Issue link: https://www.ascpskindeepdigital.com/i/1539961
74 ASCP Skin Deep Autumn 2025 According to Howard, "Laser use is regulated by state, and in most states, Class III and IV devices require oversight from a licensed medical provider and formal training." Practitioners must understand laser physics, skin typing, and comprehensive safety protocols before offering any laser services. Some states require specific certification programs, while others mandate a certain number of hours of supervised training or continuing education credits. Optimizing Treatment Outcomes Having performed over 50,000 treatments, Sandra Oulmas, founder of Oulmas Paris Aesthetics in Falls Church, Virginia, brings extensive expertise as a nationally recognized laser specialist. Her approach emphasizes the critical factors that influence treatment success beyond equipment selection. "Skin pigmentation and ethnicity remain at the center of laser safety," Oulmas says. "Fitzpatrick IV–VI skin types require conservative energy parameters and technologies that minimize the risk of postinflammatory hyperpigmentation." Oulmas also highlights how advanced laser devices like PicoSure and CoolPeel have expanded treatment options for diverse skin tones, although success depends entirely on the provider's expertise. (See "Inclusive Excellence: Serving Diverse Skin Tones" on page 73.) Age considerations also play a crucial role in treatment planning. "We're often working with slower collagen turnover, thinner dermis, or more cumulative sun damage in mature patients," Oulmas says. "Results may take longer to manifest, and expectations should reflect the regenerative timeline of mature skin." Treatment location significantly impacts outcomes and healing patterns. "Facial skin often heals rapidly and predictably, but the neck, chest, and extremities heal more slowly and are more prone to pigmentary shifts," Oulmas says. These areas frequently require modified settings or pretreatment preparation to achieve optimal results. Current skin condition assessment proves equally essential. "Active inflammation, compromised barrier, or subclinical sensitivity can affect both safety and comfort," Oulmas says. Her practice often prepares clients with barrier-repairing or pigment- suppressing topicals before treatment, making stabilization a standard part of the protocol. Oulmas outlines realistic expectations for treatment series: "Pigment and vascular conditions typically improve over 2–4 treatments spaced several Laser training should include hands-on experience with different skin types, understanding of contraindications, and protocols for managing adverse reactions. STOCKSY