Fractional Skin Resurfacing Treatments
Fractional CO2 laser ablation has grown in popularity as an alternative for some to traditional plastic surgery. What do Cosmetic Dermatologists want to know about C02 fractional treatments?
Treating Specific Conditions:
1. Reliant Ultrapulse DeepFx is best for vertical lip (smokers) lines, deep wrinkles, acne scars. The fractional laser treats deep and stimulates more collagen and ablates more tissue for more tightening.
2. Reliants ActiveFx is better for more superficial pigment and more surface textural problems
3. For Stria (Stretch Marks): Use ActiveFx: 80-100 mj, density 1-2. Use Density 2 for thicker Stria. (Note: Do NOT use the DeepFx for Stria.)
4. For Melasma: Medical experts don’t recommend treating Malasma at this time. (See below for current thoughts or changes.) This may change. Melasma is a whole topic an issue by itself.
5. Tattoos: DeepFx might be good for resistant Tattoos
Pre and Post Treatment Tips:
1. Use mild moisturizers to avoid acne flare-ups.
2. No need to use Aquaphor or Vasoline. Mild moisturizers are usually enough.
3. Be circumspect of the Lanolin in the Aquaphor.
4. Using Aveeno Water Gel can lessen downtime up to a day!
5. Post TotalFx Treatment: Use “Soaks” every 3-4 hours for comfort.
6. Post Care: Use Cold ice packs or chilled air cooler for 30-45 min after treatment for patient comfort.
7. Use Valtrex for all patients. (One case of disseminated herpes on the face won’t make your patients happy.) Might use Acyclovir since it costs much less (Four Dollars at Walmart!).
8. Check all patients by phone the next day, this makes you both feel better.
9. Don’t give pain medications 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. Prolonged pain suggests infection: bacterial, viral, or fungal.
10. Use Pliaglis mixed with Cetaphil cleanser or moisturizer. 90% Pliaglis and 10% cleanser or moisturizer in the mix.
11. Experts worry about Lidocaine toxicity. Compounded Lidocaine works as well or better than Pliaglis. Pliaglis costs $60 per treatment. Compounded Lidocaine usually costs only about $6 per treatment.
12. Experts do NOT routinely prescribe oral antibiotics unless indicated for an acne outbreak. Keflex 500 mg TID, Doxycycline 100 mg BID, Erythromycin to prevent outbreaks.
13. Sunscreens: Use everyday after skin is healed. Wear your hat and stay out of sun.
14. Use a good UVA blocker as further protection.
Fractional C02 lasers can produce great results if used correctly like any technology, it’s not perfect.
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