How Do Medical Lasers Work?

Class IV medical lasers are devices specifically designed to emit various wavelengths of light (visible and non-visible) to treat many different medical conditions. They are the highest-powered type of laser used in medicine and have the potential to cause damage to the skin and eyes if used incorrectly. In the state of California, only licensed physicians, physician assistants, nurse practitioners or registered nurses may legally operate Class IV medical lasers.

Each laser is designed to emit a single wavelength of light that generates powerful thermal energy for an intended target (i.e. hair, blood vessels, pigment/melanin). Because of this, not all lasers can treat the same condition. Each one has a very specific and specialized purpose. However, there are several lasers that can treat a wide range of skin problems because they use multiple wavelengths of light.

As an example, hemoglobin is a molecule that attaches to and carries oxygen in red blood cells. Lasers that target hemoglobin can be used to treat skin problems that involve unwanted blood vessels like rosacea, red acne scars, angiomas or spider veins. Other lasers are specific for pigment or melanin. These devices are used to treat tattoos, unwanted hair (pigment lines the follicle), sun spots, age spots and other skin pigment problems. Lastly, some devices target water. These lasers vaporize skin and can be used to resurface and regenerate large or small areas of skin, depending on the desired effect or the outcome that’s wanted. Acne scars, wrinkles and texture issues (pores) are treated with this type of laser.

At Celibre Medical, we use a variety of different lasers. Some of the lasers we use include: the Lumenis LightSheer, the Sciton Profile, the Cynosure V-Star, the Candela V-Beam, the Quantel Medical Aramis, the Laserscope Lyra, the Palomar Q-Yag V, and the Hoya Conbio Medlite C6 to name a few. If you’d like to learn more about our laser equipment and the skin conditions they treat, please visit celibre.com/equipment.

Why Does It Happen in Laser Treatment of Sun Spots

Overview | Treatment | Cost

You may have heard of or read the term “frosting” when researching laser treatment for age spots, tattoos, or brown birthmarks and thought, “that sounds strange?” And while “frosting” typically conjures up visions of birthday celebrations or winter windshields, in the laser world, it’s a term that we use to describe what we see happening in the skin as it’s treated with a q-switched laser. It has nothing to do with dessert or freezing and everything to do with appearance. When we see a thin, white layer or “frost” on skin that’s just been treated with laser, we know we’re in the sweet spot—no pun intended! Let us explain a bit further.

A q-switched laser uses a powerful beam of light energy. That delivers both heat and a sound wave to its target, physically breaking apart pigment. In the case of tattoos, age spots, or brown birthmarks, this target is melanin or pigment in the skin. As melanin is broken up, the process creates a reaction of sorts that triggers the release of gas that becomes trapped beneath the skin’s surface. This trapped gas looks like a layer of white frost, and this is how the term “frosting” came about.

The phenomenon of frosting is completely temporary. The “frost” completely disappears within several minutes after treatment. However, it’s an important marker for a laser practitioner to see because it tells us two things: we are hitting our intended target, with the right energy and speed and we don’t need to pulse or treat the lesion any further once it appears. Frosting during laser treatment is a visual sign that gives us instantaneous feedback about how effective our laser settings are and when we can stop treating a pigmented lesion.

So, what happens after frosting from a patient’s perspective? The frosted appearance quickly fades and most patients describe a slightly crusty or flaky appearance of the skin after laser treatment. This usually lasts anywhere from 4 to 7 days (for the face). The treated areas may look and act like light scabs. But what’s really happening is that the treated melanin and melanocytes are rising to the skin’s surface to be sloughed off and replaced by new, healthy skin.

This process of skin regrowth and rejuvenation is how lasers work to remove. Pigmented age spots, birthmarks, freckles, or brown, flat moles. It can take repeated treatments with the laser to completely fade or remove. These spots because the skin must regenerate slowly over a period of time.

Q-switched lasers offer a great solution to the problem of unwanted brown, pigmented spots. There are options that involve treatments that don’t produce frosting. But these tend to be a bit slower and take more treatments overtime to give the same results. Whichever treatment method you chose. We can provide you with expert care and will walk you through your treatment process step by step.

Are you searching for a better way to cover-up and hide unwanted spider veins and broken capillaries on your face? Maybe you spend extra time in the morning applying makeup to hide these pesky red, blue or purple blood vessels only to find that they’re showing again by the middle of the day? If you’re a man, you may feel embarrassed that you have to use makeup at all! Stop working so hard to hide your facial spider veins and consider laser treatment to safely and easily get rid of them.

Broken capillaries or spider veins are a very common problem. Most people have them; however, if you’ve spent years in the sun, tanned indoors or worked outdoors, you may have more because they are a part of the “photoaging” process. Photoaging occurs when the ultraviolet (UV) radiation from the sun and indoor tanning beds cause the skin to age prematurely, thinning it and making these vessels more prominent in appearance.  The cheeks and area around the nose are typically where you find them, but spider veins can pop up anywhere on the face and body.

No matter what color spider veins you have (red, blue or purple), Celibre Medical has a laser that will work for each. Because the depth of the blood vessel is what determines the color, different devices are used to penetrate to the correct level, hit their target and cause it to disappear after treatment.

Because we have several different and effective laser devices, we can treat facial spider veins on people with different skin types (colors). Practices that offer a single laser to treat each and every patient, regardless of the color of vessel or skin type, can’t guarantee safe or effective results. However, Celibre Medical has an excellent record of safety and patient satisfaction because we’ve built our laser arsenal with you at the top of our priority list. We understand the importance of both, and this makes us the very best at what we do.

We understand how difficult it can be to have a port wine stain (vascular birthmark), especially when it’s on the face.  Laser treatments can offer life-changing results, and we are honored to help patients like you through the removal process. At Celibre, our treatment of choice for port wine stain removal is the pulsed dye laser.

Each of these birthmarks has different qualities—no two are exactly the same, so not everyone responds the same to treatment. Port wine stains are a malformation of the blood vessels at the surface of the skin that can occur anywhere on the body.  The size, depth and number of blood vessels in the birthmark impact the response to treatment and the number of treatments necessary to see improvement. Research suggests that the location of the birthmark can dictate how quickly and successfully it responds to laser treatment.

Not all port wine birthmarks will disappear completely, so we often tell our patients that treatment success should be defined in some cases by improvement in the appearance of their birthmark rather than total removal.  When discussing this limitation up front, we also discuss why it’s impossible to tell beforehand what degree of improvement we’ll see. The only thing that we can know is that your port wine stain will improve.

The pictures above were taken of a patient who received six pulsed dye laser treatments for her port wine stain. A series of 8 to 12 was recommended at consultation, and although she didn’t finish the treatment program, as you can see, she had about 75% improvement in the appearance of her facial port wine stain.

If you have a “birthmark” that you’ve always wanted to get rid of, Celibre Medical and class IV medical lasers can help. Birthmarks come in one of two varieties: red or brown. Port wine birthmarks are red in color because they are made up of blood vessels close to the surface of the skin. Another term for this type of mark is a vascular birthmark. Brown birthmarks are darker than your normal skin color. They can range from light tan to very dark brown. These birthmarks are comprised of melanocytes, which are the skin’s pigment (melanin).

Before we describe options for both red and brown birthmarks. It’s important to know that birthmarks are not usually a “one and done” process. Fading of most birthmarks will take several laser treatments for optimal results. In some cases, fading, rather than complete removal, is the end goal.

Class IV medical lasers can safely remove several types of birthmarks on all skin types (colors). Here is a brief list of some of the birthmarks that respond to laser treatment:

Café-au-lait

These are tan to brown birthmarks that usually appear in infancy. They can range in size from ½” to several inches across, are flat and have the same texture as surrounding skin. Café-au-lait spots can occur anywhere on your body.

Celibre Laser Birth Mark removal patient

Becker’s Nevi

Another pigmented birthmark, Becker’s nevi are often darker in color and larger than café-au-lait spots. They are more common in males, and while they’re often present at birth, people can also develop them in puberty. They generally affect only one side of the body (i.e. are unilateral), and will extend across the chest or shoulder, or down the arm. These birthmarks are more difficult to remove with lasers.

Photo courtesy of Dermnet New Zealand

Nevus of Ota

Nevus of Ota are most commonly found in Asian, Hispanic or African skin types.  They often present as dark bluish or greenish patches at the temple forehead or eye, usually only on one side.  These birthmarks are successfully treated with high powered q-switched Nd:Yg lasers.

Port Wine Stains

Port wine stains (red, vascular birthmarks) can be small or large, and often involve the facial. The color can range from red to deep purple (hence the name), and they are always present at birth. Pulsed dye lasers are an effective treatment for port wine stains, and can often remove them entirely. Keep in mind, this process may involve several treatments that are spread over a long time period.

Celibre Laser Birth Mark removal patient

Removing birthmarks with lasers can be a delicate and tricky process. No two are alike. Each has its own location, color, shape and size which makes laser treatment of birthmarks a highly-individualized process. Generally, birthmarks are either red or brown, and there are several different types of each. Examples of red or “vascular” birthmarks include port wine stains and hemangiomas. Brown or “pigmented” birthmarks include café-au-lait and nevus of Ota/Ito. The reason it is important to distinguish between these two groups is that they each require different yet specific lasers to treat them effectively.

Red, vascular birthmarks require lasers that target blood vessels, while brown, pigmented birthmarks need lasers that target skin pigment or melanin. It is also important to note that while many of both types of birthmarks can be fully removed using these lasers. Sometimes the best we can do is fade the birthmark so that it’s not so noticeable.

Pulsed dye lasers use technology that targets hemoglobin. Hemoglobin is part of the red blood cell, so it’s a great target if we are trying to get rid of anything that has blood vessels. Vascular birthmarks respond very well to this type of laser. But usually take more treatments over a longer period: 6 to 10 treatments total to see full results. Again, sometimes we can get rid of red birthmarks completely, and other times, the laser fades them a great deal.

Q-switched lasers are the treatment of choice for pigmented or brown birthmarks. Because these contain melanin (skin pigment), they usually fade quickly with the proper treatment. Celibre Medical currently uses two q-switched YAG lasers for these types of spots. We have found that most patients get full results or significant fading after just 3 to 5 treatments with either of our devices. We tell our patients that the sun can stimulate the pigment in the birthmark to return. So heavy, repeated sun exposure of the treated area should be avoided. Q-switched lasers are safe to use on any skin type (color). This is important to know because pigmented birthmarks can be more common in people with darker skin like Hispanics and Asians.

No matter which type of birthmark you have, Celibre has a laser that can safely and effectively remove it. We pride ourselves on being at the forefront of laser medicine and only use the latest, FDA-approved lasers to treat birthmarks. We’ve made sure that we’ve taken extra time and care in choosing our devices so that we can offer treatment to almost anyone with any type of birthmark anywhere on the body. Because of this, we have years of experience in treating a wide array of both types of birthmarks on all skin types. And this is why you can trust Celibre Medical to safely and effectively treat yours as well.

Tattoo removal lasers are powerful devices designed to specifically break apart tattoo ink that was meant to be permanent.  While they are both safe and effective in most cases, when used improperly, you can be at risk for unwanted side effects, including scarring.

If you are having or thinking of having laser tattoo removal, be aware of the possibility of side effects.  Choose your laser facility and practitioner carefully to minimize the chances of scarring and make sure you’re treated by someone who is highly experienced.  Doing your homework up front to find an experienced practice will limit the risk of scarring.

Scarring that can happen after laser tattoo removal generally falls into one of three categories: hypopigmentation (lightening of the skin), hyperpigmentation (darkening of the skin), or textural changes in the skin. Let’s talk a bit more about each of these and why they can happen.

Hypopigmentation after laser tattoo removal is somewhat common – and usually temporary. Remember, the laser works by delivering light energy to the pigment in the tattoo, and often, it is the same wavelength of light that is used to remove excess melanin in the skin. You may see a slight lightening of your natural skin tone where your tattoo was previously and this change often returns to your normal skin color after healing. However, it can be a more permanent change if you’re not taking care of your treated skin with proper sunscreen protection, having your treatments done too close together (without proper healing) or having treatments that are too aggressive (laser energy settings that are too high with bleeding during treatment).

Hyperpigmentation or darkening can also be a common, but is a temporary phenomenon, and is common with darker skin types. Even if your laser practitioner follows all the proper settings and precautions, it can still happen. The best way to avoid this unwanted side effect is to make sure that your laser practitioner is using a tattoo removal device that is right for your skin type (color).

Textural changes in the skin can happen with laser tattoo removal treatments that are done too aggressively. This may include energy settings that are too high for your skin and/or not allowing enough time to properly heal between treatments. Yes, we get it…you want your tattoo gone yesterday, but is it really worth the risk of trading a scar for your tattoo? We’ve seen scars from tattoo removal that look much worse than the original tattoo.

To minimize the risk of improper healing after your laser tattoo removal treatment, follow your practitioners post care guidelines carefully. Make sure you protect your treated skin and tattoo from the sun and keep the area well moisturized while healing.

Finally, make sure that your practitioner is licensed and credentialed to treat you with the device that they are proposing to use for your treatment. As common as laser tattoo removal is, you would be surprised to learn how little training some practices offer prior performing the treatments. Ask lots of questions and be your own advocate. When you do, your chances of having any unwanted side effect or scarring after laser tattoo treatment will be reduced dramatically.

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The answer to this question depends largely on what type of acne scars you have. There are several types of acne scars we treat.

• Dark pigmented acne scars (brown spots in darker skin types).
• Red pigmented acne scars (red spots in lighter skin types).
• Textured acne scars (bumpy, rolling, disk shaped, pitted, ice pick, etc.)

Within these categories there are additional variables that determine how we treat acne scars.

Treating pigmented acne scars is very different than treating textured acne scars. In addition, treating brown acne scars is different than treating red acne scars and treating rolling textured scars is different than treating pinpoint or ice pick textured scars. For pigmented acne scars, there are three options – Pulse dye lasers for red acne scars, q-switched lasers for brown acne scars and depigmentation programs such as Cosmelan and our own proprietary program for getting rid of the brown acne scars without laser treatments.

For textured acne scars, we have several options including the Aramis and Q-switched lasers (with no downtime) and the Erbium laser for laser resurfacing (5-7 days of social downtime). To determine which type of laser we would recommend for your textured acne scars, we evaluate you in person to see how deep the scars are, what your goals are and what your preference for downtime vs. no downtime procedures is.

Have you been considering laser treatments to improve your lines and wrinkles?  Because of the hype in our industry, you may be surprised to learn that not all lasers treat lines and wrinkles effectively.  We’re here to help you make sense of your laser options for smoother, tighter, firmer and younger skin. We’ll explain their similarities and differences as well as discuss why certain treatments might make more sense for you versus others that your friends or family members may have had.

First, it’s important for you to understand that there are two primary laser technologies proven superior for improving skin’s texture and laxity: CO2 and erbium.  Many different companies produce lasers using these two energy.  While similar, these types of lasers do  have subtle differences.

Fractional Laser Resurfacing

So, which one would be the choice for you? The answer really depends on your goals.  Are you a 35-year-old who just wants a bit of smoothing and brightening? Or are you a 65-year-old who has smoked and sunbathed for the past 40 years? As you might guess, these two patients will require different laser resurfacing treatments.

More aggressive treatments (for more severe damage) will require more recovery time. The longest downtime is usually following fully ablative CO2 resurfacing. These patients will need 2 to 4 weeks for recovery. Other non-ablative resurfacing procedures (with less dramatic results) carry no downtime at all! Keep in mind that more aggressive treatments are usually a “one and done” type approach. No downtime procedures may require a series of treatments.

So how do these treatments work to smooth your skin and erase lines and wrinkles? Lasers use thermal (heat) energy to injure your skin. This precise injury forces your body to make new collagen. As your skin heals and new collagen forms, you see tighter, firmer skin.

In addition to CO2 and erbium, radio frequency treatments have also been developed to tighten skin. While the mechanism by which these work is different than lasers, the underlying “collagen remodeling” is the end result.

Just as technologies have evolved, so has our approach to laser resurfacing. Twenty years ago, full CO2 resurfacing was the only way to get younger, fresher-looking skin. The recovery times were long, and often complications occurred including permanent color changes and scarring. In 2005, the first “fractional” treatment was introduced. This technology allowed for “only a fraction” of the skin to be treated with the laser, rather than the entire skin surface. Not only did this reduce recovery time (to about a week) and complications, but the results were similar to traditional CO2 resurfacing. Today, fractional laser resurfacing is the preferred method to rejuvenate skin.

Fractional resurfacing treatments are excellent for improving fine lines under the eyes, smoker’s lines at the top lip, and crow’s feet at the sides of the eyes.

Too often consumers become focused on a specific laser done because they saw it on The Doctors or Dr. Oz.  Instead of focusing on a particular brand of laser, we suggest evaluating the practitioner using the laser. Look at before and after photos of patients with similar issues as yours and examine the results that your potential practitioner gets with the lasers they use.

Choosing a laser resurfacing treatment can be a daunting process, but with the help of a knowledgeable and skilled practitioner and a good understanding of the goals and limitations of the procedure, you can find the perfect fit for you.  Call us today for your free consultation.

When you think about anti-aging treatments, you might think first about procedures to help your face look smoother, fuller, firmer and less wrinkled. But your face isn’t the only indicator of your age. In fact, many of our patients who’ve had effective facial rejuvenation come to us asking about other areas that they feel don’t “match” their face or give away their age. One of these areas is their hands.

Your hands are exposed to view every day. Depending on your profession or daily activities, they may draw more attention or even take center stage over your face! One of the most frequent complaints about aging hands are prominent, “ropey” looking veins on the backs of the hands. While there’s no great preventative treatment for this, there are effective ways to improve it.

Asclera is an injectable product that can be carefully injected into unwanted veins on the hands. It causes the treated vein to harden or “sclerose” and this triggers the process of the vein being slowly broken down and removed naturally by your body. The treatment is called sclerotherapy. If you’re thinking, “I thought that was a treatment for spider veins on the legs?” you’re right! It’s the same exact process, and it works just as effectively for unwanted veins on your hands.

This treatment is ideal for smaller veins, so if you still have larger ones that you don’t like, sometimes we can couple sclerotherapy with dermal filler treatments of Radiesse.  Radiesse helps to add back fullness to the backs of the hands. This can be an effective camouflage for larger veins. It also helps your hands look fuller, softer and smoother.

Don’t let your hands spoil your age. There are effective anti-aging solutions for your hands and we can help you decide which one is right for you!

Nevi is the fancy, medical term for “moles”. Most of us have at least a few moles on our skin. Chances are that no two of yours look the same, because nevi come in a variety of sizes, shapes, colors and textures!

One type of birthmark is a “speckled nevi”. These look like large, flat light brown patches with lots of darker, freckles within them. Sometimes they may fade during the winter and get darker in the summer or with sun exposure. If you run your fingers over the surface, they may feel a bit like sandpaper. If you’ve got one and you wish you didn’t, class IV medical lasers may be able to help.

Laser treatments for brown birthmarks isn’t always a sure thing. While many fade significantly, others don’t. We tell this to our patients up front and set their expectation for improvement in appearance and not necessarily total Removal. At Celibre Medical, we’ve had good success treating these types of birthmarks (and others) with q-switched laser technology. Q-switch lasers are safe for most skin types (colors) and they will often fade the brown pigment of speckled nevi birthmarks, while leaving the dark freckles behind.

While laser treatment of these birthmark can be challenging, we’ve found that by thoroughly discussing the ins and outs of treatment and results up front with our patients, they are very happy with their results.

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Have you had freckles your whole life? Or maybe you have a darker skin type or a long history of sun exposure and you’ve noticed small brown spots popping up everywhere?  Whatever you call them – sun spots, freckles, birthmarks or brown spots—there’s a good chance that you have a few that you wish you didn’t.  One uncommon place for these spots is the lips. No one is happy with attention-drawing discoloration on such a highly visible area as the mouth! If you’re a woman trying to hide these, your lipstick shades are limited to the very dark end of the spectrum. And lip gloss is completely out of the question!

Many people worry that these spots are a sign of something bad, but in most cases they’re harmless. And if you’ve wondered about laser removal of brown spots on a sensitive area like the lips, you’ve landed on the right page! Lasers can safely and effectively remove dark spots from anywhere on the body, even the sensitive mucosa of the lips. The specific type of laser that we use at Celibre Medical Corporation for this treatment is the q-switched YAG laser.

The q-switched YAG laser is safe to use on anyone, regardless of their skin type or color. Treatments for brown spots on the lips are usually quick and relatively painless. Best of all, there is no downtime! Most people see improvement after just a single treatment and many get complete results after three!

Don’t struggle trying to cover up unwanted dark brown spots on your lips. Lasers offer you a unique, effective and safe solution!

Sun Spot Removal

Sun Spot Removal Before and After Pictures

After laser brown spot removal, consider wearing lip protection that has SPF (sun protection factor) in it if you spend a lot of time outdoors.

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There are several types of birthmarks – red birthmarks are vascular (made up of small blood vessels at the surface of the skin) and brown birthmarks that are made up of melanin (the skin’s natural pigmentation) that is darker than the surrounding skin. In addition, birthmarks come in a variety of sizes and density of pigment.

Although most birthmarks are effectively treated with class IV medical lasers, it is difficult to predict the number of laser treatments that are required for birthmark removal. The realistic expectation that we set for patients is that they have to be prepared for only improvement or fading rather than just complete resolution. In some cases we can get complete birthmark removal, but even in those cases, there is a possibility that at some time in the future, more laser treatments will be required if the birthmark reappears.

Although many birthmarks may resolve completely, it is impossible to predict which ones and with how many laser treatments. Most birthmark removal patients see good progress after three (3) aggressive laser treatments. After three treatments, if the patient is not making progress with their laser birthmark removal program, we sometimes advise them to stop because not every birthmark will respond to lasers. Most treatments do not involve any downtime, and laser treatments for birthmarks are usually less than 30 minutes.

There are so many different lasers for skin resurfacing that you might wonder which one would be good for you?  At Celibre Medical Corporation, the technology that we’ve found to offer superior safety and results with our patients is the erbium YAG laser.

Erbium is an older technology, but it works, and we know that it can provide consistent benefits with little risk for our patients. It’s a great procedure to consider if you have fine lines and wrinkles, acne scarring, or if you just want to improve the laxity and firmness of your skin.

Erbium laser resurfacing does this in two ways. First, it removes the outer skin layer (the epidermis) while it simultaneously deposits heat deeper in the skin (the dermis) to stimulate collagen production. When combined with the new epidermis that is generated after treatment, erbium laser resurfacing can produce brighter, tighter, healthier and younger looking skin!

You will most likely need more than one treatment spaced at least four weeks apart to achieve optimal results. If you work or have other commitments, you will also need some “social downtime” or recovery period.  This “downtime” lasts around 5 to 10 days following each treatment.  There is very little discomfort during your healing period, and most patients return to their normal schedules about five to seven days after treatment!

Laser Resurfacing Before and After Pictures

If you have a Nevus of Ota birthmark, then it’s possible you’ve considered laser treatment to remove it. These greenish, bluish birthmarks typically appear on the face and can be difficult to hide. If you have or are considering removing your Nevus of Ota birthmark, q-switched laser treatments are an excellent option.

Nevus of Ota birthmarks can appear green, grey or blue because the excess pigment is located deep within the second layer of skin.  Laser light works to remove these birthmarks by penetrating deep into the skin to reach the target. The type of laser light used to target this pigmentation is called q-switched.

Although q-switched lasers work very well to clear these birthmarks, sometimes, we can only achieve partial clearance. Having realistic expectations for your treatment is key to a positive experience with laser treatments.

If you’ve decided that now is the time to remove your nevus of Ota birthmark, call Celibre Medical today for your FREE consultation to learn more about q-switched laser treatment options.