In this episode of The Beauty Equation Podcast, Dr. Christelle Oliver-Dussault, Dr. Harpreet Lotay, and Amanda Manholt take a closer look at the belief that lasers can instantly fix aging skin. They explain how laser and light-based treatments actually work, including the difference between ablative and non-ablative options, and why collagen stimulation takes time. The hosts discuss realistic expectations, recovery considerations, and the importance of skin type and provider expertise—particularly for patients with pigmentation concerns. Through practical examples and clear education, they highlight how lasers can deliver meaningful results when used thoughtfully as part of a personalized, long-term aesthetic plan.

Disclaimer: The Beauty Equation is for informational purposes only and not medical advice. This podcast does not create a doctor–patient relationship. Always consult a qualified healthcare provider before making medical or aesthetic decisions. Information may change as the field evolves.

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About the Hosts:

Dr. Harpreet Lotay is a family physician specializing in aesthetic medicine. She is the founder of Sona MD in Kamloops, BC, and serves as Chief Medical Officer at Bios Wellness Clinics. Known for her artistic approach and comprehensive non-surgical treatments, Dr. Lotay combines medical expertise with an eye for natural results. She is also an educator, a national trainer and holds academic appointments where she shares her knowledge in clinical dermatology and aesthetics. You can get in touch with her on Instagram @hlotaymd

Dr. Christelle Oliver-Dussault is a family physician specializing in aesthetic medicine, women’s health, and psycho-education. She brings a holistic, whole-person perspective to her clinical work, blending science with a deep understanding of the mind-body connection.

She is also the founder of Reclaim The Pink Within, a movement that empowers women to rediscover themselves during life’s most transformative stages. In addition, she is passionate about medical education and mentors the next generation of family physicians through her work with the department of Family Medicine at the University of British Columbia.

You can connect with her on Instagram @drchristellemd

Amanda Manholt is a clinic manager, patient consultant, and co-host of The Beauty Equation Podcast. With over 30 years of experience in beauty, aesthetics, and leadership, she has guided patients and teams alike toward confidence, growth, and empowerment. Known for her ability to connect with people and simplify the often-overwhelming world of aesthetics, Amanda brings a warm, practical, and relatable perspective to every conversation. You can find her on Instagram @crowsfeetandconfidence.

Websites

https://sonamd.ca/

https://www.getyourpinkbackproject.com/

You might go out to the lake one week, a couple

days in that week, and be quite tanned, and then

go for a few days where you have lots of work. You don't get out

to the lake, and your tan fades a little bit. So your

baseline melanin is unpredictable.

So when you go in to see your laser tech, sometimes it's very

difficult to tell what laser setting should be used,

and also if the settings that were used last

time are gonna work this time. And so it's hard to give you an aggressive

enough treatment in the summer months safely to get you the

results you want. So in our clinic, we do choose to shut down

our lasers in the summer. So then in the winter, we know you've got

generally baseline color that's not gonna vary too much. It

allows us to kind of tune in our settings and be as aggressive as

we want. Welcome back to the beauty equation. I'm Dr. Christel

Oliver Dusseau. I'm Dr. Harpriet Lotte.

And I'm Amanda Manhole. So today we're going to

shift gears and talk about lasers,

something that I think scares a lot of people and a

field that I actually don't know that much about. And to kick it off,

I'm going to get Harpreet to share a story of how

she first encountered lasers and how

that spurred her on to learn more about their

use and their safety. So I'll let you take it away for sure. I

mean, lasers are such an integral part of our

aesthetic toolbox, but they are a bit of a

mystery box. You know, a lot of people think they're a

magic wand. You know, something that will magically

make something disappear or instantly correct

issues, and they don't really understand the intricacies of it.

And to be frank, when I first started learning

about lasers or got into aesthetics, I didn't know much about

them either and didn't understand how

they interacted with tissue and specifically didn't have

a great understanding about how lasers will

treat melanated skin differently

than less melanated skin. So the amount of pigment

in your skin will actually determine much

of the effect of the lasers. And so

when I started doing Botox and getting interested in aesthetic medicine,

I was with an oculoplastic surgeon in his office.

Botox was a new thing. It was very exciting. They

just come out with fillers. And then this new device

called IPL was on the market, and it was this magic

box that would amazingly clear pigment

and take away reds, and it could even reduce hair.

And I Was working with a technician

who was very, very fair skinned and

very adept at using the laser. But neither of us

understood the intricacies of it. And one evening, as we do in

aesthetics, we're like, oh, I want to try that. And I'm like, I want to

try that. I have this one little brown spot by my cheek.

Let's do my entire face. And so away we go.

And she put in a filter for this flash lamp that really

should be used for Scandinavian skin. And away we went.

Yes, Amanda, this would have been a great treatment for you.

I'm sorry that I missed it. Yeah, well, this

was a while ago. This would have been about 24 years ago. So

she, you know, fired up the IPL machine,

which is not a true laser. And we're gonna fire up the. Fire up

the almost laser. IPLs are not quite

lasers, and we'll get into that. But she fired this up

stuck in a filter that would have been perfect for her skin type and

fired away. And I'm a bit of a stoic, and I've never had this treatment

done. I don't know if it's supposed to hurt or not. And it was

spicy, let's just put it that way. And, you know, we're

done the treatment. And she's like, oh, you look a bit red. There's

a few squares. Oh, they're getting a bit welty.

Essentially, I burnt my face,

ladies. Burnt it. Squares all over my face,

scabbed over and across my forehead.

The entire forehead was burned. And I had to. I actually

wore a head like a scarf across my forehead while this

healed up, because it was essentially like a second degree

burn. Wow. Did you scar from it at all?

So it took a good year for the scars to

somewhat fade. And I will share with you that even

to this day that I have a few very light

squares that in the summer will become a little bit more

pigmented than the other areas. So I've seen them.

Yeah, I've seen them in the summer because I was like, wait a minute.

Oh, there they are. It's fair. Like, it's very light,

but if you look for it, you can still see it. Yeah.

So light based treatments can be extremely powerful.

And with that experience, you know, having seen how well it

had worked for my friend, who was a different skin type to me,

and then experiencing how devastating this can be to

somebody because, you know, then you're kind of trying to cover it up

with makeup and whatnot and, you know, having to use

topical creams, et cetera. You Know, it really made me

determined to learn a lot more about the technology and how to

use these powerful instruments very safely.

So that's really what spurred my interest into this, this

whole field of energy. Nice.

Yeah. I feel like my understanding is still very

basic because again, it's not something

that you're exposed to. And I even know, like, I have colleagues who are,

you know, dermatologically trained and they wouldn't necessarily even

have the laser training. It's some dermatologists will even go on to do a

subspecialty like a fellowship training in lasers.

So where I'm at, and I'd say probably a lot of people would understand this

degree, is that lasers are essentially. A light based device.

And if you look at the color spectrum on lights, different

wavelengths will, you know, pick up different colors, so

reds for vascular lesions and maybe

browns for brown spots. But if there isn't that contrast, particularly

for more pigmented skin, you need quite a different approach or much more

precise beam. And so

when you were learning about it, what did you find helpful?

To, I suppose, learn the

subtle differences, because IPLs, I think, are that

magic one where it covers quite a lot, but it's not very specific.

And with that, you can have a lot of sort of adverse events in the

wrong patient. Yeah, absolutely. And more

importantly, in the wrong hands. Yes, yeah, yes,

exactly. Exactly. And then, you know, your expectations have

to match too. So there's a lot of misconceptions about lasers. Like

I mentioned, it's sort of thought of as a magic wand. So

oftentimes patients also think that it's a one and done treatment, and that's

not often the case. So, you know,

lasers are, I like to say in some cases

it's like a fancy scalpel. So depending on the

target that the laser is focused on, it can use to cut

the skin. And then depending on how

you tune the energy up or down or the strength

of it, it can be something that warms the skin.

And if you're using a particular wavelength, you know,

it will blow up certain chromophores we want to

call parts of the skin. Right. So pigment cells, for

example, or pigment bits in your skin often act like a

magnet for certain colors of laser. I like to

explain to people that a laser, if you look at the whole

rainbow, there are those colors, like you mentioned, each of those

colors vibrate at a different frequency and

that's what creates that color. And so when you learn

about lasers, you learn about wavelength. So you'll hear people

talk about a 4:50 wavelength or

a 550 or 600 or 755 or

1064. And those numbers relate to how fast

that vibration of the energy is. And it correlates to

a color, and it correlates to

what it's magnetically attracted to. So if you have a

green laser, it'll be attracted to the complement, which is

red, which is blood. So which is gonna be very good

for treating blood vessels or rosace.

And then if you have a higher wavelength, like a

1064 or a 10000

Hz wavelength, like a

CO2, that will be attracted to water in our

skin. And those lasers act like almost like

scalpels, and they create heat and heat shock proteins, and

they're delivering this controlled sort of injury

to the skin that your skin will heal from. So

in my case, what happened is that we used a wavelength that

was too short and that doesn't penetrate

very deep. So Interestingly, the number

400 to 1064 also correlates to how

deep that energy will penetrate the skin. And our

pigment cells live close to the surface of our skin. And so

those shorter wavelengths will actually hit those pigment

cells. Sometimes by accident, the heat will affect them and you'll get

burning. So that's what happened to me.

So, yeah, it's a tool like any other.

It's not a magic wand, and it's

extremely effective. Now,

I had an issue, but that didn't stop me from getting other

lasers done. I've had multiple halos, which is perfect for my skin

type. And in fact, lasers were one of the solutions for the

injury that I suffered. So I don't want people to be scared of them. They're

actually extremely, extremely useful. I

think it's fair to say, though, that if someone is interested

in having a treatment, a laser treatment on their skin because they're

bothered by broken capillaries, hyperpigmentation,

you know, the typical brown spots, or they're looking at improving the

texture. It is probably the

most important thing to make sure that whoever they're seeking treatment

with has a lot of experience and

thinks critically. I know we've talked all the time,

frequently about ipl, bbl, so intense pulse

light or broadband light, being

so dependent on whoever is delivering the treatment.

And, you know, I think it's kind of scary because if I,

if I understand correctly, it. It's not that if you can get your

hands on a laser, you can hang a shingle and, and say you're open

for business. Where we live, I don't know that there

it's kind of the wild west in terms of,

you know, what's out there. So kind of buyer beware.

I still love it. Yeah. Experience is everything.

Your point about regulation is right on point.

So let's just touch on ipl, for

example. It's kind of the difference between having

a shotgun, which is

what an IPL is, versus a

very precise sniper weapon. Let's just call it that

way. Right. That's a really good analogy. Yeah.

And this shotgun you don't need a license for

in Canada. You can just get it.

And I've heard of instances where people have bought an IPL

and then have been treating people in their home.

And it's a very, very powerful

machine. And so if you imagine that shotgun,

you can put filters in front of the shot buckshot so that you can

focus the, you know, the target a

little bit. But if you use the wrong filter on the wrong person, you're going

to end up shooting the wrong thing in their sk, whether it be

pigment or, you know, get too much heat.

And so you do want to

really be sure that the person you're seeing is a professional and they

can handle, you know, adverse outcomes too. So they

know what to do if your skin doesn't respond like they expect.

Yeah. And I think the difference between

a, you know, a good practitioner and a really great

practitioner is being able

to gauge that response in the skin and know that, you

know, you know, those base settings, they're there, they're typically safe as

long as you fit the skin type parameters.

But, you know, on the other side of that is if they can push it

a little bit. Wow. Like, some of the results are just

mind blowing. So it's that sort of sweet spot between

they need to be cautious and responsible. But

sometimes when it's appropriate, they can amp it up a little bit

and get some pretty amazing results.

Yeah. Just, it's like trying to drive a Ferrari, right?

Yeah. You want an experienced driver. So we've

talked a little bit about light based treatments, which again, we

were. You know, people tend to use the term laser, even though

technically, if we want to nerd out, they're not lasers, they're light based treatments.

Let's talk a little bit about the other kinds of treatments. Treatments that truly are

lasers. So things that are slightly

or completely ablative.

Yeah. When we use the word ablative, that means

destruction, tissue destruction in a controlled way. That means

that the top layer of the skin is going to be affected and

sloughed off or sandpapered off. Okay.

When we're talking about non ablative, it means that the energy is

delivered below the skin. Remember I said that the wavelengths

determine where the energy energy is delivered. So

the longer wavelengths, you can actually just deliver the energy down

deep. And if you tune it up high power, the heat will actually

affect the top of the skin and you'll drill a little hole.

And those ablative lasers can be fully ablative, which

is like take sandpaper, rub it across the skin and

you're really rubbing a layer of skin off. Or

it can be like aerating your skin, which would be

what we call fractional lasers and

fractionally ablative. So these are all terms that we use especially

for resurfacing lasers. And when I use that word, I mean

things that you're doing to help with fine lines and wrinkles

and usually create collagen at the same time.

So along with your topical

skincare, lasers are a great tool to

really stimulate your skin to create more collagen. That's

essentially what we're doing, but we're doing it more rapidly and a little

bit more assertively in a controlled way.

I think it's another, or I think another good point

to mention is the seasonality that comes

with lasers and why in some

parts of the world, people will be doing, you know, IPLs,

BBLs, you know, halos of these sort of things. Maybe year

round where we live, we tend to shy

away from that and we, you know, tend to do these

treatments in the, the cooler months and when there's less

sunshine. I mean, right now I feel like I haven't seen the sunshine and

I don't know when. Yeah, as we approach the

winter equinox. I know, I can't wait for it to start

getting longer days. I tell you. Yeah, you go to work in the

dark and you come home in the dark. It's the, you know what it is.

It's laser season in Canada, folks. Folks. Yeah, fire em

up, folks. That's true. So why is there

seasonality in the northern hemisphere or places where we have four

seasons? I like to explain it this way.

The melanocytes or the pigment producing cells are very,

very sensitive to laser. And

when we're in the summer, we're stimulating our skin

with sun exposure to create pigment. And those

melanocytes are like little minions. They get kind of

hyperactive and they start spitting out pigment in

a very unpredictable way. And you might

go out to the lake one week, a couple days

in that week and be quite tanned

and then go for a few days where you have lots of Work, you don't

get out to the lake and your tan fades a little bit. So

your baseline melanin is unpredictable.

So when you go in to see your laser tech, sometimes it's

very difficult to tell what laser setting should be used.

And also the settings that were used last time are gonna

work this time. And so it's hard to give you an aggressive enough

treatment in the summer months safely to get you the results

you want. So in our clinic, we do choose to shut down our

lasers in the summer so that in the winter we know you've got

generally baseline color that's not gonna vary too much. It

us to kind of tune in our settings and be as aggressive as we want.

We also know that skin that has been lasered is very

sensitive to light. So if you have laser done

and your skin is recovering, you've got all this metabolic

activity of skin cell production, and your

melanocytes are a little bit more irritable as well. And then you go

out into the sun, you get unpredictable results there

as well. And you will get bronzing and you will get

hyperpigmentation that can be

temporary. There are some places, like in

California and where the sun is fairly consistent.

And in those places, every season is laser season,

because most people have a very consistent sun

exposure. Yeah, I'm moving to San Diego. Yeah, I know,

right? It would be great. If

someone does want to get a laser treatment done,

what would be the best way for them to prepare

for their treatment? Well, like so many

aesthetic treatments, I think that people have to remember that

it's your skin doing all the work. And again,

people think it's magic and the laser is doing all the work. And

the truth is, it's not. All it's doing is stimulating your skin.

So if you have a collagen

inducing, resurfacing type laser, it's almost

like aerating your lawn. You're drilling holes

into the skin and you're delivering some energy and you're

stimulating a response. And if we follow that

logic, the healthier your skin is, the better the response will

be to that stimulus. So one of the best things that you can

do before you have laser is start yourself on a really good

medical skincare regime. If you

are highly melanated, like myself, and you

tend to hyperpigment, you might want to start

on something that decreases the hyperactivity of your

little melanocyte minions. Some people will pre

treat with hydroquinone or something like

Kojic acid if they're not interested in

hydroquinone. Containing creams. And

those are some things that you can do. And of course your baseline

health is going to impact your skin's recovery. So sleeping

well, drinking water, eating well,

all those boring things that we wish pills could fix.

Right, of course. Or a milkshake. And then what about

aftercare in terms of recovery? Particularly

if we're focusing on those fractionally ablative lasers that

will have a bit more, more downtime. How can patients

care for their skin? So if we're

talking about very ablative lasers,

you really want to be gentle with your skin. So you're

going to stop all of your retinol containing skincare,

all of that harsh skin care and you'll know that you've had an

ablative laser because you'll have scabbing and it will be open

skin. So those types of lasers can take up to a

month to heal from. But to be honest, we do very few of those now.

There's very few patients that need that type of aggressive laser.

And in fact people have told me when I mention laser,

especially those patients that are in their late 50s or 60s, they're like, oh,

I don't want laser because my friend had it and her skin

looked sort of plasticky or something afterwards. Those

results we used to see in old

timey, old fashioned type of lasers which were fully ablative

and sometimes they'd go too deep. We don't do those kinds of

lasers very often anymore. We tend to do

fractionated ablative lasers and those are

much easier to recover from. One of the lasers that

falls into that category would be halo laser

and that's about a 10 day downtime total

from treatment to really nice glowy

skin. And again, the care for that is

gonna be very gentle skin care, especially for the first three or four.

Then you can gradually bring back some less

active skincare into the regimen and then going on

to seven to 10 days, you can reintroduce most things,

maybe hold back on the retinol for about another week to

three weeks. And that's going to depend on your skin's sensitivity

and how used to retinol it was before you had the

laser. And then sunscreen

always sounds, but that's, that's just a given. But we'll talk about it every single

time we talk to you. Yes, I think one last

thing to maybe mention briefly is discomfort, because that

is a question I get a lot in consult, like, well, does it

hurt? And you know the word we like to use is

spicy. Yeah, well, I love

bbl. I am like the Poster child for bbl because I'm, you

know, Fitzpatrick one Scandinavian skin prone

to redness, broken capillaries.

And I hate having it done.

And I love the results. It's. To me, it feels like an elastic.

It's like snap, snap, snap the whole time. Because of course, we don't numb for

that one. No, it's more annoying, I think

is. Is. And it's the flash. You know, we have. There'll be

eye shields on, but it's still quite, quite bright. It's just sort of a little

jarring. But yeah, truth be told, as soon as, you know,

the foot's off the pedal, there's nothing, you know, you look a bit red that

when I look like a tomato when I leave, but by the next day I'm

fine. And then the other treatments like

that we do in our clinic would be the halo, which

to be honest, a BBL halo combo is like chef's kiss.

It is my favorite for people that are looking

to do a general refresh. They've got sun damage. They, you know,

they. Oh, it's so good. We just did.

Had some really amazing results and I'm really hopeful that

that woman will give permission to share the before and afters because even

the improvement in those, like the, the lines here, these sort of

lines that. Accordion lines on the. Accordion lines.

Yeah, under the cheek, between, you know, below the cheek and

yeah. You know, away from the mouth. They were so greatly improved.

And so for a treatment like that, you know, the. For the halo

portion, we will apply a topical lidocaine for an hour prior.

So it makes it more comfortable. I don't

know. You. You guys have both done halo, right? I have. Have you

done one, Christelle? No.

So I have a lot. I had LASMA with my pregnancies, so I'm

currently doing the hydroquinone. So the pre treating was

talking about to get rid of the last little bits of

hyperpigmentation before I schedule the

halo. And I'm also prone to hyperpigmentation, so I might look like

I'm semi fair right now, but I have kind of. I would say

type 3, 4. I will

tan very easily. I hyperpigment and I have

melasma. So one of those that

sometimes are the ones that I think will run into trouble

because you won't necessarily think that when you're going into a place to get say

like an IPL and then you'll end up with that hyperpigmentation. So

I suppose I have a sort of laser story in the sense that When I

was getting laser hair removal, I had a lot of. I had a bit of

a mustache. I ended up with hyperpigmentation

on my upper lip afterwards, which took a very long time to go

away. And even though I did it in the winter months,

wore my sunscreen, this was well over a decade ago,

I still ended up with a bit of hyperpigmentation, which got worse when I was

pregnant, because that's hormonally driven. But.

Yeah, so hydroquinone. I'll let you guys know maybe in a few

months time once I have. Oh, let's do it. Let's do it. But this, all

this brings my point home about who is doing this treatment,

because if you go somewhere to have a laser treatment,

you best be getting lots of questions asked of you. Yes,

yes. It is so very important that they ask you things

like, how do your. Your skin respond when you get a mosquito bite?

Are you prone, you know, do you know your

ethnic heritage? Because you can have somebody with dark

skin, maybe you have one grandparent that had very

highly melanated skin, and you don't maybe look like you're that

dark. But. But I tell you, can. It can bite you.

So I think it's important to

go to a provider that you feel is asking all of the right questions.

Yeah, and I had this done in my early 20s. I wasn't asking the questions

either. I didn't really know what I was doing. I just wanted to get rid

of the hair. And. And that's the thing. You shouldn't have to

know to ask the questions. Right. So let's just circle

back to Fitzpatrick types, because we've

mentioned it a few times, but many of our listeners might not know what that

is. So the Fitzpatrick classification

is a way to classify

skin based on its tendencies to take on color,

and it classifies it on the way it heals

and expected healing in response to energy,

let's just say. And so if you can imagine

somebody with blue eyes, very light hair, and

very pale skin, that would be a type one

Amanda. And then you might have someone with

light hair, slightly darker eyes.

They tend to tan, but it's still a bit

hard to tan. They don't hyperpigment. They might be a

type 2. And then type 3 would be darker hair,

darker eyes. They take on color reasonably

easily. They will burn sometimes, and they may

or may not hyperpigment in response to a bug bite

or a cut or something like that. And then

type four would be, you know, typical

Latin or Mediterranean skin types,

some Asian Skin types. Right. French,

French Canadian, that sort of olive, Eastern European.

Yes. All of these skin tones. Then

going up to five, which would be some African

skin tones depending on the region, and some

South Asian, Indian skin

types. And then six is your darkest dark.

And you know, one other fallacy that I think a

myth, I would say, or belief that people have is that

darker skin types are somehow tougher.

And it's the exact opposite. Right?

It's the exact opposite. So the type

1 skin type, you can do almost anything to it and get away with

it. It's the toughest. Trust me. We've done a lot of it to me.

And then your type 6 skin types, you know,

rub it the wrong way or throw too much energy at it, it

will hyperpigment. It's extremely delicate sen

to different topical medications even,

you know, I've seen hyperpigmentation in response to

going too high on retinols too fast. So they, they really

are a more delicate skin type for sure. And I think

we think that it's stronger, more protective because you think, oh, they're really good

at making melanin. Melanin and protecting themselves from the

sun. But almost they, they get too good at it. So it doesn't take

much for them to make that. And that's why you run into troubles.

Yes. I always thought it was wild that, you

know, when we look at my skin and we look at your skin, for example,

that the number of melanocytes, so the little

cells that produce melanin or pigment

can be very similar in numbers. It's just

mine are like Garfield. They're snoozing.

They're, they don't, they don't party. They're very, they

just don't make as. As much pigment. Yes. Yeah. And, and

you know, somebody that has a darker skin, you know, they've, they're ready to boogie

down. And then there's, you know, that's a whole other podcast. But I mean there's

different types of melanin. Right. And I, I don't have a

lot of the type that protects my skin. Yes.

So. Oh gosh, we're at 32

minutes. Yes. So, yeah, so

when there's so much. But I think this is really, really good.

There's just so many subtleties and different types of light based and laser

treatments. But I think it's very good introduction to

understand how useful it is, but how harmful it can also be

in the wrong hands. Yeah. So know where you're going,

know what you're trying to improve. Right. Is.

And, and I think sometimes people want to say, oh, well, it's all, it's

everything. I want invisible pores and I don't want any color and I don't want

this and I don't want that. And I think it's about

learning to assess someone and sort of think, okay, what would

be the most impactful improvement for this person? Is it the

right time of year? So sometimes we have to sort of go, okay, yeah, I

mean, BBL Halo would be oh, bomb. But it's July, so what can

we do now to sort of get them ready for that next step?

It's, that's, it's a lot of fun, you know, coming up

with the right treatment plan. It is. And a

takeaway for people out there who are looking for

lasers. To your point, Amanda, have a sense of what you want to improve.

First, know that every laser is not going to treat every problem.

Know that it might be more than one session and if it is

more than one session, maybe that's a good thing because that's probably

not going to be a heavy handed laser that has a

lot of downtime. So sometimes choosing more sessions

is a better choice. And when you're going in

there, your provider should be asking you many more

questions than maybe you are asking them.

Yeah. Yes, exactly. So on that

note, if you have questions on today's

episode or you would like us to go in more detail depth into one area,

or you've had a treatment and you want feedback, get

in touch with us and we will try to cover it in future

episodes. And please remember to like and

subscribe to our podcast. Absolutely.

Until next time. Bye for now. Bye for now.