Washington, D.C. dermatologist Tina Alster, MD has a legacy that’s hard to match. In a 1997 New York Times article, journalist Maureen Dowd famously dubbed her the “Laser Queen,” and for good reason. With over 35 years in dermatologic laser surgery, Dr. Alster has mastered treatments for nearly every known skin condition at The Washington Institute of Dermatologic Laser Surgery. She’s treated everything from complex birthmarks and stubborn scars to simple cosmetic tweaks. To say she knows her way around the best lasers for skin is a massive understatement.
We caught up with Dr. Alster at a recent dermatology meeting and asked her for advice on choosing the best lasers based on specific skin concerns. Her go-to devices, which she calls her workhorses, are tried and true. “Not everything new is better,” she says, noting that many lasers are simply “repackaged with shinier coats.” Here, she shares her top laser treatments for common issues and insider tips on making those treatments work for you.
Redness, Rosacea and Vascular Lesions
Best Laser: Pulse Dye Laser (Cynergy, Vbeam)
Why It Works: For issues like redness and vascular lesions, Dr. Alster recommends the pulse dye laser as the gold standard. “I can treat so much with [this laser],” she shares. It effectively tackles rosacea, broken capillaries and other vascular issues that can be difficult to hide. Laser treatments for redness can require multiple sessions, but the pulse dye laser has a relatively short downtime. She suggests starting slow to see how your skin responds before committing to a full treatment series.
Acne Scars and Stretch Marks
Best Laser: Fractionated Non-Ablative Laser (Fraxel)
Why It Works: Dr. Alster swears by combining the pulse dye laser with Fraxel for acne scars and stretch marks. “You can mix those two together and get really good results,” she explains, noting that the combo helps smooth skin by stimulating collagen where it’s needed most. Patience is key she says. For scar treatments, “a mix-and-match approach can help achieve the best results over time.” Give your skin time to heal and build up collagen between sessions for smoother, more even skin.
Wrinkles and Fine Lines
Best Tool: Microneedling Device (Dr. Alster uses the Collagen P.I.N.)
Why It Works: Dr. Alster is a big fan of microneedling, especially for fine lines around the mouth and large pores. “The Collagen P.I.N. device I use has 36 needles designed to go deeper than typical microneedling devices. I really get good results,” she says, as it rejuvenates the skin by encouraging collagen production. If you’re worried about lines or textural concerns, Dr. Alster says consider pairing microneedling with lasers like Fraxel for a double dose of rejuvenation. “Go easy on the treatments at first and adjust as you see what your skin needs.”
Sun Damage and Age Spots
Best Laser: Intense Pulsed Light (IPL) + Fraxel
Why It Works: For age spots and other signs of sun damage, Dr. Alster suggests IPL, especially when combined with a fractionated laser like Fraxel. “IPL is great for treating pigmentation caused by sun damage,” she explains. These treatments work on both the surface and deeper layers to reduce sun damage and even out skin tone. “Sun protection is essential,” she adds. She recommends diligent sunscreen use after IPL or Fraxel treatments since new sun exposure can reverse your results. “Think of your skin as a blank canvas—keep it protected.”
Hyperpigmentation and Melasma
Best Laser: Q-Switched Laser
Why It Works: For stubborn pigmentation, especially melasma, Dr. Alster uses a low-fluence Q-switched laser for a gentle approach. “With melasma, we need a gentler touch,” she advises, explaining that overly aggressive treatments can actually worsen pigmentation. Low-fluence lasers break up pigmentation safely, making the lasers ideal for sensitive skin. Melasma treatments require caution. She recommends avoiding the sun and heat, which can trigger flare-ups. Regular maintenance treatments may be needed to keep melasma at bay. “It’s not a one-and-done treatment as melasma.”
Tattoo Removal
Best Laser: Pico Laser
Why It Works: While she doesn’t use it every day, Dr. Alster still turns to the Pico laser for tattoo removal. “Even though tattoo removal has become more accessible, the Pico laser is still one of the best tools in skilled hands,” she says. This laser works at the right speed and wavelength to target tattoo ink without as much downtime. “Tattoo removal is a marathon, not a sprint,” she advises. “Be prepared for multiple sessions, and remember that older tattoos or certain colors may require more work.”
Dr. Alster’s Final Tips
Dr. Alster stresses that choosing the right laser—and the right provider—is critical for achieving the best outcome. Her advice? “Do your research, find a qualified provider and don’t feel rushed into anything new just because it’s trendy.”
