Thulium laser: focus on this fractional laser peel to smooth skin.

The thulium laser is a technology used in dermatology to improve visible signs of aging, smooth wrinkles and enhance skin texture. It operates on the principle of fractional photothermolysis at a 1927 nm wavelength. When excited, the metallic element thulium emits light that is absorbed by water in skin cells and generates heat thus creating controlled microperforations, which in turn trigger a cellular repair process and production of collagen. Initiating collagen and elastin production makes the skin smoother and firmer. Collagen forms a network of strong fibers that supports the skin like a scaffold. Stimulating its production increases skin density and firmness. Elastin is a protein that provides skin with flexibility and elasticity.

The thulium laser is designed to treat the skin’s superficial layers—the epidermis and superficial dermis—and to reach the deeper dermis. It is considered less aggressive than ablative lasers because it leaves the skin’s surface nearly intact while reaching mid-dermal layers since this wavelength is moderately absorbed by water reducing the risk of side effects.

This peel is suitable for patients, male or female, seeking to smooth the skin of the face, upper chest, and neck. This treatment is designed to penetrate the dermis. It treats spots and irregularities caused by skin aging. Indeed, by reaching the mid-dermis, the laser targets the melanocytes and the melanin deposits responsible for hyperpigmentation by fragmenting them. It stimulates surface cell renewal, improving tone evenness.

To do this, the device emits fractional laser beams. The density and intensity of the spots are set based on the depth of scars or wrinkles to be treated. Based on vascular action, this mechanical resurfacing technique is gentle. In addition, the risk of scarring, infection or pigmentation complications is low. It acts in intervals on the skin, which means the laser does not treat the entire skin surface at once. It delivers targeted microbeams that create tiny zones of thermal impact, interspersed with areas of intact skin. For full coverage, two or three sessions are required. After treatment, the skin surface is firm, elastic, luminous, and smooth, with an even, radiant tone.

The session of peel with fractional laser lasts about one hour. An anesthetic cream is applied to the treatment area one to two hours before the procedure. This reduces heat and tingling during the session. The treatment causes skin peeling, redness, and possible swelling on the treated area. These effects typically resolve three days after the procedure. A social downtime of two to three days is generally recommended, especially to preserve skin integrity during its regeneration phase.

Observe basic guidelines for satisfactory results. After the session, expose the treated area to LED light to reduce healing time. Avoid tanning booths in the month before a laser peel. Avoid sun exposure and apply SPF 50 sunscreen.

The side effects of the fractional thulium laser are generally mild and transient, since it is a nonablative laser that operates at intermediate depth in the dermis, but they may vary based on factors such as skin phototype, individual sensitivity, and treatment intensity.

Common side effects of the thulium laser include mild, transient reactions such as erythema, redness, lasting 24 to 72 hours, a warmth or mild burning sensation after treatment, moderate swelling around the eyes and a desquamation fine peeling after 2 to 4 days. The skin may also feel tightness or temporary dryness. Other, less common side effects may occur, such as post-inflammatory hyperpigmentation seen in darker skin types or with early sun exposure, localized hypopigmentation, crusts or transient micro-craters with high settings.

In a study of 71 patients (mean age of 56 years) who underwent a single thulium laser session, it was observed that more than 50% of patients experienced tugging, swelling, sensitivity, discomfort, and a burning sensation early in the recovery period, which subsided quickly over time.

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• Split‐Face Study Using a 1,927‐nm Thulium Fiber Fractional Laser to Treat Photoaging and Melasma in Asian Skin. Dermatologic Surgery (2013).

• GERONEMUS R.G. & al. 1927-nm Fractional resurfacing of facial actinic keratoses: A promising new therapeutic option. Journal of the American Academy of Dermatology (2013).

• CULVER A. & al. Investigating the efficacy of a fractionated 1927 nm laser for diffuse dyspigmentation and actinic changes. Lasers in Surgery and Medicine (2023).

• GRECO G. & al. A Prospective Comparison of Patient Reported Outcomes After Facial Laser Resurfacing. Plastic Reconstructive Surgery (2025).