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We recently had a patient ask us about the difference between Q-switched laser treatments and microdermabrasian for removing age spots.

Q-Switched lasers are Class IV Medical Lasers and as such can only be used by nurses or physicians. Q-switched lasers work to remove pigment in the skin (age spots, freckles, tattoos and other pigment) by differentiating between the darker pigment in the tattoo or age spot and the lighter colored surrounding skin tissue. The laser light is attracted to the darker tissue (like a black t-shirt on a sunny day) and in doing so, the heat and light energy generated by the laser is preferentially absorbed in the darker cells of the spots or tattoos. Because the freckle, age spot or tattoo absorbs most of the light energy, the tissue that contains the pigment is damaged. With all lasers, to fix a problem with the skin, we first create an injury. In this case, the injury is the destruction of the cells containing the pigment. Because of the high energies used by Q-switched lasers, the cells containing the pigment can be permanently destroyed and then replaced by healthy new cells without the tattoo, freckle or age spot pigment.

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In contrast, microdermabrasian is very different than Q-switched lasers. The first major difference is that non-medical personnel like estheticians are allowed to use microbermabrasian machines. Another major difference is that Q-switched lasers penetrate into the dermal (lower) layer of the skin (about 2/10ths – 3/10ths of an inch), whereas microdermabrasian only gets to the very outer layers of skin (about 1/100th of an inch). Because microdermabrasian can only reach the very outer layers of the skin, there is no way for it to reach the type of pigment – age spots, tattoos and freckles – discussed above. And even if microdermarbrasian could reach more deeply in the skin, the method it uses to remove imperfections is similar to sandpapering wood. It rubs the skin smooth. For wrinkles, age spots and freckles, no amount of this type of rubbing will remove the pigment. Finally, if there is pigment in the skin very near the surface, even if microdermabrasian is able to make the pigment appear less visible, this is only a temporary effect as the treatment has not destroyed the cells that contain the pigment. Q-swtiched laser can destroy these pigmented cells permanently.

Although we acknowledge that there are many cosmetic treatments that have value, we see many consumers and/or patients that have been misled in their expectations about microdermabrasian. Regardless if someone ultimately chooses lasers over microdermabrasion or vice versa – the two modalities should never be compared as Q-switched lasers will always out-perform microdermabrasion on pigmented lesions. Be an educated consumer and make certain that the person rendering your treatment clearly understands your goals and defines exactly how the chosen treatment will meet those goals.


Lori Haney, RN, MEP-C
Certified Medical Laser Safety Officer

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