Lasers and Energy-Based Devices for Skin Health: Scientific Evidence and Clinical Applications – by Dr Anjali Mahto, London Dermatologist
Modern energy-based skin treatments, including lasers, intense pulsed light (IPL) and ultrasound devices, are increasingly understood not as beauty interventions but as medical tools that actively remodel skin structure. These technologies deliver controlled thermal or mechanical energy into the dermis, stimulating the skin’s intrinsic repair mechanisms. Through micro-injury and heat stress at precise depths, they activate fibroblasts, encouraging new collagen and elastin production while even altering gene expression patterns associated with ageing.
Scientific studies support these effects. Broadband Light (BBL) therapy has been shown to stimulate the formation of collagen and elastin while reducing pigmentation and vascular irregularities. One landmark study found that a series of BBL treatments reset the expression of over 1,200 genes in photoaged skin to resemble the patterns of youthful skin. Rather than relying on surface treatments, modern energy-based interventions use the skin’s own biology to rebuild strength, resilience, and vibrancy.
How Skin Ages Structurally
To appreciate the role of these treatments, it is important to understand the biological changes that underpin visible ageing. In young skin, a dense network of type I collagen and elastic fibres maintains firmness, elasticity and smoothness. Fibroblasts are abundant and active, continuously synthesising extracellular matrix components.
With age and cumulative environmental exposure, this architecture deteriorates. Fibroblasts detach from the matrix and produce fewer structural proteins while releasing higher levels of matrix metalloproteinases (MMPs), enzymes that degrade existing collagen. Elastic fibres become fragmented, and the dermis thins. The skin becomes less able to withstand mechanical forces, leading to fine lines, wrinkles, and loss of elasticity. These changes are compounded by impaired cellular signalling pathways, further tipping the balance toward matrix degradation.
The net result is skin that is thinner, weaker, and less resilient. Restoring collagen and elastin production is therefore not merely a cosmetic goal but a biological imperative for maintaining skin health.
The Evolution of Lasers and Energy Devices
Early laser devices focused on fully ablative resurfacing. Technologies such as the CO₂ laser and Er:YAG laser removed the entire epidermis, dramatically improving wrinkles and texture but at the cost of long recovery periods and higher complication risks.
Over the past two decades, fractional approaches have emerged. Fractional ablative lasers create microscopic zones of vaporisation, leaving surrounding tissue intact and significantly accelerating healing. Non-ablative fractional lasers, in contrast, heat dermal water without removing epidermal layers, stimulating collagen production with minimal surface injury.
Hybrid systems, such as Sciton’s HALO, combine both ablative and non-ablative wavelengths in a single treatment, targeting multiple layers of skin simultaneously. Broadband light (BBL) systems extend these principles into filtered IPL technology, offering multi-chromophore targeting with minimal downtime. In parallel, ultrasound-based devices like Sofwave provide non-invasive collagen stimulation through mechanical energy rather than light.
These advancements have expanded treatment options, allowing for tailored interventions that address individual skin needs while reducing risks and recovery times.
Key Technologies: How They Work
Sofwave (High-Intensity Ultrasound)
Sofwave uses parallel beams of high-frequency ultrasound energy focused approximately 1.5 millimetres into the dermis. This creates thermal injury zones that denature collagen and trigger a controlled healing response. Fibroblasts are activated to synthesise new collagen and elastin, leading to gradual skin tightening and improved elasticity over several months.
Clinical studies have shown that Sofwave treatments produce significant improvements in facial laxity, particularly around nasolabial folds and the lower face. Most patients experience visible lifting within three to four months, with minimal downtime and excellent safety across a range of skin types.
HALO (Hybrid Fractional Laser)
The HALO laser delivers both ablative 2940 nm Erbium:YAG energy and non-ablative 1470 nm infrared energy in a single pass. This dual-wavelength approach removes microscopic columns of aged epidermis while heating the adjacent dermis to stimulate collagen production.
In clinical studies, two HALO treatments produced visible improvements in photodamage, texture, and pigmentation in over 80 percent of patients. The procedure requires a short recovery period, typically involving three to five days of redness and peeling, and yields progressive dermal remodelling over months.
BBL (BroadBand Light)
BroadBand Light (BBL) uses a broad spectrum of filtered light to target melanin, haemoglobin, and water, treating pigmentation irregularities, vascular lesions, and textural changes. In addition to these visible improvements, BBL induces dermal heating that stimulates fibroblast activity and collagen synthesis.
Histological studies confirm increased collagen density after BBL treatments, and gene expression profiling has shown that BBL can partially reverse molecular signatures of ageing in treated skin. Maintenance treatments are often recommended once or twice per year to preserve results.
UltraClear (Cold Fibre 2910 nm Laser)
UltraClear uses a 2910 nm wavelength delivered through a flexible fibre optic to achieve precise fractional ablation of the epidermis and superficial dermis. The system’s intelligent pulsing balances ablation and coagulation, allowing for controlled injury that stimulates deep collagen remodelling while minimising downtime.
Clinical studies have demonstrated significant improvements in acne scarring and photodamage with minimal side effects. UltraClear treatments promote new collagen formation and dermal thickening while reducing pigment irregularities and fine lines.
ClearSilk (1064nm Non-Ablative Laser)
ClearSilk operates at 1064 nm, delivering non-ablative thermal energy to the mid-dermis. This gentle heating stimulates fibroblast activity without causing epidermal disruption, making it ideal for maintenance treatments and for patients seeking subtle skin rejuvenation with no downtime.
Clinical research on 1064 nm lasers has shown improvements in fine lines, texture, and early photodamage after a series of treatments, typically spaced one month apart. ClearSilk offers a maintenance pathway for patients committed to long-term skin health.
Biological Mechanisms of Repair
Energy-based devices leverage the skin’s innate wound-healing pathways. By delivering controlled injury to targeted layers, they initiate an inflammatory response that clears damaged matrix components and recruits fibroblasts to sites of repair. Fibroblasts then produce new extracellular matrix proteins, including types I and III collagen and elastin fibres, restoring dermal density and resilience. Growth factors such as TGF-β are upregulated, promoting matrix synthesis, while transient activation of matrix metalloproteinases clears fragmented proteins, paving the way for organised tissue rebuilding.
Studies confirm that fractional laser treatments and ultrasound therapies significantly increase collagen gene expression and stimulate organised deposition of new fibrillar networks over a period of three to six months post-treatment. Molecular profiling of treated skin also shows normalisation of gene expression patterns associated with ageing and photodamage.
Realistic Patient Expectations
Energy-based skin rejuvenation requires a realistic understanding of process and outcomes. Structural remodelling is gradual, unfolding over months rather than days. While initial improvements in tone or pigmentation may be visible within weeks, the deeper benefits of collagen thickening, elastic fibre repair, and dermal strengthening continue to develop over three to six months.
Most patients require a series of treatments to achieve optimal results. For example, Sofwave typically involves one to two sessions, HALO often requires two sessions, and BBL protocols generally recommend an initial series of three sessions followed by maintenance treatments.
Downtime varies by modality. Non-ablative treatments such as Sofwave and ClearSilk have minimal recovery, with only transient redness or swelling. Fractional ablative lasers like UltraClear and HALO involve short periods of redness, scaling, and mild discomfort but offer more dramatic structural improvements.
It is critical to emphasise that maintenance is necessary. Collagen degradation is an ongoing process driven by intrinsic ageing and environmental exposures. Even after successful initial treatments, regular reinforcement through maintenance sessions preserves and extends results.
The Future of Skin Health
The future of skin health is moving towards increasingly personalised, combination therapies. Advances in imaging, including VISIA and 3D scanning, allow for objective assessment of skin structure and damage, guiding tailored interventions.
Laser-assisted drug delivery represents another frontier, with fractional ablation creating microchannels for topical agents to penetrate the dermis more effectively. Innovations in pulse duration, energy modulation, and synergistic device pairing will further refine the ability to trigger controlled, therapeutic regeneration without unnecessary damage.
The paradigm is shifting decisively away from superficial cosmetic correction toward a deeper, evidence-based understanding of structural skin preservation and repair.
Conclusion
Energy-based skin therapies are not cosmetic luxuries. They are biologically grounded interventions designed to stimulate the body’s intrinsic ability to regenerate and rebuild. Technologies such as Sofwave, HALO, BBL, UltraClear, and ClearSilk operate at the molecular level, reversing key features of structural ageing, restoring collagen and elastin networks, and improving the skin’s overall function and appearance.
At Self London, consultations are structured around objective diagnosis, personalised planning, and evidence-led intervention strategies designed to support your skin’s structure and vitality at every stage.
