Lasers & Treatments
By Elizabeth Rostan, MD
Filed Under
DEVICES & TREATMENTS
Quick Look
AGING SKIN
Around age 30, our skin stops producing collagen. Aging and sun damage lead to collagen loss as well as loss of elastic tissue in our skin. Collagen can be thought of as the strength of our skin and elastin the stretch or rebound of our skin. This collagen and elastin loss continues and leads to fine lines, sagging skin, wrinkles, and texture changes.
VISIBLE SIGNS
As we age, skin visibly changes in several way and a lot of it has to do with things beyond your control-
- Rough, dry and dull skin surface
- Brown spots/ discoloration
- Broken blood vessels
- Fine lines & wrinkles
- Texture changes
BELOW-THE-SKIN
Effects and changed appearance of your face.
Loss of fat above the skin
(cheeks, chin, nose and eye area)
Loss of elasticity/ Sagging skin
(hands, decollete, cheeks, eye hollows jowls and sagging neck)
LET’S TALK SKIN
Don’t be alarmed! Wrinkles are a natural part of aging but this aging is greatly accelerated by sun exposure. A few lifestyle changes you can start early 20s – 30s that can help minimize wrinkles:
- Stop Smoking
- Minimize sun exposure
- Moisturize
- Your Skin
- Anti-aging Skincare Routine
- Adopt a Skin-friendly Diet
- Skin-friendly Diet
- Pamper the delicate eyelid skin
Today we will focus on the laser treatments used to rejuvenate and renew skin and help you understand how we think of these treatments as the fountain of youth and bring some understanding to the many options of lasers.
What Are Anti-aging Laser Treatments?
Anti-aging laser or energy treatments stimulate the skin to produce new collagen and elastic tissue thus renewing the skin and improving fine lines and wrinkles.
I am often asked “how long do these treatments last?”. The answer is the effects of these treatments don’t just suddenly disappear; however, time and aging continue with continued loss of collagen and elastin loss that is accelerated by sun exposure. These treatments are like making deposits into a savings or retirement account – but the currency is COLLAGEN.
Anti-aging laser and energy treatment stimulate collagen and vital skin structures to replenish and restore what is lost with aging and sun damage.
Laser Treatments and Benefits
Photofacial
INTENSE PULSED LIGHT (IPL)
Blotchy pigment | Redness | Blood Vessels Fine Wrinkles | Texture | Sun Damage Brown Spots
+ Great for face, neck and chest
Pigmented Lesion Removal
(GentleLase, IPL and Fraxel Dual)
Sun Spots | Freckles | Melasma | Other pigmented lesions
+ Light peeling of the darker spots for 3-5 days after treatment
Vascular or Redness Treatments
(VBeam, IPL and GentleYag)
Broken | Blood Vessals | Rosacea Facial Redness | Flushing
Laser Toning
(GentleYag, SmoothBeam, VBeam and IPL)
Deeper Lines & Wrinkles | Texture
+ These lasers stimulate collagen production at different depths in the skin, ulimately giving it a healthier glow and smoother texture
+ Treatments are typically performed monthly – minimal or no downtime
LASER RESURFACING:
(C02 and erbium lasers)
Severe Sun Damage | Deeper Lines & Wrinkles Scarring (around mouth or eyes)
+ For areas of most severe sun damage, deeper lines, wrinkles and scarring – usually used on local areas (around mouth or eyes)
Photofacial
INTENSE PULSED LIGHT (IPL)
Blotchy pigment | Redness | Blood Vessels Fine Wrinkles | Texture | Sun Damage Brown Spots
+ Great for face, neck and chest
Pigmented Lesion Removal
(GentleLase, IPL and Fraxel Dual)
Sun Spots | Freckles | Melasma | Other pigmented lesions
+ Light peeling of the darker spots for 3-5 days after treatment
Vascular or Redness Treatments
(VBeam, IPL and GentleYag)
Broken | Blood Vessals | Rosacea Facial Redness | Flushing
Laser Toning
(GentleYag, SmoothBeam, VBeam and IPL)
Deeper Lines & Wrinkles | Texture
+ These lasers stimulate collagen productionat different depths in the skin, ulimatelygiving it a healthier glow and smoother texture
+ Treatments are typically performed monthly – minimal or no downtime
LASER RESURFACING:
(C02 and erbium lasers)
Severe Sun Damage | Deeper Lines & Wrinkles Scarring (around mouth or eyes)
+ For areas of most severe sun damage, deeper lines, wrinkles and scarring – usually used on local areas (around mouth or eyes)
Well that probably got your attention!
It is more ideal to begin to renew the skin and reverse as well as prevent the changes of aging and sun damage before the skin gets to the severe wrinkling . The results are far better with yearly preventative, corrective treatments that are non-ablative versus the more aggressive ablative.
What Is Non-ablative vs. ablative?
Non-ablative Lasers
means the upper layer of skin is not disrupted or removed – thus there is no oozing and no wound of the upper skin. These treatments are considered no-downtime because there are no openings or channels created through the upper layer of skin. Non-ablative treatments are the vast majority of the cosmetic rejuvenation treatments done for anti-aging.
Ablative Lasers
means there is disruption or removal of the upper layer of skin. Fractional ablative means tiny holes or channels are created in the skin. These holes take about 48 hours to close so these treatments have oozing and drainage that lasts during that time.
Fully ablative is done in areas of severe wrinkling and/or sun damage and means the entire upper layer of skin is vaporized leaving a fully open wound. This is the most aggressive treatment and has the high level of potential complications.
What Is Fractional Treatment?
A fractional laser treatment is a laser that treats a fraction of the skin by computer controlled impacts that cover a certain portion of the skin surface – say 15% – 30%. The density of the fractional laser treatment refers to the percentage of impacts or coverage.
A low density treatment (20% or less) will have less downtime and may be preferred for a variety of reasons (work or social schedule, skin color, goals of treatment) versus a high density treatment. Energy can also be changed with high energy being more painful and with more downtime.
Skin Concerns Treated
- Fine Lines & Wrinkles
- Texture
- Tone Discoloration
- Melasma
Goldilocks System A Family Of Fractional Lasers
Start a good skin care regimen, sun avoidance and collagen stimulating treatments sooner rather than later (just like your savings accounts).
I like to refer to the family of fractional lasers as the Goldilocks bear family:
the ablative fractional CO2 laser – Acupulse
Fraxel 1550 nm – deeper penetrating laser for deeper lines and texture changes
(OK that it’s not in the fable…) –more superficially penetrating 1927 nm laser but at a moderate to aggressive energy and density (number of impacts) – Lutronic Lase MD Ultra or Fraxel 1927
– this is the 1927 nm at low energy and density OR Clear & Brilliant (1440 nm) which only operates at very low energy and density thus “baby fraxel” (the 1927 is probably a little better for pigment)
Laser Toning
Laser toning refers to these treatments I have been describing that are designed to “wake-up” the skin – stimulate collagen and renew the deeper part (dermis) of your skin so that on the surface it looks more radiant and fresh
Laser toning can be achieved with a variety of devices:
- + IPL (intense pulsed light)
(the Hollywood facial) - + Low energy q-switched laser
- + Vbeam pulsed dye laser
- + Fractional Non-ablative Laser (the Hollywood facial)
UltraLase MD, Fraxel and Clear & Brillant™
How to Choose?
Lots of freckles/ discolorations
GentleLase pretreat followed by Lase MD Ultra -either “Teenage or Baby Bear”
Lots of freckles/ discolorations and moderate lines/wrinkles
GentleLase pretreat followed by “Mama Bear” Fraxel 1550
GentleLase pretreat followed by “Papa Bear” – Acupulse fractional ablative CO2 laser
Redness, broken capillaries, flusing
Add Vbeam PDL or YAG treatment for larger veins