Monday, February 23, 2009

19 Fractional CO2 Laser Tips for Cosmetic Dermatologists

By 5. Tattoos: DeepFx might be good for resistant Tattoos

Fractional CO2 laser ablation has become increasingly popular as an alternative to traditional plastic surgery. So, What do Cosmetic Dermatologists & Plastic Surgeons want to know about C02 fractional treatments?

Treating Specific Cosmetic Conditions:

1. 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.

2. Reliants ActiveFx is better for more superficial pigment and more surface textural problems

3. Stria (Stretch Marks): Use ActiveFx: 80-100 mj, density 1-2 (use Density 2 for thicker Stria). 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 that have resisted other treatments.

Pre / Post Treatment Tips for Fractional C02 Laser Treatments:

1. Use mild moisturizers to avoid acne flare-ups.

2. You don't need to use Aquaphor or Vasoline for this. Mild moisturizers are enough.

3. Be aware of the Lanolin in the Aquaphor.

4. Using Aveeno Water Gel can lessen downtime up to a day!

5. 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?)

6. Post Care: Cold packs or Zimmer Cooler for 30-45 min after treatment.

7. Valtrex for all patients. (One case of disseminated herpes on the face is not good.) 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. 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 possible Lidocaine toxicity so excercise care. Compounded Lidocaine works as well or better than Pliaglis. Pliaglis costs $60 per treatment. Compounded Lidocaine costs 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: Make sure they use everyday after skin is healed. Wear your hat and stay out of sun.

14. Good UVA blocker as further protection.

Fractional C02 lasers can produce great results if used correctly, but like any cosmetic medical technology, it's not perfect.

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