Both are fractional lasers. Both treat the skin in microscopic columns. Both improve tone, texture and pigmentation, and both are chosen over ablative resurfacing when downtime matters. On paper they look interchangeable.
In practice they occupy different points on the same scale, and the difference is mostly about depth and intensity. Which one suits you depends less on the devices than on what you are treating and how much recovery you can accept.
What they have in common
Both are fractional, treating a percentage of the skin surface in a grid and leaving untreated tissue between the columns. That untouched skin drives the healing and is why either recovers faster than treating the whole surface at once.
Both prompt collagen production, so results build over weeks rather than appearing immediately. Both are delivered in courses. Both require sun protection afterwards and a patch test beforehand.
Where they differ
Depth
This is the main difference. Fraxel reaches deeper into the skin, which is why it is more often discussed for textural problems like acne scarring. LaseMD works more superficially, which suits pigmentation, dullness and early textural change.
Deeper is not better. Deeper is appropriate when the problem sits deeper, and unnecessary when it does not.
Intensity and downtime
The trade follows directly from depth. Fraxel typically involves more redness and swelling and a longer recovery, often several days of visible healing. LaseMD is usually a day or two of redness with light flaking afterwards.
Sessions
LaseMD is designed around repeated lighter treatments. Fraxel achieves more per session and correspondingly needs fewer, though both are planned as courses.
The serum step
LaseMD is delivered with an active applied through the channels opened by the laser, chosen for what is being treated. Fraxel is a resurfacing treatment without that built-in delivery component. Whether it matters depends on whether pigment or brightness is the target.
Which suits which problem?
Dullness and uneven tone. Usually LaseMD. The problem is superficial and a lighter course addresses it without unnecessary recovery.
Superficial pigmentation and sun damage. Either, with LaseMD often preferred where the pigment sits in the upper layers and the serum step adds something.
Acne scarring. Usually the deeper option, or something more intensive again. Light resurfacing does not reach the depth at which indented scarring sits, and a course of it will not fix what a deeper treatment is needed for.
Fine lines. Either, depending on how established they are.
Skin quality with no single complaint. LaseMD, most of the time. The problem is diffuse and a gentler repeated approach suits it.
What neither of them does
Neither tightens significantly lax skin, which requires treatment working at a depth resurfacing does not reach. Neither is a substitute for ablative resurfacing where the change needed is substantial. And neither addresses the underlying cause of pigmentation, so treating melasma or post-inflammatory marks without also addressing sun exposure and any active condition means treating the same thing repeatedly.
Does skin type change the choice?
Skin type is part of every laser decision and is assessed individually, at a patch test rather than from a description over the phone. Any resurfacing treatment carries some risk of pigment change, and both the device and its settings are chosen with that in mind.
This is a conversation to have at consultation, and it is one of the more important reasons for having one before booking a course.
How the decision is actually made
Not by comparing device specifications. Three things decide it in practice.
The first is what is being treated and how deep it sits, which is the single biggest factor. The second is how much downtime you can accommodate, which is a practical constraint rather than a preference and it legitimately changes the answer. The third is your skin type and how it has responded to previous treatment.
A clinic with more than one device can match the tool to the problem. A clinic with one device will recommend that device, which is worth bearing in mind when reading comparisons written by people who only own one of them.
Can they be combined?
Treatments at different depths are frequently used together across a plan, addressing different components of skin quality in sequence rather than at once. Spacing matters, since skin needs to recover fully between resurfacing treatments of any kind.
That is a clinical judgement rather than something to assemble yourself from a menu.
What to expect either way
Both need sun protection afterwards, for weeks rather than days. Both build results over the weeks following a course rather than delivering them immediately. Both require pausing retinoids and acids around treatment. And with both, the honest measure is a photograph taken before you started rather than a daily look in the mirror.
Getting the right one
The useful question is not which laser is better but which is appropriate for what your skin actually needs, and that is established by looking at it.
Pulse Light Clinic is CQC-registered and doctor-and-nurse-led, and has been treating skin in London since 2001.
Book a consultation to have your skin assessed and the right treatment matched to it.
