Laser resurfacing treatments can help many people improve the look of their skin — but they aren’t a one-size-fits-all solution. During your consultation, your plastic surgeon can discuss your particular skin problem and help you determine the right treatment to give you the results you need.

“A light-skinned woman with many fine wrinkles and not too many jowls is a great candidate for laser resurfacing,” says Josh Korman, MD, FACS, a plastic surgeon in Mountain View, Calif. Here’s what your doctor will consider when determining if laser resurfacing is right for you:

  • Your skin tone is light enough. Traditional CO2 lasers can create problems for people with darker skin tones. “The CO2 laser basically takes all of the color out of the skin, and there is no guarantee it will come back evenly enough to mimic normal black skin,” says Lori Cherup, MD, a plastic surgeon at Radiance Plastic Surgery in Bridgeville, Pa. “The darker the skin type, more difficult it is to use lasers with safety—you might get healing response that has abnormal coloration. Eventually, it evens out, but it takes a while—even after the skin heals, it leaves a deforming coloration to the skin.” The discoloration can happen to even the fairest-skinned patients, but people with darker skin tones will be at higher risk. Your doctor will be able to assess your level of risk based on your skin tone.
  • Your problem spots are shallower in the skin. Whether you are looking to minimize acne scarring or you’re hoping to clear away warts, dark spots or wrinkles, laser resurfacing can only help if the issues are located near the surface of the skin. Deep scars or discoloration will be beyond the reach of the laser, which only works on the upper layers of the skin. “Sometimes pigment is much darker than you might think, and it’s actually very deep, so you can’t laser deep enough to get rid of it,” Cherup says. Your plastic surgeon can assess your trouble spots and let you know if the imperfections you’re hoping to address are within the reach of the laser.
  • You have specific kinds of skin issues. Lasers can make a big difference in shallow wrinkles, acne scarring and brown spots. “Diode lasers can make a lot of improvement in skin that’s sun damaged or have abnormal blood vessel formation that’s part of the skin’s response to UV damage,” says Cherup. But some skin problems, such as stretch marks or deep wrinkles, are not successfully treated with laser resurfacing.
  • The problem areas are on your face. The CO2 and fractional lasers can only be used on the face. “The face will absolutely heal, but on the arms, legs and chest, there are not enough sebaceous glands to guarantee you’re going to heal,” Cherup says. “You’ll likely burn as a result.”
  • Your skin isn’t sagging. Laser resurfacing is capable of tightening skin to some extent, but it will do little to minimize loose, sagging skin in the jowls. “You can always improve superficial wrinkles with the CO2 laser, but you can’t improve the deeper layers—that’s an architectural change in thickness and fat,” Cherup says. For the kind of tightening you need to remove jowls, a plastic surgeon will likely recommend a facelift to improve your look.
  • You don’t have an active acne flare-up. While laser resurfacing can be very effective in smoothing away scars from past acne breakouts, it’s been known to exacerbate acne flare-ups after treatment. So people who are prone to frequent acne breakouts may need to reconsider having a laser resurfacing treatment.
  • You don’t frequently get cold sores. The laser skin resurfacing can make you more prone to cold sores immediately after the procedure. If you’re a patient who is prone to getting cold sores, your doctor may prescribe anti-viral medications to take in the days leading up to your procedure, to help minimize the chances of cold sore-related complications.

If you’re interested in laser resurfacing, your doctor can help you determine if you’re a good candidate — and, alternatively, help you come up with an alternative treatment option if laser resurfacing treatment isn’t right for you.