as it can cause skin burns or scars if not performed correctly.
Dr. Herrmann also said, "Sometimes one treatment effectively zaps capillaries, but often a series is needed to knock down more diffuse redness, especially in the setting of rosacea. Redness may also return slowly over time, so future treatments may be recommended."
What Is the Aftercare of PDL Treatments?
Since PDL targets the deeper layers of skin instead of the surface, you can pretty much return to your normal skin-care routine. That said, go gentle! Stick to moisturising instead of active ingredients for about a week or until any redness subsides. Dr. Herrmann reminds us that sun protection should always be worn after laser treatments and can be applied immediately after treatment.
Is There Anyone Who Shouldn't Get PDL?
Like many laser treatments, people with darker skin tones may not be a good candidate. "Very dark skin has a higher chance of sustaining burns, so we typically avoid treatments in these cases," said Dr. Herrmann. Make sure to talk to your dermatologist about your options if you have more melanated skin.