Fractional CO2 laser ablation has grown in popularity as an alternative for some to plastic surgery. What do physicians want to know about this technology?
Treating Specific Conditions:
DeepFx is best for vertical lip lines, deep wrinkles, acne scars. It goes deep and stimulates more collagen and ablates more tissue for more tightening. ActiveFx is better for pigment and more superficial textural problems Stretch Marks (Stria): Use ActiveFx: 80-100 mj, density 1-2 (use Density 2 for thicker Stria). Do NOT use DeepFx for Stria. Melasma: Experts are not sure it will work. They do not recommend at this time. They are doing test spots and experimenting with it. Melasma is a whole topic unto itself. Look for a specific blog about this in the future. Tattoos: DeepFx might be good for resistant Tattoos
Pre and Post Treatment Tips:
Mild moisturizers avoid acne flare-ups You don't have to use aquaphor or vasoline. Mild moisturizers are good enough (personal communication from company reps). Be careful of the lanolin in the aquaphor. Using Aveeno Water Gel gets you one less day of Downtime! (From Dr. Weiss). What is Aveeno Water Gel? How do we get it? Post TotalFx Care: Use "Soaks" every 3-4 hours. (What type of soaks? Saline Soaks (saline and gauze)? How long do you soak every 3-4 hours?) Post Care: Cold packs or Zimmer Cooler for 30-45 min after treatment Valtrex for everyone. One case of disseminated herpes on the face is not good. Can we use Acyclovir? It costs less, much less (Four Dollars at Walmart!). Check all patients the next day, this makes you and them feel better. Don't give pain meds after treatment. If they have pain, you want to know about it and see them. They should not have pain for more than a few hours after treatment. Prolonged pain suggests infection: bacterial, viral, fungal. Can we discuss post procedure infections and how to treat them? Pliaglis can be mixed with cetaphil cleanser or cetaphil moisturizer. 90% Pliaglis and 10% cleanser or moisturizer. Experts worry about Lidocaine toxicity. Compounded Lidocaine works as well or better than Pliaglis. Pliaglis costs per treatment. Compounded Lidocaine costs about per treatment. Do the experts have a financial interest in Pliaglas? Are the experts afraid that they will be sued if they talk about compounded lidocaine? The discussion on this topic did not seem to be open, honest and complete! Experts do not routinely use oral antibiotics unless indicated for acne outbreak prevention: Keflex 500 mg TID, Doxycycline 100 mg BID, Erythromycin can be used to prevent acne outbreak. Sunscreens: Use everyday after skin is healed up. Wear hat and stay out of sun until healed. Use a good UVA blockers.
Fractional C02 lasers can produce great results if used correctly like any technology, it's not perfect.
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