Question
Confused about Laser Resurfacing treatments after disappointment with CO2
I am Mexican and Filipino, but the Mexican side is questionable, as I may have French roots because I'm very fair and have had freckles as a child through adulthood. When I had hyperpigmentation/melasma and fine lines under my eyes I went to get a CO2 treatment. The results were less than satisfying; I ended up having more lines on my lower lids plus hypopigmentation on the area, as well as above my upper lip. I have consulted various doctors, and I am overwhelmed with their suggested treatments: Fraxel Restore, fraxel Re:Pair, Plasma, and Cool touch, can't remember the rest. Is there anything that can help me get rid of the fine lines without causing more undesirable effects like the ones from my CO2 experience, which made me wary of laser treatments. I was told that I would have smooth skin--but I didn't. It would be two years in December since my treatment (2006) and I am still red/brown on the lower side of my lips. Thank you for any help.
Answers (3)
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1
October 20, 2008
Laser resurfacing with CO2 laser.
I don't blame you for being confused about laser resurfacing since there are many lasers and even more claims about lasers. I no longer use the CO2 laser because many patients develop bleaching of the skin after resurfacing with the CO2 laser. If, on the other hand, you are disappointed because there was not enough correction following the laser resurfacing, then perhaps the energy settings used were too low.
By far the best laser available to treat wrinkles and discoloration of the face is the Contour laser, manufactured by Sciton. The Coutour laser is really two different Erbium lasers in one. When the Contour laser is used in the "ablation" mode, then it functions as a conventional Erbium laser and is quite effective to treat superficial lines. When the "coagulation" mode of the Contour laser is added to the treatment panel, then this laser is effective for the treatment of even very deep facial wrinkles and I have not seen any skin bleaching with the Contour laser. Patients treated with the Contour laser look fine with makeup in a week or less, but without makeup the treated skin can remain pink for weeks. Most patients tolerate this well, and are pleased with the improvement in the texture of the skin which can be quite dramatic.
2
September 13, 2008
Fractional CO2 may be the best choice
Answer by Michael Sinclair, MD
Part of the problem you are experiencing is that most doctors will recommend whatever treatment they can offer. Since there are many laser companies selling laser equipment, you will end up with wide variety of answers. There are a few basic principles you can use to help yourself. Because of your mixed ethnicity, you have to assume that you are at risk for hyperpigmentation. That means lower settings and more treatments is probably going to give you a better result. Strict sun avoidance before and after the procedure will help alot...in fact, it may be critical.
If you have more issues with mild color irregularity, then IPL may be your best option. If you have more issues with fine lines and wrinkles, then a device that operates at 1440 nm may be the best choice. If you have more deep wrinkles, then a fractional CO2 may be the best choice. If you have more problems with acne scarring, then a fractional 1540 nm device may be the best choice. There are LOTS of manufactures that make the above devices. The skill of the doctor operaing the equipment and figuring out what you need will be more important than which device they have. Try to find a doc that does a lot of this kind of work on people with somewhat darker skin. Avoid going to a strip mall where the technician is paid to get you to sign up regardless of your needs.
For more information, you can click here...
http://www.epilution.com/services/fractional-resurfacing.html
3
September 12, 2008
Fraxel Re:store is best option
My experience is that Re:store is the best for skin type IV for both melasma and scars. The settings must be conservative, so more sessions (6-9) would be necessary. Cooltouch has no benefit for melasma, but may help scars. Topical tazarotene and TriLuma may also help melasma and hyperpigmentation. Hypopigmentation is, unforunately, a complication of CO2 lasers, and it can be very long-lasting. I am not aware of any modality that really helps this complication.
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9/14/08
Thank you. I appreciate your recommendations.
My posting was somewhat edited incorrectly.
I would like to know what treatment/procedure
is best for my skin type to reduce/eliminate
lower lid fine lines,fine lines above my lip,
and overall texture (I have enlarged pores), with the least amount of hyper/hypo pigmentation
side effects. Any suggestions?
Do I just have to live with the fine
lines/wrinkles I have now and may have
later? I am so unhappy with my lines. They
are not deep wrinkles, but am afraid they
will be soon.
I do wear 30spf sunscreen with
Octinoxate and Zinc Oxide daily, and have
a skin care regimen that includes tretinoin,
hydroquinone, and exfoliation. Should I try
chemical peels for my fine lines/wrinkles?
Thanks again.
desperateinthebay
10/24/08
You know what. I am filipino with olive
skin tone. I have had 3 mor more
dermabrasion as well as one co2 laser by
very qualified plastic surgeons. I have had great results. I
recently had IPL by a dermatologist 1x and the
result was disastrous, not to mention
no one in his office mentioned possible
scarring or hyperpigmentation due to
high setting. Plastic surgeons who are
good will at least give you idea as to what
the risks are. Now I am considering
CO2 laser again to correct the darn IPL
scarring I received. It really is best
to see a plastic surgeon who is qualified
to do these procedures and not to go to any
med spas or dermatologists who claims that
they know what they are doing. More people
are getting hurt since these guys started
doing cosmetic procedures such as non-ablative
lasers, which are supposed to have reduced time time
1/2/09
i've had c02 done and it was great, so naturally i decided to have a 2nd treatment, im afraid that it's a wrong decision, it's been a month and i still have red discoloration, a week after my scabs peeled off - my derma gave me bleaching creams and ointments, now it's turning from red to brown... im slightly hoping it will even my color again....