Ultraclear laser risks

Risks of UltraClear Laser Treatment

UltraClear is a fractional ablative fibre laser that uses a 2,910 nm mid-infrared wavelength to resurface the skin. While the device is designed to limit thermal spread and reduce the risk of certain complications compared with older ablative CO₂ lasers, all laser resurfacing procedures carry the potential for side effects and complications. These range from expected, temporary changes that are part of normal healing, through to uncommon but serious outcomes that may require further treatment.

The nature and likelihood of complications depends on a number of factors, including the treatment settings used, the area of the body being treated, your skin type, your general health, and how you heal. Risks are generally higher with more intensive treatment settings, treatment of off-face areas such as the neck and chest, and in patients with darker skin tones.

Dr Roth (MED0001185485), Specialist Otolaryngologist & Head and Neck Surgeon, will assess your suitability for treatment and discuss risks specific to your circumstances at consultation before any treatment is agreed to.

Expected Side Effects During Healing

The following changes are a normal part of the skin’s healing response following laser resurfacing. They are expected and do not indicate that something has gone wrong, though their severity will vary between individuals and between treatment sessions depending on the settings used.

• Redness (erythema): Some degree of redness is expected after all treatments. With lighter settings this may resolve within one to two days. Following more intensive treatment, redness may persist for several weeks to a few months as the skin remodels.
• Swelling (oedema): Swelling is common, particularly around the eyes and cheeks. It typically peaks within the first 24 to 72 hours and then gradually subsides. Sleeping with your head elevated can help to reduce swelling in the initial post-treatment period.
• Crusting and peeling (desquamation): As the treated skin heals, crusting and peeling are a normal part of re-epithelialisation. It is important not to pick at or forcibly remove crusted skin, as this increases the risk of scarring and pigmentation changes.
• Itching (pruritus): Itching during the healing phase is common and reflects active skin repair. Prescribed moisturisers and cool compresses can help manage this. Scratching should be avoided.
• Sensation of warmth or tightness: A feeling of heat, tightness or mild discomfort in the treated skin is normal in the days following treatment.

Pigmentation Changes

Changes to skin colour following laser treatment are among the more common complications and can affect patients of all skin types.

• Post-inflammatory hyperpigmentation (PIH): Darkening of the treated skin can occur as the skin heals, particularly in patients with Fitzpatrick skin types III to VI (medium to dark skin tones). PIH is usually temporary and fades over months with appropriate sun protection and, where indicated, topical treatments prescribed by your practitioner. In some cases it may be prolonged.
• Hypopigmentation: Lightening or loss of pigment in the treated area is a less common but more concerning complication because it can be permanent. The risk is increased with aggressive treatment settings or repeated treatments in the same area. Hypopigmentation may not be immediately apparent and can develop months after treatment.
• Demarcation lines: A visible line of colour difference between treated and untreated skin can occasionally occur, particularly when treatment is not feathered appropriately at the margins of the treatment zone.

Infection

Laser resurfacing temporarily disrupts the skin’s protective barrier, which creates a window of increased susceptibility to infection. The following types of infection can occur.

• Bacterial infection: Bacterial infections, most commonly caused by Staphylococcus aureus or Pseudomonas aeruginosa, can occur during the healing phase. Signs include increased redness, warmth, swelling, pain, and discharge beyond what would be expected as part of normal healing. Prompt medical attention is required if infection is suspected, as untreated bacterial infection can increase the risk of scarring.
• Viral reactivation — Herpes simplex virus (HSV): Laser resurfacing can trigger reactivation of the Herpes simplex virus (cold sores), even in patients who have had no prior history of cold sores. This is a well-recognised risk with all ablative laser procedures. Reactivated HSV can cause significant pain, crusting, and — if not treated promptly — scarring. Prophylactic antiviral medication is recommended for all patients undergoing ablative laser treatment and will be discussed at consultation.
• Fungal infection: Fungal infections are less common but have been reported following ablative resurfacing. They may present with an unusual pattern of healing, persistent redness or discomfort, and warrant assessment by your practitioner.

Scarring

Scarring is an uncommon but serious potential complication of laser resurfacing. The risk is increased with more intensive treatment settings, infection, picking at the healing skin, treatment of off-face areas (such as the neck, chest, and hands), sun exposure during healing, and in patients with a personal or family history of hypertrophic scarring or keloid formation.

• Hypertrophic scarring: Raised, thickened scars can develop if healing is disrupted by infection, trauma, or inadequate post-treatment care. Early treatment with topical silicone, corticosteroid injections, or other modalities may improve the appearance of hypertrophic scars.
• Atrophic scarring: Depressed scars can occasionally result from laser treatment, particularly if complications such as infection occur during healing.
• Keloid formation: Patients with a predisposition to keloid scarring are generally not suitable candidates for ablative laser resurfacing. This will be assessed at consultation.

Textural Changes

• Milia: Small white cysts (milia) can form in the treated area during healing, caused by entrapped keratin. They are usually self-resolving and can be managed by gentle cleansing. Occasionally removal by a practitioner is required.
• Skin texture irregularities: Uneven skin texture following treatment is possible, particularly if healing is complicated by infection or if post-treatment care instructions are not followed.
• Prolonged redness: In some patients, redness persists beyond the expected healing period. This is more common following intensive treatments and usually resolves over time, though the timeline varies between individuals.

Ocular (Eye) Complications

Treatment in the periorbital (around the eye) area carries a specific risk of injury to the eye. Appropriate protective eyewear will be worn throughout any treatment. Patients should not rub or touch their eyes during or immediately after treatment.

• Corneal or scleral injury: Laser energy reaching the eye can cause injury to the cornea (the front surface of the eye) or sclera (the white of the eye). Appropriate laser-rated eye shields are worn throughout treatment to prevent this.
• Ectropion: In rare cases, aggressive resurfacing of the lower eyelid area can contribute to outward turning of the lower eyelid (ectropion). This is more of a risk in patients who have had prior eyelid surgery. This will be assessed at consultation.

Other Potential Complications

• Allergic or contact dermatitis: Some patients may develop a reaction to topical agents used during or after treatment, including anaesthetic creams, moisturisers, or prescribed post-procedure preparations.
• Delayed wound healing: Patients with certain medical conditions — including poorly controlled diabetes, immunosuppression, or those taking anticoagulant medications — may experience slower or more complicated wound healing. These factors will be assessed at consultation and may affect whether treatment proceeds.
• Flare of pre-existing skin conditions: Laser treatment can occasionally trigger a flare of underlying skin conditions, including rosacea and acne. This will be discussed where relevant at consultation.
• Acne-like breakout: Some patients develop an acne-like eruption in the treated area during the healing phase, which is usually self-limiting.

Special Considerations for Off-Face Treatment

The neck, chest (décolletage), and hands have fewer pilosebaceous units (hair follicles and sebaceous glands) per unit area than the face. These structures are important for re-epithelialisation after ablative laser treatment. As a result, treatment of off-face areas carries a meaningfully higher risk of scarring, prolonged healing, and pigmentation changes compared with treatment of the face. Treatment settings in these areas are conservative by necessity, which may affect the degree of improvement achievable.

Considerations for Patients with Darker Skin Tones

Patients with Fitzpatrick skin types III to VI have a higher baseline risk of post-inflammatory hyperpigmentation and hypopigmentation following laser resurfacing. While UltraClear’s fractional delivery system is designed to reduce thermal injury to surrounding tissue, all ablative laser treatments require conservative settings in darker skin types to manage this risk. This will be discussed in detail at consultation.

What to Do If You Are Concerned After Treatment

If you notice any of the following after treatment, contact the practice promptly:

• Increasing pain, redness, swelling, or warmth beyond the first few days
• Discharge or crusting that does not correspond to normal healing
• Blistering or ulceration
• Any concern about the appearance of the healing skin

Do not attempt to self-treat complications. Early assessment and management significantly reduces the risk of lasting effects.

Making an Informed Decision

Undergoing any cosmetic procedure is a significant personal decision that should not be made hastily. The information on this page is intended to give you a thorough understanding of the risks involved so that you are able to make a genuinely informed choice. It does not cover every possible outcome and is not a substitute for a face-to-face consultation.

Dr Roth encourages all prospective patients to take as much time as they need before deciding whether to proceed with treatment, to ask questions at consultation, and to raise any concerns at any point in the process.

Return to UltraClear laser information | Contact us to arrange a consultation