Lasers Frequently Asked Questions
Our 4 physicians often answer questions from people like you posted on Realself.com about lasers. We thought some of their answers might be useful for you.
Q: Laser Hair Removal and Time Before Sun Exposure?
Hi. How long after having a laser hair removal treatment (Soprano XL) should I wait before sun exposure. Also, I have 6 sessions booked and have a vacation in July. If I were to stop my treatment in order to go on vacation and continue a while after returning (will be away for a month), will the treatment still be as effective? Thanks
A: Sun exposure during laser hair removal treatments
You should minimize your sun exposure during laser hair removal treatments, as the laser that targets your hair follicle will also want to pick up pigment from your skin. You can achieve a more effective treatment if your skin is as pale as possible, because higher laser energy settings can then be used. I would coordinate with your practitioner when you will be on vacation, so you can maximize from all your sessions.
Q: Blue Veins at Temples and Under One Eye, Why Do I Need Two Treatments?
I’m going to have blue veins around the eyes and temples removed with a ND Yag Laser. Why are two treatments necessary?
A: Multiple treatments vs. one treatment for facial veins
Two treatments may not necessarily be needed, but it’s better to plan for an additional treatment than to try to perform one aggressive treatment.
Q: C-Section Scar Revision- What’s The Cost? Is Surgery My Only Option?
I have a C-Section scar that is crooked, too high and is indented in some areas. Im 5’3″ & 105 lbs. The scar is now 9 mon old. Its very noticeable and embarrasing. My jeans nor bathing suits cover it. Is surgery my only option and what are the average cost for this procedure?
A: Treatment options for C-section scar
Every person is unique and what one person needs to improve a scar may not be what another patient needs. There are a wide variety of lasers that can be used to help improve the appearance of a scar such as the pulse dye laser, intense pulsed light and Deep FX fractionated CO2 laser. Some patients may also benefit from excision of the scar.
Q: I Am Breast Feeding, Can I Have PDT?
Very interested in photodynamic therapy but am breast feeding (combined with weaning) a child of 11 months. Should I delay treatment or is it safe to go a head?
A: PDT while breastfeeding
While there has never been a study on the use of PDT with Levulan or Metvixia or Allumera in women who are breast feeding, it is hard to imagine that any of the topically applied products would penetrate into the blood stream to affect breast milk.
Q: Discoloration and Burns in Previous Session, Should I Discontinue Treatment?
Hello Doctor, Presently I am undergoing laser hair removal treatment for my face. Upon completing my second session I got severe burns in my lower lip area. It is almost 3 weeks now, they just got healed and peeled off. I have a lighter skin(skin discoloration) in that burnt area. My 3rd session is scheduled in couple of weeks. Can I continue the treatment? Or do I need to wait for 2 more additional weeks to get those areas treated again. Will this discoloration become normal. Please advice!
A: Asses the burn before resuming laser treatments
If someone has had a burn from a laser treatment, being evaluated to assess the severity of the burn and if there is any scarring would be prudent before proceeding with further treatment. The technician may want to reconsider the type of laser being used or the settings. Typically discoloration alone from laser hair removal treatment resolves, but may take some time. In the meantime strict sun protection is imperative.
Q: Ultherapy Uneven Results After 1 Month- Do I Need Another Treatment?
I have done the full face ultherapy about one month ago. Right after the treatment my left side of the face was much tighter and more lifted than the right side. A month later and I look the same, asimetrical. Should I repeat the treatment just on the right side?
A: Wait at least 6 months to see full results from Ultherapy
We all are asymmetric to a certain degree, and when we do procedures to cosmetically enhance our appearance, we sometimes tend to notice these asymmetries even more. Being able to compare your before and after photos would be a good place to start. That being said, it can take up to 6 months to appreciate the full effects of an Ulthera treatment. So if there is a true asymmetry from the treatment, you may want to give it more time to see the full results.
Q: CO2 resurfacing: Lifting in eye brow/upper eye area?
Could Co2 fractional resurfacing have a (semi)lifted/tighting effect/some lifted effect in eyebrow/upper eyelid area? Could it simulate a sort of (semi) upper eye lid correction, so to say? Could it give a more ”open” appearance for the eyes? For how long could these specific results last? In my case: There is only little/subtle improvement needed, nothing drastic at all. Some specific note/details to be aware of?
A: Ulthera is better for lifting the brow
CO2 laser resurfacing works best for minimizing wrinkles and improving the skin’s texture. If you have wrinkles, pigmentation and/or texture problems with your skin, you will probably benefit from CO2 treatments. However, if lifting your brow region is your main goal, you should look into Ulthera. Ulthera is a more effective treatment to lift and tighten the brow area.
Q: How long to wait for the second fractional CO2 laser treatment? Treating large pores and wrinkles.
How long to wait in between the treatments? Would like to make optimal use of the collagen improve story which would be 3-4 months. But for wrinkles 2-4 weeks is recommend. Therefore what would be wise to do? Could waiting too long, overshoot the goal, in other words; could you wait to long for the next treatment? Min & max pauses in between?
A: Fractional CO2 laser intervals
It generally takes at least 6 months for the full effects of collagen remodeling to occur. We have found continued improvement for up to 2 years! So, we recommend treatments to be given no sooner than every 6 months.
Q: Best technique for burn scar removal?
I have some small, not so deep, burn scars. I’m considering either some sort of laser treatment or microneedling. Which would work better? I may do the needling combined with PRP or Acell or something. I’ve heard that works quite well. Any suggestions?
A: Deep FX for burn scar treatments
Deep FX treatment is effective in improving both the appearance and functionality of burn scars. This laser treatment is used by the military hospitals to treat wounded warier scars. The laser procedure was also featured on the “Today Show” which detailed the treatment in triplets who were accidently burned in childhood.
Q: Can I Go out in the Sun with High Spf Suncreen After Having a Photofacial?
A: Sun exposure after photofacial treatment
You should try to wait a few days before exposing your face to the sun after an IPL photofacial treatment. If you do go outside make sure you have on a good, broad based UVA/UVB sunscreen (and a hat if possible) so that your skin is protected from the sun’s damaging rays. The better protected your skin is from the sun, the longer the photofacial results will last.
Q: How many sessions of photo facial to see results?
How many for improvement, and then how often to sustain the improvement?
A: Best photofacial results
The number of photo facial treatments you will need depends on the condition of your skin and your desired results. Usually patients need a series of 3-6 treatments, that take place every 4-8 weeks. The results of photofacial treatments are long lasting, however annual touch-up treatments may be needed to keep your skin looking its best.
Q: Ultherapy works best, where?
Where on the body us Ultherapy the most effective?
A: Ultherapy skin tightening for the face and neck
Ultherapy is a great non-invasive skin tightening treatment that provides effective results for the face and neck. It is a great treatment option for patients with mild sagging who do not need to undergo a surgical facelift. It can be used to lift and tighten the following areas: brows, eyelids, forehead, neck and jawline.
Q: I just had Botox and I want to do Ulther in two weeks, is this ok?
A: Botox and Ulthera combo treatments
It is ok to have an Ultherapy treatment two weeks after having Botox injections. In fact, you can actually get both Botox and Ultherapy treatments on the same day. Botox settles in very quickly, so waiting the two weeks is perfectly safe.
Q: Deep Lateral Lines Under Eyes- Other Options?
I had Botox on my eyes, it cleared up the lines at the sides of my eyes, but the lines underneath my eyes and wrinkles that run under my eyes and from the side of my eyes in straight lines down to my cheek bones are so bad. I have been told they don’t use Botox under the eyes, so how can U clear up this problem? I look so old and its making me unhappy!!
A: Lasers for under eye wrinkles
Laser treatments for wrinkles under the eye can provide great results, but you need to see a very experienced laser physician when treating this delicate area.
Q: I have acne scars on my face. What is the best way to remove them? Does Fraxel work?
I heard that Fraxel is effective for acne scars. Will Fraxel work?
A: Lasers for acne scars
Fraxel laser treatments will work for treating acne scars to make them less visible. However, I prefer using Active/Deep FX laser resurfacing treatments for acne scars. The Active/Deep FX works to improve your skin texture by targeting deep scars.
Q: What is the best treatment for deep acne scars on cheeks and bumps on chin and nose?
I have suffered with acne since I was 11. I am now 21 and I have many deep scars on my face and these little bumps on my nose and chin. Please help me out.
A: Active/Deep FX laser treatments are best for acne scars
Active/Deep FX laser treatments are a great option for reducing the appearance of acne scars. The Active/Deep FX laser resurfacing treatments should get rid of your acne scars and improve the texture of your skin.
Q: Best laser treatment for scars and large pores?
Between Pearl, Laser Genesis, and Fraxel Laser, which most successfully reduces pore size, acne scars, and chicken pox scars?
A: Proper cleansing routine will minimize pores + Intense Pulsed Light treatment
While virtually every laser company likes to think that their specific laser reduces pore size, there is NO laser that actually does so. Pore size is best reduced by proper cleansing with a salicylic acid cleanser and a Clarisonic skin brush. This cleansing regimen will reduce pore size by removing its contents.
Instead of a laser, the Intense Pulsed Light from Lumenis has been demonstrated in multiple clinical studies to further reduce pore size. This effect is secondary to destroying or minimizing the size of a hair. Remember that a “pore” always contains a hair so the smaller the hair and the less “stuff” that is in the pore, the smaller it appears.
Q: Number of laser sessions to see skin improvement?
I am looking to rejuvenate sun damaged skin. Will it require lots of laser sessions?
A: Number of laser sessions depends on type and strength of laser
The number of laser treatment sessions all depends on the laser used and the strength of the treatment. The stronger the treatment, the more days of healing and redness, but the greater the improvement. You need to talk with your dermatologic surgeon to plan out how much time you can take off from being social. That will dictate what laser and laser strength will be used and the anticipated improvement.
Q: Which laser is the best for a black tattoo removal?
I have a black angel tattoo the size of my hand. It has great detailing and has light and dark black throughout. I hate it now and I have to use cover ups when I wear dresses. I can’t wear skirts to work. I want it gone. This thursday I have an appointment set up with an MD in Raleigh NC. What type of questions should I ask to make sure this guy is legit. Also is there a certain type of laser that works best? I really don’t want any scars.
A: Treatment of black tattoos
Black tattoos tend to be the easiest of tattoos to treat. Virtually any of the q-switched lasers will work. I would treat the tattoo once a month rotating the treatments between a q-switched ruby, q-switched Alexandrite and q-switc hed 1064 nm Nd:YAG laser. Newer techniques may allow for complete removal in as few as three treatments. But complete removal varies based on the amount of tattoo pigment as well as its type and depth.
Q: Best method to treat depressed scar?
What method is the best to treat the depressed scar on upper lip and how much it will cost to revise it?
A: Best way to treat a depressed scar
Treating a depressed scar involves both filling the depression and surface of the scar to make it less noticeable. I would recommend a combination of subcision with a Fractionated CO2 laser treatment called Deep FX. There will be some bruising and healing over a week and you may require 2-3 treatments for a best result. But the treatment should be extremely effective.
Q: Best laser system for dense, dark back hair with light skin?
My 18 year old son is in desperate need of laser hair removal on his back. It is very dense and dark. His skin is light. What is the best laser system to use for his problem? Also should he shave it or leave it the way it is for treatment. I don’t want to commit to spending a large amount of money on a system that won’t work.
A: Hair removal for black hair on the back
Laser hair removal is a very safe and effective procedure. There are now many different lasers that can work, some better than others. The newest laser is the Lightshear Duet. This laser can remove all the back hair in a 15-20 minute procedure with little pain. Over the past 15 years my back has been treated with the IPL, a variety of Nd:YAG lasers, the regular Lightshear and a variety of alexandrite lasers. My treatment with the Lightshear Duet was by far the quickest and easiest and least painful procedure I ever had.
Q: Is it safe to have an Affirm treatment immediately after having Juvederm injections?
I am planning on having Juvederm injections in my cheek area. How long should I wait before having Affirm treatments?
A: Affirm laser and fillers
The Affirm is a non-ablative fractionated laser that improves fine lines and wrinkles. Although I respect both of the doctors that answered the question, they are wrong. I published a research study that proved that lasers do NOT affect fillers placed under the skin in any way.
Q: Dark circles under eyes: Laser and Juvederm side effects?
Dark under eyes: One month ago a plastic surgeon used a laser to correct extra blood flow and Juvederm for the hollows. My eyes have been irritated (burning, tension) since.
A week and a half ago the doctor said the laser probably caused dry eyes and I’ve been using extra strength eye drops day and night, but they’re still red and irritated.
Questions: Do you think it was the laser or could it be the Juvederm causing this discomfort? I don’t know if I should get the Juvederm removed or not?
A: Dry eyes after laser and Juvederm
There are many different lasers that can be used to improve the appearance of dark circles around the eyes and I don’t know what laser your surgeon used or the settings for that laser. In 20 years of using lasers to treat dark circles as well as blood vessels around the eyes I have never seen or heard of a patient that developed dry eyes. In our office we use the Q-Switched Ruby laser for dark circles and Cool Touch Varia for blood vessels around the eyes, and the Active and Deep FX fractionated CO2 lasers for wrinkles. We also use the Aluma or Thermage to tighten skin around the eyes.
It may be wise to get a second opinion for your problem.
Q: Is IPL treatment painful?
Does IPL hurt to have done?
A: Pain is related to the type of IPL
Since the invention of the IPL over 18 years ago, over 20 different companies make a similar machine and they are all called IPL. The best is the Lumenis One. This IPL is from the company that invented the IPL and has technology that no other company has. It is the most effective and least painful IPL in the world. It works with just 1 or 2 treatments and a “package” of 5 or more treatments is not necessary, so you save money, time and pain.
Q: Active FX vs. Fraxel laser treatments – Which is better?
It seems like Fraxel and Active FX are both supposed to treat the same problems, but which one is better?
A: Active FX is better than other fractioned lasers
The Active (and Deep) FX lasers are more powerful than ALL other fractionated lasers. More power means quicker healing and less pain with possible less side effects. The Active/Deep FX laser is more expensive than ALL other lasers. That is why most doctors have the cheaper lasers. You only have one face, make sure the best laser is used.
Q: Is pulse dye laser safe for patient with seborrheic dermatitis?
Is it ok to get Pulse Dye Laser treatment for acne scars and rosacea if I have facial seborrheic dermatitis?
A: Pulse Dye Laser is safe when used properly
The Pulse Dye Laser is effective in treating redness and blood vessels. This is great for rosacea but will not help sebhorrheic dermatitis. Your dermatologist can recommend an effective treatment.
Q: Treatment for crepey skin on cheeks?
About 6 months ago I started to develop creepy skin on my cheeks. The wrinkles only appear when I laugh, which doesn’t make them less annoying for me. These wrinkles are not marionette lines or nasolabial folds or crow’s feet, just crepe-like skin on my lower cheeks. It bothers me A LOT. I’ve read a lot of answers here about how dynamic wrinkles can be treated with Botox, but not on the lower face area. What are my options? Will laser or a chemical peel help?
A: Treatment for fine facial wrinkles
Fine wrinkles on the facial skin can be treated with a variety of lasers. The most effective are ablative lasers like the CO2 or Er:YAG. These ablative lasers can be fractionated for easiest healing. A variety of non-ablative lasers can also be used. It would be best to see a Dermatological Surgeon who has a variety of lasers so that he/she can choose the treatment that is best for you.
Q: Skin care before and after IPL treatment?
Can I keep using active ingredients before and after my IPL treatments like Vitamin C serum?
A: Obagi NuDerm System enhances IPL results
We have recently published a clinical study on the use of the Obagi NuDerm System before and after 2 IPL treatments. (Woodhall, Goldman, Gold and Biron: J Drugs and Dermatol 2009; 8:862-867). Our study found that we could increase the efficacy of the IPL by over 100% when patients used the NuDerm System 4 weeks before and during the 2 IPL treatments given 4 weeks apart. In short, using the Obagi NuDerm System gave similar results as 2 additional IPL treatments.
Q: Is eyebrow tattoo removal possible?
I had eyebrow tattoo done two days ago. They are terrible, too long, bad shape, too dark. Can I get eyebrow tattoo removal?
A: Eyebrow tattoos can be eliminated with a specific laser treatment
The treatment of unwanted tattoos whether they are on your body or eyebrows can be performed with a variety of special lasers called “Q-Switched Ruby, Alexandrite or Nd:YAG lasers.” It is difficult to predict how many treatments will be necessary, but if performed by an experienced laser surgeon with the right laser the results can be nearly perfect.
Q: Laser resurfacing or non-surgical procedures to tighten under eye area?
I had upper eyelid surgery about 4 years ago and fat removal and laser resurfacing as well. I would like to further tighten the skin under my eyes. Can I do that with more laser resurfacing or other non-surgical techniques? I prefer not to be under anesthesia again.
A: Factional or confluent Ultrapulse CO2 laser
The most effective laser for tightening the skin around the eyes is the Active and Deep FX Ultrapulse CO2 laser. There are many different fractionated lasers that may help. But the Ultrapulse CO2 appears to be the most effective with the least pain and down-time. Physician experience is also important, since the laser can be used in a variety of settings. So be sure to select an experienced Board Certified dermatologist or cosmetic surgeon. In my office, this procedure is performed entirely under topical anesthesia and patients can put make-up over the area in 4-5 days with complete healing in 7-10 days.
Q: How to remove old insect bite scars on legs?
I have old scars in my legs caused by insect bites. I’m terribly uncomfortable to go to the beach. What can I do?
A: Treating old scars depends on the type of scar
The best way to remove old scars depends on what the scar looks like. A red scar can be treated with a pulse dye laser. A brown scar can be treated with a Q-Switched Ruby or Alexandrite laser. A depressed scar can be treated with a variety of injection fillers or fat transfer and/or subcision. And, an elevated scar can be treated with injections of triamcinalone and/or 5% % Flurouracil.
Q: How can I tighten skin without surgery?
My jowls are dropping along with my other facial features. Can you suggest some skin tightening procedures that don’t require going under the knife?
A: There are many non-surgical ways to tighten skin
There are many non-surgical ways to tighten skin. The recommended procedure depends on the extent of loose skin as well as the location.
It is important to remember that any non-surgical skin tightening procedure will not be as effective as surgery, and all non-surgical skin tightening procedures require multiple treatments given every 3-4 weeks to reach maximal effectiveness.
My favorite skin tightening procedures are:
- Aluma which is used for the neck and body areas. (Usually requires 6 treatments with best results 3 months after the last treatment).
- Active FX for the face, neck and chest. (Usually requires 1-2 treatments and takes 3 days to heal.)
- Affirm for the face, neck and chest. (Usually requires 3-6 treatments with best results after 4-6 weeks)
- Cool Lipo and/or Smart Lipo for the neck, abdomen, knees and arms. (Usually requires one treatment with best results in 2-6 weeks).
Q: How can I prevent stretch marks?
A: There is no proven way to prevent stretch marks
There is no proven way to prevent stretch marks.
- When caught early and when they are still reddish, the Intense Pulsed Light or Pulse Dye Laser can be effective.
- Once they turn white or pale, the CoolTouch, Smooth Beam, Affirm, Active FX, or Fraxel can minimize their appearance.
Q: What’s the best laser hair removal machine?
The clinics near me offer a number of different laser machines. Names like Light Sheer, IPL, Yag, Duet, Cool Glide. What do the medical expert think works best in laser hair removal?
A: The most effective lasers are the Lightshear, Alexandrite and IPL
The most effective lasers are the Lightshear, Alexandrite, and Intense Pulsed Light.
The Long pulsed 1064nm Nd:YAG is, at best, only half as effective and requires many more treatments but is best for dark-skin types.
Laser hair-removal works best on dark hair and works very poorly, if at all on blond or grey hair.
Q: Is laser hair removal permanent?
I want to get rid of hair for good on my under arms, legs and bikini line. Will laser hair removal work?
A: There is never any permanent hair loss in every patient for every hair
There is NEVER any PERMANENT hair loss in every patient for every hair. Most patients will achieve an 80% hair loss or more after 4-5 treatments, which are given monthly.
Hair may gradually return over 1-3 years. This hair can be treated with “touch-up” treatments every year or so.
Q: How to get rid of acne scars?
What’s the best way to get rid of acne scars on my chin and my cheeks?
A: Improving acne scars
While there is no way to make one’s skin that of a porcelain doll, acne scars can be improved. This usually requires a number of treatments with the CoolTouch, Smooth Beam, Affirm, Active FX or Fraxel lasers, which can minimize their appearance.
We often combine lasers with subcision and/or injection of fillers.
Q: Best way to get rid of wrinkles – Professional strength solution?
I’m looking for a wrinkle treatment that really works. I’ve given up on the wrinkle creams and lotions, spending tons of money only to see my facial lines get deeper and my wallet get skinnier. I am aware of Botox and Restylane but not many other wrinkle solutions (professional strength!!).
A: Superficial wrinkles and fine lines
In addition to topical skin care with growth factor and antioxidant creams, a variety of non-invasive lasers have been found to be very helpful. These include the Affirm, CoolTouch, Fraxel, Active FX, Titan, and the like. Topical skin care takes at least 2 months to show an improvement. Depending on the type of laser, 1-6 treatments may be necessary to achieve the best effect. Topical skin care in addition to lasers works best.
Deep wrinkles, facial folds and creases – Surgery, such as face-lifts and the many names doctors call it like the “life-style lift” or mini-facelifts, are all very similar. The more invasive the procedure, the better and longer-lasting the results. Only your dermatologic or cosmetic surgeon can advise you if surgery is necessary or if the use of filling substances, such as Sculptra, Fat, Radiesse, Juvederm, or Restylane, will be best for you. At times a variety of fillers are used in one session.
Dynamic wrinkles – Botox or, when it is approved by the FDA in 2008, Reloxan are the only non-surgical methods for improving dynamic wrinkles. Endoscopic surgery may also work but is much more invasive.
Q: Darkness under eyes made worse by Hyaluronidase – laser correction?
I have always had darkness under my eyes, I have light skin, blonde hair, blue eyes, and I have been prone to under eye darkness. I recently had all my fillers dissolved under my eyes with Hyaluronidase. My eyes seem to look worse now, Its been a week, I have more bags and the under eye darkness is back. My question, is there a laser that takes away darkness or are fillers my only option again if done right?
A: Lasers can improve under eye darkness
Lasers can improve under eye darkness. There are different causes of this problem:
- Pigment
- Capillaries
- Hollowness
Lasers can improve all aspects. If you look at some of my before and after photos, you will see many of patients had darkness/hollowing that was improved with laser resurfacing. A combination of fillers and lasers may be best.
Q: Where to get Botox injected for horizontal lip line? Could surgery be a better option?
Have tried Botox injections on inside of cupid’s peak and on outside. Have heard mixed reviews on best place (and amount) of Botox to inject. Suggestions? I am considering having surgery to permanently take care of lines (ie. cutting of depressor nasi septi muscle), recommendations for doctors in Canada who do this?
A: Laser resurfacing is excellent for lip lines
If surgery is not an option (you need to see a plastic surgeon to determine this), laser resurfacing could be an excellent option. Laser resurfacing can soften eliminate lines in this area. Seek out a dermatologist in your area with lots of laser experience, particularly in the use of CO2/Erbium lasers.
Q: Solution for a red nose?
The tip of my nose is almost always red. It’s either entirely red or in spots of redness. I’ve read that is probably the result of blood vessels. They don’t seem to be broken though, they don’t look like veins. Just redness. Always. Can i fix this? Can the blood vessels be eliminated? Laser procedure maybe. If so, what’s the best type of laser?
A: Pulsed dye lasers are the gold standard for diffuse redness
- Numerous published research studies have shown that the pulsed dye laser is superior to IPL for treating diffuse redness and capillaries.
- We offer both IPL and pulsed dye laser in our practice.
- The ND Yag laser is a good option larger, visible vessels larger than 1 mm in diameter. Is has little value for diffuse redness.
- You may need multiple treatments, depending on your goals. These are spaced 4-6 weeks apart.
- Seek a Board Certified dermatologist with lots of laser choices and lots of experience. The dermatologist should be the one performing the treatment. (Not turning the treatment over to other staff members).
Q: Laser resurfacing for rosacea, sun damage and wrinkles?
A dermatologist wants to do laser resurfacing for Rosecea. He says other resurfacing won’t remove spider veins. I’m 62-sun damage and wrinkles, what would be best for me?
A: Vbeam perfecta is the gold standard for facial vessels
If you want to address rosacea, the Vbeam perfecta is the best laser for this. For wrinkles and sundamage, fractional resurfacing, possibly in combo with CO2/erbium resurfacing is the best. If you have lots of brown spots, I would use a q-switched alex laser as well. All five of these lasers used together in one treatment session will give you everything you want. See some of my before and after photos for examples of patients treatment in this manner.
Q: Smoothbeam vs Fraxel Restore for collagen production?
Which between Smoothbeam Laser and Fraxel Laser stimulates collagen better? Does Fraxel Restore remove scar tissue while Smoothbeam only remodels?
A: Fraxel Restore vs Smoothbeam for acne scars
Actually, it would very reasonable to use both lasers together during each treatment session. Since they both have different modes of action in the stimulation of collagen and altering scar tissue, the combo of the two lasers may be the best. It is important to seek out dermatology practices that have many different lasers, because combining technologies often times yields the best results. If a practice only has a couple of lasers, they will only offer a limited selection with limited results, and often will be biased.
Q: Pearl laser by a technician?
I am considering the Pearl laser treatment but it will be done by a technician. Should I look for a new doctor elsewhere?
A: Laser resurfacing should be done by a dermatologist or plastic surgeon
The laws in the U.S. vary greatly from state to state as to who may perform laser surgery. In general, state laws are becoming stricter because there has been so may bad outcomes and lawsuits involving cases where a patient was treated by a non-physician. Dermatologists study only the skin for 3 continuous years and are intimately familiar with the biology, physiology, and treatment of diseases of the skin. During residency training, many of us have performed thousands of laser procedures under strict guidance, and this is also where we learn to deal effectively with complications of laser surgery. A one day course can never replace this. Experience matters. Take the treatment of your skin very seriously, do your research, and this will enable you to have the best outcome.
Q: Laser resurfacing to smoothen hair transplant cobblestone effect?
I had a hair transplant years ago that probably was a mistake. I’d now like to just be bald. Trouble is, the transplanted area is covered in 2 to 3 mm depressions, many a much darker pink than the rest of my caucasian scalp. I can’t just shave the area.
My impression of laser resurfacing is that it can bring smooth skin to patients who begin with relatively mild skin problems. For those with more significant problems, improvements are partial.
Can laser resurfacing give me a smooth pate, or is it likely to leave a bumpy, discolored mess?
A: A combination of lasers will work best
The scalp is an area which can be resurfaced, very much in the same manner as we would resurface the face. It is difficult to tell without seeing your scalp, but I would consider using the Vbeam perfecta to address the red or pink areas and then resurface the scalp with the Fraxel repair. Depending on the amount of damage, you may need multiple treatments.
Q: Profractional vs CO2 Fractional laser resurfacing?
What is the difference between Profractional Laser Resurfacing and CO2 Fractional Laser Resurfacing?
A: Fractional CO2 wins this battle
We have 3 fractional CO2 lasers, one standard CO2 laser and an erbium laser. Theoretical information is great, but look at the before and afters of both the Fraxel repair and profractional and you will see that the Fraxel repair photos are more impressive and require less treatments. In fact, the majority of patients require only one treatment with the Fraxel repair. I have posted photos of patients that I have treated so that you can review for comparison. Whatever you decide, choose a dermatologist or plastic surgeon that performs the treatment and does lots of cases. I have not seen any cases of permanent hypopigmentation with Fraxel repair, unless there was an infection or some other complication.
Q: Chemical peel vs laser resurfacing for various facial folds?
Chemical peel or laser resurfacing for severe perioral lines, nasolabial folds and folds under mouth corners? Which technology is best? The surgeon said a facelift won’t help, suggested Chemical peel, he doesn’t use lasers.
I’m willing to do both. Research has confused me. I am 60, have 15 facial age spots, and years of sun exposure. Don’t tend to scar, but recently hyperpigmented after using Efudex on 2 pre-cancer cheek spots, VERY slowly fading. On my nose it healed quickly.
A: Laser resurfacing wins easily
Laser resurfacing can be done with much greater precision that a chemical peel. Chemical peels that are done for deep perioral lines either don’t work or they go too deep and leave the patient with scarring and severe hypopigmentation. I have seen many patients damaged from chemical peels. Nasolabial folds are best addressed with fillers. I have posted photos under my profile with examples of patients with perioral lines that I have resurfaced.
Q: How long will redness after CO2 laser persist?
I had CO2 Laser done a month ago. My doctor “forgot” to tell me that I should use a skin lightener on the second week of recovery. Now, I was told to become aggressive in the treatment of the hyperpigmentation. I am using Phaze 13, hydroquinone, and tretinoin. My face is so dry and flaky. The skin appears red still but the brown has faded a lot. Problem now is the redness is still red, but lighter. How long will this redness persist? Make-up will not hide it.
A: Redness after CO2 can persist for a few months
Worst case scenario is probably 6 months. Something to consider is the irritation from the topical products that you are using. Irritation from the products is most likely prolonging the course. You should talk to your doctor about changing products or adding something to sooth and moisturize the skin.
Q: Getting V-beam after Fraxel laser?
How long after receiving Fraxel Restore treatment can V-Beam be done? I’ve had 5 Fraxel done and probably will go for more in the future (will wait at least a year), but want to see improvement of the redness from my acne scars.
I also seem to get flushed easier than ever after Fraxel. Will V Beam improve this condition as well?
A: I would start the Vbeam now
In fact, I often combine that Vbeam on the same day with the Fraxel treatment…this cuts down on the number of visits, the days of downtime (in total), and the lasers work better when used together. The Vbeam should improve the flushing as well. Ask if your doctor has the Vbeam Perfecta, which is the latest generation and is more effective the the Vbeam.
Q: Fraxel or Photofacial for fine lines?
If cost is not a factor, which would be more effective between Fraxel or Photofacial for one series of treatment for fine lines and sun damage on my face and neck area?
A: Most likely a combination of lasers is best
Contrary to popular belief, there is not one single best laser for treating what you describe. I often combine the Fraxel restore or Fraxel Repair with 2-4 other lasers in the same treatment session to get the best result. This doesn’t increase your social downtime and the results are much better than using just one laser. Each laser has a very specific job….the laser that is best for wrinkles will not be the best for brown spots or capillaries. If a physician only owns one laser, that’s all they are going to be able to recommend. Look for a dermatologist that performs all his/her own treatments, and has multiple lasers to address all of your concerns.
Q: Erbium Yag or Fraxel for Rhinophyma?
I’m beginning to show signs of Rhinophyma. There are a few nodules on one side of nose and some thickening on tip of nose which I absolutely hate. Which of these two lasers, Ebrium Yag or Fraxel, would improve my condition? These two seem, from what I have read, have less downtime than the CO2. I am on Tazorac and cream antiobiotic. It helps somewhat but my main concern is the thickening on end of nose.
A: CO2 or erbium is preferred
We have all 3 lasers that you have mentioned in your question, and my 1st choice would be the CO2 laser. The Fraxel is not designed to target individual nodules, so it is not ideal. The erbium could be used, but the downtime would be the same as the CO2.
Q: Removing pearly papules with CO2 laser?
I have pearly papules and I was told that they can be removes through surgery (CO2).
A: Yes, they can!
I have done this treatment many times. It is painless, requires no injections, and most patients go back to work the next day. You check out a video and before and afters on our website.
Q: Age spots on arms: Fraxel alternatives?
I had 4 Fraxel treatments on my entire arms to treat age spots. They did not work. The doctor suggested hydroquinine cream for the summer and also treated the larger ones with liquid nitrogen. So far after 2 months, I still have NO visible results. The doctor suggested 1-2 complimentary IPL treatments in the fall but am concerned they won’t work either. Additionally, my skin actually appears crepey which I don’t recall before the Fraxel. I spent $3000 which is not easy for me to come by. Any treatment suggestions or alternatives?
A: There are treatment options that work
The q-switched alexandrite laser made by Candela is our favorite tools for treating age spots on the arms. If performed by a skilled dermatologist, you should see significant improvement in one treatment.
Q: Laser treatment for fine lines and sagging skin?
I am 51 and have fine lines, no acne, some sagging around the jowl line and good skin texture. What procedure should I get considering my needs? Would Active FX or Pearl laser work? I am also having a mini facelift done concurrently. Minimal recovery time is important.
A: Combo approach is best
When you say “minifacelift”, are they doing a skin only approach or are they tightening the underlying muscle and fascia as well? This is important. At our center, we get excellent results combining surgery and resurfacing, specifically with the Fraxel repair.
We have the Active FX laser as well and because the Fraxel repair penetrates much deeper than Active FX, we find the Fraxel repair is much better for wrinkles and tightening. The Pearl is a very superficial penetrating device and is best for patients will lots of brown spots. I would expect no tightening from pearl and no long term reduction in wrinkles.
Q: What will get rid of smoker’s lines without plumping my lips?
A: CO2 and Erbium resurfacing
These 2 lasers used together are the most effective and the only predictable way to remove smoker’s lines. None of the new Fractional lasers can predictably do this.
Q: Best alternative to laser hair removal for dark skin?
I was told my dark complexion makes me a bad candidate for laser hair removal. What are my alternatives for permanent hair removal?
A: Dark skin laser hair removal
I have been successfully treating very dark skinned patients for over 8 years with the Gentle YAG laser. In experienced hands, this laser is the safest and best laser for permanent hair reduction in dark skinned patients. I have performed thousands of these treatments without and complications.
Q: Best tattoo removal?
When I was younger this tattoo was cute. Now I hate it and want to remove it. What’s the best way?
A: Multiple lasers
This tattoo is going to require multiple lasers. For the black ink, I would use a q-switched alexandrite laser. The red will require a q-switched 532nm laser. Because of the bright green and yellow pigment, I like to use the Fraxel repair–this laser will vaporize the ink and facilitate the removal of the entire tattoo. This will definitely require multiple treatments spaced 6-8 weeks apart.
Q: Less painful treatment for treating broken capillaries?
Recently, I underwent a laser treatment for broken capillaries. I don’t recall the type of laser the doctor used, but I found after a couple of minutes, that it was unbearably painful. Is there a less painful way to rid myself of those pesky broken capillaries?
A: Pain control is the key
While IPL treatment may be less painful than lasers, this technology is less effective and has a much higher chance of side effects when compared to other lasers. Pulsed dye lasers are considered the gold standard for the treatment of vascular lesions (capillaries), and will give you the best results in the fewest number of treatments. For my patients that are pain-sensitive, I will use topical 4% lidocaine and give the patients the option of taking valium and or vicodin/percocet. There is no reason that you should have to suffer through these treatments. Seeking out an established dermatologist that specializes in laser procedures will be the best way to ensure that your pain issues are addressed properly.
Q: Laser hair removal for salt and pepper facial hair?
I am 58 years old and have partially gray hair. The hair on my face is quite dense and mixed dark and white. Waxing is not for me and at this point I am forced to shave every day. Is there a laser hair removal treatment that would be effective? If not, would electrolysis work?
A: Lasers are not effective for gray or white hair
There is still no reliable laser treatment that can predictably remove gray, white or blonde hair. Using a dye to change the hair color to black doesn’t work either. Lasers would be an excellent choice for treating your darker “pepper” hair.
Electrolysis is going to be your best alternative for the “salt” colored hair, but it is uncomfortable, requires many treatments, and can be costly.
Q: How much does pulsed dye laser treatment cost?
How much does one pulse dye laser session cost?
A: Depends on the area being treated, who is doing the treatment and where you live
Cost depends on these 3 variables. If you are treating one tiny spot, the cost could be $100.00. Some patients need to treat their entire face, neck and chest and this can cost $1500-$2000. If you live in a major city, cost will most likely be more than it would be if you lived in a smaller town. Lastly, the experience of the treating physician will affect the cost because demand will be higher. Don’t go for the cheapest price, do your research and choose a dermatologist or plastic surgeon that performs the procedure and doesn’t have someone else in the office doing the treatment. This will ensure the best outcome for you.
Q: Pulsed dye laser for cherry angioma treatment?
For a moderate case of cherry angioma, how many pulsed dye laser sessions are recommended to see desired results (on average)? How long does the treatment last?
A: Pulsed dye laser is an excellent choice for cherry angiomas
The pulsed dye laser in considered the gold standard for treatment of vascular lesions like cherry angiomas. It has an excellent safety record and can remove cherry angiomas in one treatment, unless they are very large. Other choices include:
- Nd:YAG (Gentle YAG)
- KTP lasers
- IPL
Having used all of these devices, I recommend the pulsed dye laser or Nd:YAG.
Q: Collagen injections for facial scars?
Can collagen injections work on facial scars such as chicken pox scars? The old pock marks really bother me.
A: Collagen can help but there are other options
Collagen can help, but it doesn’t last very long and will need to be repeated every couple to few months. Restylane or Juvederm will last a bit longer. A long term fix is possible with laser resurfacing (fractional CO2, Fraxel restore, CO2), but this will be more expensive, may require multiple treatments, and will require some social downtime.
Q: Why did laser treatment result in demarcation lines?
I am a 42-year-old Asian woman. I had full facial Micro Laser Peel (20 micron depth) and 20% ProFractional Laser Resurfacing (200 micron depth) 16 days ago. The day of the procedure, I had a lot of bleeding all over my face and could see very distinct parallel longitudinal red bands (3 on each side) running down my cheeks, as if some of my skin had received far more exposure to the profractional laser than other parts. Beginning a week after treatment I started to get a hyperpigmentation reaction exactly corresponding to the vertical bands on my cheeks. There were no bands on my forehead or chin following the procedure, and I have not had any hyperpigmentation occur on those areas either. Can anyone explain what is going on?
A: Hyperpigmentation from higher density treatment
You are exactly right. It sounds like there was overlap of the treatment area and you may have been treated with densities and high as 30-40% in these hyperpigmented areas. We published a study about 1 year ago looking at fractional treatments in Asian skin and our conclusion was that the risk of hyperpigmentation was higher with increased density. Most likely, this will be temporary and could last a few weeks to a few months. This is why it is important to have your treatment done by a physician that is very experienced in these procedures. There are topical treatments that can help resolve this more quickly, and you should discuss these options with your doctor. Sunblock with zinc oxide and/or titanium is very important everyday to help resolve this and keep this from persisting longer.
Q: Alternatives to deep chemical peels?
My dermatologist said some of my acne scars are deep, and I will need a deep peel for them. Are there other successful, more cost-effective alternatives to a deep chemical peel?
A: Fractioned laser treatments are safer and more effective in most cases
The best treatment for most acne scars is laser resurfacing, specifically with the new fractionated CO2 lasers. You may need one treatment or you may need a few. This will be more expensive than a chemical peel, but the safety and results are much better.
Deep chemical peels have a higher risk of infection, scarring, and permanent loss of skin color. Seek out a well established dermatology or plastic surgery office where the physician performs the treatment and takes care of you afterward.
Some acne scars are best treated surgically (punch excision), followed a few weeks later with laser resurfacing, but your dermatologist can determine this during your consultation.
Q: Length of time between laser hair treatments?
A few laser practitioners I have been to have given me conflicting advice about the length of time I should wait between treatments. Some say 4-5 weeks is the ideal period while others have indicated 7-8 weeks is much better if one is to target a greater proportion of hair in the right growth phase. What is your view on the ideal length of time that one should wait between treatments?
A: Hair regrowth is variable for different areas and individuals
In general, the best way to approach this topic is to use the regrowth of hair in the treated area as your guide. In other words, when a significant percentage of the hair starts growing back, return for the next treatment. It could be as short as 4 weeks on the face, and as long as 12 weeks for the legs or more.
Q: Can sclerotherapy treat facial veins?
I have a vein under my eye that I would like treated. This is a single larger vein, not spider veins. Is facial sclerotherapy a possibility?
A: Sclerotherapy is not recommend for the face
Depending on the size of the vessel and the color, there are at least 3 different lasers that I would consider using. The problem with sclerotherapy around the eye is that the product that is being injected can cause vision loss or blindness, and this has been reported in the medical literature.
Care must be taken when using lasers around the eyes as well, but this is why it is extremely important that you go to a dermatology or plastic surgery office that specializes in these procedures. The physician should be performing the treatment and not delegating the procedure to someone else in his office (i.e. nurse, PA, technician).
Q: Is it possible to regain pigment in skin after massive laser hair removal burns?
I was burned by laser hair removal all over my legs, when the blisters healed the area under the burns lost all pigment. I’ve done microdermabrasion a few times but that will only temporarily even out the skin color. Is there anything permanent that can be done to get the skin pigment back? What are potential treatments? My goal is to just go on a beach vacation and not look like a tortured person – I’m young and I’m just hoping to be in the sun again!
A: Pigment loss, scarring
Restoring lost pigment is very difficult, particularly if there is scarring. There is one treatment that I have used over the past 2-3 years which has actually been very successful. The prescription product, Latisse, which is FDA approved for stimulating growth of eyelash hairs, has a possible side-effect of stimulating skin pigmentation if it comes in contact repeatedly with the skin. I have asked my patients to use this product twice a day on the spots of pigment loss to take advantage of this pigment stimulating side effect. It has worked in over 75% of patients that I have tried it on. It usually takes 2-3 months to see a response and continued use to some extent is probably necessary.
Q: How Long After Active and Deep Fraxel Procedures Can I Get Sculptra Injections?
A: Sculptra and lasers can be performed at the same time
Sculptra injections are commonly done at the same time as the Active and Deep FX or any other laser procedure. The lidocaine mixed into the Sculptra provides some anesthesia to make the laser procedure less painful. I usually perform Sculptra treatments every 4 weeks. The treatment can be performed irrespective of the time of any laser procedure.
Q: Spot treatment with laser resurfacing
I heard that laser resurfacing is a better long-term solution than Botox or Fillers for deep wrinkles and creases. Is this true for the person who has only a small area they want spot treatment on (such as crows feet)?
A: Best treatment depends on extent of wrinkling
Maybe, it depends on the extent of the wrinkling and the condition of the skin. Oftentimes, if there is extensive photodamage elsewhere, it is better to resurface the entire face. Non-ablative fractional lasers are another way to improve deep wrinkles and works well in conjunction with a neuromodulator like Botox or Dysport as well as skincare products like TNS from SkinMedica, Tensage from Biopelle, Neocutis or Elastoderm from Obagi Medical Products.
Q: Fraxel laser treatment results?
Can you tell me more about the benefits you can get from Fraxel laser resurfacing? What sort of skin problems get the best results from Fraxel?
A: Fraxel laser tightens skin and smooths out fine lines and wrinkles
The skin is tightened and collagen and elastic fibers are stimulated to grow. This smooths out fine lines and wrinkles. Fraxel laser treatments are best for fine lines and wrinkles as well as superficial sun damage brown spots.
Fractionated lasers vaporize a percent of the skin tissue unlike the older CO2 and Er:YAG laser resurfacing that has been popular for the last 20 years. By “fractionating” the laser similar results can be achieved with less pain and less patient “down-time.” There are also many “non-ablative” fractionated lasers like Fraxel, Affirm multiplex, eMatrix, etc. These non-ablative lasers have the advantage of having no “down-time” from the procedure, but the disadvantage of requiring many more treatments to achieve the desired results.
Q: Fraxel laser treatment dangers?
I am considering getting Fraxel laser surgery done to reduce the appearance of acne scars. You mentioned that there are a higher chance of side effects with a higher intensity laser beam. Is scarring one of these side effects?
A: Fraxel laser can cause scarring so go to an expert in laser surgery
Scarring is ALWAYS a side effect with ANY laser. That is why it is VERY important to go to a physician who is an expert in laser surgery. Reducing the appearance of acne scars usually takes more than one treatment. We have found that patient’s can expect a 50% improvement with each treatment so that 1 treatment gives you a 50% improvement , 2 treatments give you a 75% improvement, 3 treatments gives you a 87.5% improvement, etc.
Q: Is the Fraxel laser good for under eye wrinkles?
I have fine lines directly under my eyes. My doctor applied Botox to the outer eye area (where the lines were very minimal); but I still have fine lines. I’ve tried Fraxel under my eyes about 6 times last year, and saw a vast improvement. They still bother me though. Should I go back for more Fraxel to build more collagen?
A: The more laser treatments, the better the results
The more treatments you get the better. Remember, the more aggressive the treatment (ablative CO2 laser is more aggressive than non-ablative lasers) the better the results. If you want almost no downtime it will take many treatments to get the same results as an ablative laser which will have 1-2 weeks of redness and healing.
Q: Does Fraxel work for long term collagen production?
Does Fraxel Laser create long term collegen production? I know the C02 works very well. Does Fraxel just take away skin and not damage the tissue so it can produce more collegen?
A: Fraxel and collagen
Fraxel is a trade name for fractionated laser treatment. There is a non-ablative fractionated Fraxel which does not work very well to increase new collagen. But, the CO2 – ablative Fraxel and other fractionated CO2 lasers do promote collagen production to remove fine lines and wrinkles. I recommend the Active and Deep FX fractionated CO2 lasers since they are less painful and have faster healing that other fractionated lasers. The collagen they produce lasts 5-10 years but any laser cannot stop you from aging so plan on additional treatments every few years to maintain your correction and look younger.
Q: Active FX vs. Fraxel laser treatments – Which is better?
It seems like Fraxel and Active FX are both supposed to treat the same problems, but which one is better?
A: Active FX is better than other fractioned lasers
The Active (and Deep) FX lasers are more powerful than ALL other fractionated lasers. More power means quicker healing and less pain with possible less side effects. The Active/Deep FX laser is more expensive than ALL other lasers. That is why most doctors have the cheaper lasers. You only have one face, make sure the best laser is used.
Q: How close can the Fraxel Restore laser go under they eye?
I want to get Juvederm under my eyes for tear troughs, however, I also want to get Fraxel Restore for skin resurfacing. I have two questions: 1) How close can the Fraxel Restore laser get to the eye for fixing under eye wrinkles and crepe under eye skin? I notice some doctors treat right under the eye in photos, and 2) Is it safe to have Fraxel Restore done full face and including under the eye two months after injecting Juvederm under the eye for tear troughs? Could this cause pigmentation?
A: Fraxel restore is safe for under the eyes
1. It is safe to treat right up to the lash line, but the physician needs to place a corneal shield (fits like a contact lens) over the eye for protection.
2. It is safe to treat 2 months after Juvederm injections, but there is a slight risk of hyperpigmentation (temporary), and this is more likely if you have darker skin. If you have fair skin, this would be a rare complication.
Q: Can Fraxel Repair help with eyelids and give them a lift?
A: Fraxel repair for eyelid tightening
The Fraxel Repair can be an excellent tool for upper and lower eyelid tightening, but it can be a very tricky area to treat and care must be taken to avoid eye injury.
Q: Track marks after Fraxel repair?
I’m looking into Fraxel Repair, but I’m concerned about track marks. Can they be avoided? I’d rather not have to deal with bleaching creams etc. after an already difficult recovery.
A: Avoiding track marks with Fraxel repair
- Almost all patients require more than one laser during a resurfacing case.
- If you use the correct combo of lasers during the treatment, the risk of track marks can be nearly eliminated.
- Only a Board certified dermatologist or plastic surgeon should be doing your treatment. If they delegate your treatment to another staff member, go somewhere else.
Q: Will Fraxel Repair help with scars left after CO2 and Fraxel Restore?
About 15 years ago, I had a CO2 laser resurfacing done for acne scarsthat left me with redness, hyperpigmentation, and hypertropic scars especially on my chin.
I recently had two Fraxel Restore treatments that gave very minimal improvement in texture and my doctor is now suggesting switching to Fraxel Repair for the more severe scarring although initially he had said he was more confident about the Restore so I would love some additional thoughts about this.
A: Fraxel Repair for scarring and hyperpigmentation
Fraxel restore and repair are the best lasers I have seen for improving scarring and pigmentary issues. It is reasonable to try the repair since the restore hasn’t done much, although you really didn’t do enough treatments to know for sure whether it will work or not. We combine a topical agent with our Fraxel repair treatments to help repigment the skin. I would also consider using the Vbeam perfecta during the treatment sessions (to treat redness).
Q: Fraxel only on skin above the lip – lip line treatment?
I am fair skinned and have fairly good skin tone and texture. However, the texture above my lips is not as good as the rest of my face and I am beginning to develop those nasty lip lines. Can I have Fraxel only on the skin above the lips and nowhere else, or will that lead to freaky uneven results? I don’t want to have a full Fraxel treatment because of the expense – I am planning to have a facelift this year and would rather put my money toward that rather than full resurfacing.
A: Fractional treatments do no work well for upper lip lines, but there is a great treatment!
Experience has shown us that fractional treatments do very little for vertical lip lines. We have both the Fraxel restore and repair and have done thousands of these treatments. The best way to erase these lines safely in using a combination of the newest C02 laser and an erbium laser to peel away layer by layer until the wrinkles are gone or significantly better. You can combine this while you are under general anesthetic or it can be done separately from a facelift.
Q: Fraxel Repair recovery and healing?
How long does Fraxel repair recovery usually last? Can you break down the recovery time for me, like how long until you can be seen in public, wear makeup, look completely normal, etc.
A: Recovery after Fraxel Repair
Even after an aggressive Fraxel Repair treatment, you can usually wear makeup in 7 days, give or take a day or two in either direction. Some patients heal faster than others.
Q: Treatment for stubborn sun damage on neck?
I had sun damage (brown spots) on my neck and forearms treated 2 years ago with IPL (4 treatments). My arms responded great, but my neck only lightened a little bit. Any other treatments recommended? Would a TCA peel or Fraxel be worth trying to improve the discoloration on my neck? Any suggestions would be appreciated.
A: Fraxel for brown discoloration on the neck
Its hard to say without seeing your neck, but you may have Poikiloderma of Civatte, which is basically caused by repeated sun exposure. This responds well to a series of Fraxel restore treatments, or to one Fraxel repair. I often combine the use of the Vbeam Perfecta and or the Alex Trivantage laser with the Fraxel laser to get the best results when treating this condition. The Vbeam is particularly helpful if there is a vascular component.
Q: Thermage or Fraxel for under eye hollows?
I’m 54 with few wrinkles, but good skin tone and texture. However, I also have major sunken/hollows under eyes with minimal fat/puffiness and discoloration. I’m not fond of fillers. Will Thermage or Fraxel work?
A: Fraxel repair for under eye area
We have both the Thermage and the Fraxel Repair and restore. The Fraxel repair works the best under the eyes. I wouldn’t even consider the Thermage for this issue. Hollowing does respond very well to fillers and usually lasts over 1 year.
Q: What is effect of Fraxel on sebaceous hyperplasia?
I am 58 with history of adolescent and young adult acne. I have many enlarged hardened sebaceous glands below corners of mouth and on cheek. They are between the wrinkled creases. They aren’t raised up much, but they can be felt and are definitely visible under the surface when I stretch the skin over. Would Fraxel make these go away, or will it make them show more?Should I have the sebaceous hyperplasia treated first?
A: Fraxel not very effective for sebaceous hyperplasia
The Fraxel repair and restore may make the sebaceous hyperplasia slightly smaller, but I would recommend treating them with a hyfrecator, the smoothbeam laser, or a CO2 laser. These work much better and can be done at the same time as a Fraxel resurfacing.
Q: Fraxel Repair for redheads with fair skin?
How does Fraxel Repair treatment work on a redhead with fair skin? Is there a danger of infection?
A: Fraxel repair works well for redheads
If you are very fair skinned, you will probably have some pinkness to your skin that will last a bit longer than in the average patient. The risk of infection is extremely low. I have only seen 2, and in one case the patient’s dog licked her face when she got home. Neither patient suffered any problems from the infections (i.e. no scarring). Problems occur when patients aren’t followed closely by a qualified doctor (dermatologist or plastic surgeon). It is very important for your doctor to be able to realize when their is a problem and how to treat it.
Q: How do doctors decide on laser treatment settings?
I have found out through personal consultation that many doctors who perform Fraxel Restore, Fraxel Repair, and VBeam lasers always use charts provided by the corresponding manufacturer as their only reference to determine the settings to be used on every single patient they treat. Is this how all doctors decide which settings to use on each patient and case? Could this be one of the reasons for their treatments to achieve very little to no results with these 3 different lasers, but also no complications?
A: There are no “cookbook” settings for Fraxel Repair or Restore
Every patient is a unique case and settings should vary depending on age, skin type, condition being treated, desired downtime, etc. This is why you should see any experienced dermatologist that does these procedures everyday. I have never had a patient not see improvement after treatment with these devices. Another issue is that often times it is best to use multiple lasers in one treatment session to get the best result.
Q: Fraxel Repair vs. Pixel laser for aging skin?
Which laser is better for fine lines, shrinking pores and age spots, Fraxel Repair or Pixel Laser?
A: Fraxel Repair best for wrinkles, sun damage
The Fraxel Repair is a more aggressive treatment and will yield better results for these issues in most patients. Simply look at the before and after photos of patients treated with both devices and you will see the clear cut winner. I would combine the use of a q-switched alexandrite laser to be sure all age spots are gone. Pixel laser requires multiple treatments, and will incur more social downtime when taking multiple treatments into account. Even with multiple treatments with the Pixel, the results don’t approach those of the Fraxel repair.
Q: What is likely to cause bad Fraxel laser results?
Which is more likely to cause damage from Fraxel Repair: the laser itself, the settings, or the practitioner? Does the pressure applied by the practitioner also make a difference or contribute to bad results from Fraxel Laser?
A: Best way to ensure great results with Fraxel Repair
The best way to ensure great results is to
- Seek advice from a Board Certified Dermatologist
- The Dermatologist should be doing the procedure (not delegating to staff, i.e. nurse)
- The Dermatologist should have done at least 50-100 cases.
- Look carefully at all the doctor’s before and after photos. Make sure the lighting, camera angles, and shadows are the same. Patients in the photos should not be wearing any makeup.
- You should feel comfortable with your doctor. If you feel like there is something wrong, don’t do it.
Q: Cleansers to use during Fraxel Re:Pair treatment?
I am on day 5 after having Fraxel Re:Pair and my doctor told me to use a cleanser by Eucerin. I cannot find it can anyone give me a good alternative to this one. Also, my skin is so itchy and painful, I have been taking benedryl nonstop. Is this normal or do I have an infection?
A: Cleanser to use after Fraxel repair
I don’t have patients use a cleanser until they have completely peeled and that is usually one week or so. After that, I recommend the Skin Medica Sensitive Skin Cleanser. You may be having an allergic or irritant reaction to the topical products that you are using. Infection is a possibility. Have you gone back to see your treating doctor and what is their Board certification in?
Q: Can Laser Resurfacing Cause Acne Breakouts?
I’ve had 3 pixel laser sessions done and have experienced breakouts afterwards. My derm told me it has nothing to do with the procedure, but I had never had acne before on my left cheek and when I peeled after my first session I had quite a few pimples and it was quite a shock… the worst episode took place 5 days after my last session: 2 huge cysts popped there (on my left cheek) out of nowhere, and now I’m left with 2 very nasty icepick scars… Is it possible that laser triggered my acne?
A: Acne after laser treatment
It is usually not due to the laser itself, but the topical agents that are used following the procedure to accelerate healing. Proper cleansing and topical care will cure the acne.
Q:Erbium Laser Resurfacing on Lower Eyelids. When Can I Get Filler?
I am scheduled for erbium laser resurfacing on lower eyelids in two months. If I wanted to get filler done under the eyes should this wait until after the resurfacing? Or how long after resurfacing would you recommend getting the filler injected if it can be done at all?
A: Filler + Laser Treatment
This is a difficult question to answer. There are many types of erbium lasers which can be set to perform fractionated or confluent treatment. In general, it should not matter what order to do the procedure and a filler can be performed at the same time as a laser procedure. Since a filler will also smooth the skin, you may not need a laser procedure after, so I would recommend getting the filler first and then after a week, schedule the laser procedure.
Q: What Causes Broken Capillaries After Laser Treatment?
In the past I have had laser treatments for broken capillaries on my face. The first treatment I have been unresponsive. The second treatment is where I have problems. After the bruising and swelling subsides I am left with new broken capillaries. I have been treated by my regular doctor and a “cosmetic surgeon”. Why is this happening? Could the settings be to high on the second treatment? In both situations the doctors were unwilling to help.
A: Lasers should not make the problem worse
This is a very difficult question to answer. I have 38 different laser and energy devices in my office so I have no idea what laser was used for your condition. In addition, each laser can be set with different energy levels as well as diameters, pre and/or post cooling and pulse durations. In general, a properly performed laser treatment should NOT make the problem worse or leave you with more blood vessels. I would advise seeing a laser surgeon who has more than one laser and enough experience to evaluate your problem.
Q: Is fractional laser compatible with Botox?
I applied urbium laser 1 week after Botox for forehead and eyes. Only 3 weeks later the effect of Botox disappeared and wrinkles recurred. Is this due to laser that might have denatured Botox?
A: Botox and fractional laser work well together
No, having a fractional laser treatment will not cause the Botox to wear off. In fact, used together they can create great results and provide and a more rejuvenated look.
Q: What kind of laser treatment would be best for blue veins on the breasts?
These are not pregnancy related. Thanks.
A: Sclerotherapy is best for blue veins on the breasts
The appearance of superficial blue veins on the breasts occurs especially after breast augmentation. We have been treating these over the last 20 years with sclerotherapy and have published are results in the Journal Dermatologic Surgery.
The procedure takes less than 15 minutes is almost painless and works very well with over 90% of our patients very satisfied after 1 treatment. Two treatments may be necessary to get complete removal.
Q: Is Photodynamic Therapy a laser treatment?
What does photodynamic therapy mean and how does it work? Is it like light treatment or laser treatment?
A: Photodyamic therapy can be a light or laser treatment
Photodynamic therapy is when you apply a chemical to the face (Levulan is the brand name). After letting it incubate it needs to be activated with a light source. Some physicians use a blue light, and others use a laser.
Q: Skin didn’t respond to PDT for back acne
I recently underwent PDT with Levulan (60 min) and Blu-U (9 mins) for back acne. Why does my skin not feel burned or appear red?
A: Need a longer incubation time
I think you need a longer incubation time (ie. let the product sit on your back for longer) as well as possibly more time under the blue light.
Q: Will Levulan give me a good cosmetic result?
My dermatologist recommended Levulan with blue light for sun damage. Can I also expect a good all-over result for wrinkles, evening skin tone, and collagen rebuilding? Are there any downsides to this treatment?
A: If you want cosmetic results you need to combine it with an IPL
If you want cosmetic results from Levulan PDT you need to activate the chemical with a laser in addition or instead of only blue light.
Q: How does Dusa Photodynamic Therapy work?
I had the procedure done today for my acne. The doctor and staff members did not an adequate job telling me exactly what was going on. They gave me an info sheet 4 weeks ago, but did not say much to me for the initial treatment day. Levulan kerastick solution was placed on my face for 30 mins. Then, I was told to rinse it of,not wash it of. Following the rinse, I was placed under the light for 5 mins. Is 5 mins a good time? Also, my face has yet to start peeling or gotten red. Is that normal?
A: Yes Levulan PDT does work for acne
Yes, Levulan PDT by DUSA Pharmaceutical works. However, if you are not peeling at all you may have needed a longer incubation time or longer under the blue light.
Q: Wart treament – Alternatives to PDL?
Thanks. So if PDL is not your first choice of treatment, may I ask what is? Again, my situation is 4 Periungual warts. If they were any other type of wart I would use Cryro or, I have been succesful with just using Apple Cider Vinegar, but because of their location on the finger tips, they are very difficult to treat. I read many good things about PDL for Periungual warts so it will either work or it won’t, but I plan to hit these at least 3 or 4 times with PDL before I give up and move on.
A: PDL is first choice to treat warts
The PDL is my first choice to treat warts. Just like any laser, it is the setting that are used that determines efficacy. In my practice 1 treatment is successful in over 75% of patients and 2 treatments are required in 20% of patients. 5% of patients need more treatments or alternative treatments.
Q: Will laser facial hair removal treatment diminish the effect of the Juvederm in same area?
I am planning to have Laser facial hair removal treatments (7) in the area above my lips. This is the same area that I have had the dermal filler, Juvederm. Will the Laser treatments cancel out the filling effect of the Juvederm or diminish its longevity in anyway or even not be effective at all? Thanks for your answer to what I think is a simple question that the folks at Juvederm can’t answer.
A: No, you can do laser hair removal and Juvederm together
No, you can do laser hair removal and Juvederm together, i do this almost every day. the company probably cannot comment as there has never been a formal study done, but it definitely can be done.
Q: Can I use Vaniqa while having laser hair removal?
I’ve read that laser hair removal is more effective when combined with Vaniqa yet a plastic surgeon told me today I should stop using the Vaniqa before I start laser hair removal because Vaniqa slows the hair growth cycle. Thoughts?
A: Yes, you can combine
Yes, you can combine Vaniqa and laser hair removal sessions and continue taking Vaniqa. However, if the laser hair removal works you should be able to stop soon!
Want more information about lasers?
Please contact Goldman Butterwick Fitzpatrick & Groff, Cosmetic Laser Dermatology at 858.657.1002 for more information on laser treatment options and to schedule a consultation. We are located in the UTC area of San Diego, minutes from La Jolla, Del Mar, and Downtown San Diego.
