How It Reduces Redness and Visible Vessels
When comparing ablative vs non-ablative laser skin resurfacing, the main difference is how each treatment interacts with the skin. Ablative treatments remove targeted areas of the skin’s surface while delivering thermal energy into deeper layers. Non-ablative treatments heat tissue beneath the surface without intentionally removing the epidermis. Fractional Plasma offers another approach, using radiofrequency rather than laser energy to create controlled fractional micro-injuries.
Choosing between them depends on several factors, including the concern being treated, its depth, the patient’s skin type and skin tone, and how much recovery time fits their lifestyle.
How Laser Skin Resurfacing Works
Laser skin resurfacing works by creating controlled areas of injury in the skin, triggering the body’s natural wound-healing response and subsequent collagen remodeling.
The depth and type of that controlled injury vary according to the technology.
The epidermis forms the outermost layer of skin, while the dermis lies underneath and contains structural components including collagen and elastin. Resurfacing treatments can target the epidermis, dermis or both, depending on the technology, wavelength and treatment parameters used.
Fractional laser treatment changes this process further. Instead of treating the entire surface uniformly, fractional delivery creates microscopic treatment zones surrounded by areas of untreated tissue. These untreated areas can support the healing process while the treated skin undergoes renewal and remodeling.
This fractional approach allows clinicians to tailor a treatment plan according to the concern being addressed and the balance between treatment intensity and expected recovery.
Ablative vs Non-Ablative Laser Skin Resurfacing
Understanding ablative vs non-ablative laser skin resurfacing starts with one question: is tissue being intentionally removed, or is thermal energy being delivered while leaving the surface intact?
Ablative laser resurfacing
Ablative lasers remove targeted skin tissue while creating a controlled thermal effect. CO2 lasers, including fractional CO2, and erbium lasers are commonly associated with this category.
With fractional CO2 laser skin resurfacing, microscopic columns of tissue are vaporized while surrounding tissue is left untreated. The resulting wound-healing response can stimulate collagen remodeling.
Ablative laser treatments are used across indications including wrinkles, acne scars, textural irregularities and signs of sun damage. Treatment intensity and recovery time can vary substantially according to the protocol, settings and treated area.
Non-ablative laser resurfacing
Non-ablative laser treatment delivers thermal energy below the skin’s surface without intentionally ablating the epidermis.
For example, a non-ablative 1570 nm laser creates controlled microthermal zones in the dermis while leaving the epidermis intact. This thermal effect can stimulate a wound-healing response and collagen remodeling.
Non-ablative approaches can be used to address concerns including fine lines and skin texture. Because the surface is not intentionally removed, they can offer an option for patients and clinicians looking to balance visible improvement with recovery considerations.
The appropriate number of sessions and expected recovery depend on the indication, technology and treatment protocol rather than a single standard schedule.
A hybrid approach
Alma Hybrid brings ablative and non-ablative laser technologies together within one platform.
Alma Hybrid incorporates a 10,600 nm CO2 ablative laser and a non-ablative 1570 nm fiber laser. Through HyGrid technology, the two laser beams are delivered side by side, allowing practitioners to customize the ratio of ablative and non-ablative energy within a matrix of micro-dots.
This gives clinicians greater flexibility to adjust the treatment according to indication, skin characteristics and recovery considerations rather than choosing exclusively between an ablative or non-ablative approach.
Where Fractional Plasma Fits
Fractional Plasma is a skin resurfacing technology that uses radiofrequency energy, not laser energy, to create controlled fractional micro-injuries in the skin.
Alma’s Opus Plasma uses proprietary fractional plasma RF technology to both ablate and heat the skin. Fractional delivery treats targeted areas while leaving surrounding tissue untreated, supporting a controlled approach to skin resurfacing.
This places Fractional Plasma in a different technological category from both ablative and non-ablative lasers. Rather than relying on a laser wavelength, radiofrequency energy generates plasma at the skin surface to produce a controlled ablative and thermal effect.
Opus Plasma is a Fractional Plasma technology developed for the skin resurfacing market. Treatment parameters can be customized according to the area and indication, allowing practitioners to adjust the desired ablation and thermal effects.
| Ablative laser | Non-ablative laser | Fractional Plasma | |
| How it works | Removes targeted tissue and delivers thermal energy | Heats deeper tissue without intentionally ablating the surface | Uses RF energy to create fractional plasma, producing controlled ablation and heating |
| May be considered for | Wrinkles, acne scars, texture and sun damage | Fine lines, texture and patients seeking a non-ablative approach | Skin resurfacing, wrinkles, texture and acne scars |
| Recovery | Depends on treatment depth, settings and protocol | Protocol-dependent and generally designed around preserving the epidermis | Designed to offer resurfacing with flexible treatment intensity |
| Alma technology | CO2 / Alma Hybrid | 1570 nm / Alma Hybrid | Opus Plasma |
Choosing the Right Option for Each Patient
The right skin resurfacing treatment depends on the indication, its severity, skin type, skin tone, previous treatments and the patient’s expectations around recovery.
There is no single resurfacing technology that is automatically right for every patient.
| Patient consideration | Options a clinician may consider |
| More pronounced wrinkles or textural concerns | Fractional ablative treatment or a customized Alma Hybrid protocol |
| Fine lines and skin texture | Non-ablative fractional laser or Fractional Plasma |
| Acne scars | Fractional CO2, Alma Hybrid or Fractional Plasma depending on scar type and clinical assessment |
| Recovery time is a key concern | A less intensive fractional approach, non-ablative treatment or customized Opus Plasma protocol |
| Darker skin tone | Careful technology and parameter selection based on Fitzpatrick skin type, indication and clinical guidance |
| Recent tan or significant recent sun exposure | Assessment before treatment and, where appropriate, delaying treatment |
Skin type deserves particular attention. Melanin-rich skin can be more susceptible to pigmentary changes such as post-inflammatory hyperpigmentation following some energy-based procedures. This does not mean that resurfacing is automatically excluded, but technology selection, treatment parameters, patient history and pre- and post-treatment care all matter.
With Alma Hybrid, clinicians can adjust the ablative-to-non-ablative ratio through HyGrid rather than working with a fixed combination. Opus Plasma provides a separate radiofrequency-based resurfacing option, expanding the range of technologies that can be considered within an individualized treatment plan.
Recovery, Side Effects and Sun Exposure
Recovery after laser skin resurfacing varies according to the technology, treatment intensity, area treated and individual patient.
Temporary redness, swelling, sensitivity and flaking may occur in the treated area. More intensive ablative laser treatments generally involve a more substantial healing process than treatments that preserve more of the epidermis, although recovery cannot be reduced to a universal number of days.
Sun exposure is another important consideration. Patients should follow their clinician’s instructions around SPF, sun avoidance and post-treatment skincare, as newly treated skin may be particularly sensitive during recovery.
A More Flexible Approach to Skin Resurfacing
Ablative and non-ablative laser skin resurfacing each offer distinct ways to create controlled skin renewal. Alma Hybrid brings both approaches together through customizable HyGrid technology, while Opus Plasma adds Fractional Plasma as a radiofrequency-based resurfacing option.
Together, these technologies give clinicians more ways to build an individualized treatment plan around the patient, the indication and the appropriate balance between treatment intensity and recovery.
Explore Alma Hybrid and Opus Plasma to learn more about Alma’s approach to customizable skin resurfacing.
Dr. Dean Berman, Global VP Medical, Alma LTD