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You probably had chicken pox when you were a kid; before the vaccination was available, it was almost a certainty of childhood. As a result, you might have one or more deep, pitted or shallow, indented scars. It’s probably safe to assume that you don’t want a permanent memento of your illness–chicken pox scars are often reminders of part of our childhood that we’d just rather forget!
The question of, if, or how we treat chicken pox scars is a frequently asked one in our office. And yes, we can and do treat them. But the exact way that’s best for you can be different based on a few different things. Shallow scars may respond better to laser treatment, and deeper or pitted scarring may be better suited for a surgical approach. Let us explain the process a bit more. There are generally two different approaches to the treatment of chicken pox scars: laser resurfacing or surgical excision of the scar.
Scar removal before and after pictures
Laser resurfacing is a process that removes layers of damaged or scarred skin while heating the deeper layer to produce collagen and make the skin appear firmer and smoother. Another term that fits this type of resurfacing is “ablative” or “fractional” laser resurfacing, because there is skin that is removed or “ablated” by the laser. At Celibre, we provide Erbium fractional resurfacing to improve chicken pox scars. This procedure works best if your scars are shallow. Usually a series of three treatments are required to see good results with this type of scarring.
The other option is surgical excision. This is usually done by a plastic surgeon who removes or “excises” the scar tissue in a single procedure. The net result is trading a deep or pitted scar for a linear one, and this may be a good choice if your scar is large, excessively deep or if you are not a candidate for laser resurfacing of the scar.
There are effective options available for the treatment of unwanted chicken pox scars. The one that’s right for you depends on several considerations. To evaluate your options, it’s best to sit down with someone who’s experienced at treating these types of scars. Call us today for your free evaluation.
Birthmarks come in all shapes, colors, sizes and locations. Many “birthmarks” may not even be visible at birth, but develop in the first few months or years of life. And while many people like their birthmarks, others do not. If you’re someone that doesn’t like having a birthmark, laser medicine has opened the door to significantly reducing the appearance of a birthmark or even removing it altogether!
Brown birthmarks have many different names: café-au-lait spots, nevus of Ota, and congenital nevus are just to name a few. And while each of these types of brown birthmarks looks a bit different from the other, they all have one thing in common: they are made of melanin. Because of this, a very specific, powerful type of laser known as a q-switched laser can be used to help remove them.
Q-switched lasers target melanin. Their energy destroy the melanin-containing cells that make up birthmarks. These cells are then replaced with new ones that do not have the memory of the birthmark. The visual effect is a fading of the birthmark. In many cases, significant fading occurs; in others, the birthmark may disappear entirely.
There are some types of brown birthmarks that should not be treated with q-switched laser. It is always a good idea to see a dermatologist and have your birthmark evaluated before having any laser removal treatments performed. However, if you get the green light to treat, birthmark laser removal can be a safe and very effective option to get rid of your birthmark permanently!
In the 1990’s or early 2000’s, when you heard the term “laser resurfacing” it meant one thing: a major procedure loaded with common side effects and a rather lengthy recovery. The CO2 laser was the only technology available for this procedure and it was “full field” which meant that the skin at the treated area was completely removed. This version of resurfacing was not an option for anyone with darker skin types (colors) meaning that for many patients, there was no option at all!
Thankfully, laser resurfacing is much different! In 2005, fractional laser technology was introduced. This new type of laser resurfacing revolutionized the procedure and addressed many of the problems and limitations of the earlier version.
Fraxel was the first “fractional laser resurfacing” technology. Fractional treatments mean pretty much what they sound like: only a fraction of the entire skin surface is treated. While you might think this sounds like a less effective treatment, it isn’t! In fact, the researchers developing this technology found that they could get comparable results with fractional treatments to full field resurfacing without many of the side effects.
So, how does fractional laser resurfacing work? It creates a grid-like pattern of microscopic perforations in the skin. The “density” of these perforations is customizable and means that a lighter treatment may mean only treat 10% of the skin, while a more aggressive treatment can be more on the order of 50 – 70%. The technology works sort of like passing the laser beam of light through a filter (like a strainer) that divides one single laser beam into lots of little tiny ones.
What happens when these beams of light hit the skin? They are transformed to heat energy, which precisely injures the skin by vaporizing it! This process creates an injury which forces your skin to recover. As you heal, you’ll form new collagen and elastin in your deeper skin as well as new skin surface. The overall effect is smoother, tighter, brighter and clearer looking skin!
Here are the major advantages of fractional laser resurfacing:
Overall, fractional laser resurfacing is an excellent treatment if you are looking to treat acne scarring, fine lines and wrinkles, want refinement of large pore size, and/or overall skin rejuvenation. Call us today to learn more about the Scition Profractional laser.
Laser tattoo removal is a safe and effective method for removing unwanted tattoos. Unfortunately, the process may take numerous treatments, even when done correctly. Patients often have to wait a period of 1-2 years to complete the process because of the time it takes the body to remove tattoo ink that has been broken down during a laser treatment.
Before Treatment Day of Last Treatment 2 Years After Treatment
The expectation we set for our patients at Celibre is that the average tattoo will require between 5 and 15 treatments. The number of treatments depends on the skin type, the type of ink, the laser used, the laser energy used, the skill of the practitioner and the depth of the ink. A common misconception among patients (and some practitioners) is that it is better to use consistently higher laser energies with each treatment to speed the removal process. While it is true that less treatments may be required to completely remove the tattoo when using higher (ablative) energy levels, this method also carries risk. The problem is that using extremely high energy to “carve out” the tattoo ink can lead to scarring or depigmentation (lightening of the skin) at the tattoo site once it is removed. Your skin type will have a large effect regarding the risk of scarring with darker skin types more prone to scarring or depigmentation. At Celibre Medical, we do not perform treatments in this manner because we want to remove the tattoo with no permanent scarring or skin lightening left behind after it is removed.
In some situations, a tattoo may become unresponsive to lasers after repeated treatments because the ink has faded so much as to make it difficult for the laser to interact with the ink. At this point, most patients will continue to observe excellent, continued fading over time as their bodies continue the remove the pigment over time. See photos (there were no laser treatments between the second and third photos, just fading over time).
At Celibre, we utilize two types of Q-switched lasers for tatto removal. Because we use two different machines, we have the ability to access much higher energies (using the Medlite C6) if and when when tattoos become unresponsive due to fading. Although uncommon, tattoos may also become unresponsive to even the most powerful Q-switched lasers. When this happens, our bodies take over to continue the fading process over time.
The term “pigmented lesions” can refer to many different skin conditions. In general, these conditions are commonly known as freckles, age spots, liver spots, sun spots, moles, birthmarks, etc. To understand how laser treatments can be used to treat these conditions, it is important to have a basic understanding of how class IV medical lasers work.
The concept is quite simple – each type of laser is attracted to a specific target area in the skin. The target for the laser is determined by the wavelength of the laser being used. So for these type of pigmented lesions, the lasers are attracted to the melanin (pigment) in the skin. When the thermal energy of the laser treatments interacts with the pigmented lesion, it breaks apart the cells that contain the pigment (melanocytes). Although the treatment is usually short, the process of breaking up and fading the pigment continues for several weeks even after the treatment is over. With repeated laser treatments, the cells containing the pigment in the sun spots, tattoos or birthmarks can be removed and replaced with cells that do not contain the pigment. This is how we can eliminate these unwanted brown spots for good with laser treatments.
Los Angeles sun spot removal laser treatments at www.celibre.com/sun-spots.
Schedule a free Los Angeles liver spot removal consultation at www.celibre.com/contact-list.
Sun damage (Seborrheic Keratosis) before and after laser treatment pictures. More sun spot removal before and after pictures by Celibre Medical at celibre.com/sun-spots-laser-removal-before-after-pictures-photos.
Lori Ishii Haney, RN, MEP-C
Certified Medical Laser Safety Officer
Very simply, yes you can get rid of Poikiloderma. Here at Celibre Medical, we have a wide array of FDA-approved class IV medical lasers and broad band light that can both safely and effectively remove the red and brown discoloration of Poikiloderma. We use pulsed dye lasers, q-switched lasers and the Sciton BBl (broad band light) to get rid of redness, sun damage and uneven skin tone.
A good question to ask is, “Will my Poikiloderma stay gone after laser treatment?” This question is a bit more difficult to answer. One factor to consider is how you developed your Poikiloderma in the first place. Chances are you spent a lot of time in the sun. UV exposure is the main culprit behind the changes that you see on your skin.
So, if you decide that you’re going to invest the time and make the financial commitment to get rid of your Poikiloderma with class IV medical lasers, then you need to take the proper steps to make sure that you protect your skin so that you don’t develop it again.
Sun avoidance works as the best type of sunscreen. Do your outdoor exercise or yard work early or late in the day, when the sun’s UV isn’t quite so intense. Even still, you must wear broad spectrum sunscreen to protect your skin from damaging UV rays, and consider protective clothing if you’re going to have extended periods of sun exposure, especially if you’re swimming or sweating.
At Celibre Medical, we’ve helped many patients rejuvenate the appearance of the skin on their neck. We can help you too. Don’t hide behind your turtlenecks any longer. With the proper laser treatment and some simple, yet effective sun-smart behavior, you can be proud to show it off again.
Poikiloderm photo (courtsey of eMedicine)
Do you oily skin and notice that your skin’s texture is less than smooth? Or maybe you have Rosacea and the repeated flares of inflammation have made your skin look rough and bumpy with enlarged pores. Many in our industry refer to these changes as “orange peel” skin. No matter how good your skin is, we all notice some textural changes and enlarged pores as we age because of sun exposure.
Orange Peel texture, large pores and lines before and after Erbium Micro Laser Peel and Restylane injections
Many salons, estheticians and medical practitioners will tell you that “orange peel” skin can be treated effectively with microdermabrasion, chemical peels or special skin care products. Because many of these textural changes in the skin stem from the loss of collagen, the treatment options that work best must stimulate it. The only one that does this effectively is class IV medical laser treatments like the laser resurfacing.
This type of laser treatment can reach the deeper layers of skin (the dermis) and trigger your body to make more collagen. This will tighten and firm your skin. Your skin will look smoother and your pores will be smaller. We have found that by combining these types of laser treatments with good, medical grade skin care products, most patients see good, lasting improvement!
Don’t fall for catchy advertising or other gimmicks. While microdermabrasion and peels can produce some result when used correctly, they can only go so far. They don’t have the ability to reach the deeper dermal layers where collagen is produced and stored to give lasting and impressive changes in “orange peel” skin.
Looking to freshen-up the appearance of your skin? Want to improve your skin’s tone, texture and firmness? Then the erbium MicroLaser Peel and the Sciton Profractional laser are excellent options.
Many patients considering laser resurfacing want to know what to expect afterward. Specifically, they want to know how much downtime they’ll to recover from the procedure. For both of these laser resurfacing options, the expectation is 4-7 days. During this time, they may be comfortable doing things around the house or working from home, but are usually not sufficiently healed to participate in social events. We refer to this recovery period as “social downtime”. Most patients can return to work, social and outdoor activities closer to the fifth day after treatment.
What will you look like during the 5 to 7 day recovery period? You’ll likely be red and you may experience some light scabbing, flaking and peeling. Each day following treatment, you will notice improvement and we provide you with a detailed skin care regimen during your recovery. This helps get you stay on the right track and ensures that you heal quickly and without complication.
Our patients love the erbium fractional resurfacing and the MicroLaser Peel and we love that we can offer such an effective and safe treatment that gives consistently beautiful results with little downtime!
If you have poikiloderma, you are used to wearing scarves, turtlenecks and collared shirts to hide it. It causes embarrassing red and brown, blotchy discoloration on the sides of the neck and chest. Laser treatment can be an effective way to improve or eliminate your poikiloderma once and for all!
Here at Celibre Medical, we’ve treated many patients with poikiloderma with our class IV medical lasers and BBL (IPL) and had outstanding results. The key to your success is understanding that a series of treatments will be necessary. We usually perform treatments every four weeks. We also offer more advanced, aggressive laser treatments for poikiloderma, but these aren’t for everyone. These may be the right choice for you if you have the right skin type (color) and you’re looking for more dramatic results in a shorter time frame.
The last piece of the puzzle is proper skin care following your laser treatments. Remember, sun damage is what causes poikiloderma in the first place; sun protection will help keep your skin looking its best after treatment. Use a good, broad spectrum sunscreen on your neck and chest every day!
Poikiloderma photo (courtesy of eMedicine)
We understand how hard it can be to have embarrassing spider veins on your legs or cheeks. Sometimes, it can feel like they limit you in almost everything from what you wear to your activities. Here at Celibre Medical, we have a very effective laser treatment program for spider veins, and we’ve helped many people just like you feel good about showing their legs again in public! However, we have a very long talk with each of our spider vein patients about what exactly lasers can and can’t do for them before we ever do their first treatment.
Class IV medical lasers and sclerotherapy can safely and effectively eliminate or diminish the appearance of unwanted leg veins, but they don’t do anything to address the underlying cause. So, while they can help your legs look better, they can’t prevent you from ever getting spider veins again. Spider veins tend to run in families—it’s not a coincidence! There is an underlying genetic component that triggers the one-way valves in your leg veins to fail. These leaky valves allow blood to go in the wrong direction to the small (usually hidden) veins closer to the skin’s surface. As these fill up with blood, they enlarge and become visible.
Laser energy and sclerotherapy can close these enlarged, visible veins, but they can’t do anything to fix the valves. Most people need repeated laser treatments over their lifetime to help keep their legs looking good. Lasers are an important tool in controlling spider veins, but they are not a cure for them.
At Celibre Medical, we always make sure you completely understand this before we start laser treatments. We’ve found that many practices don’t take the time to help their patients understand this critical fact! We want you to be beyond satisfied with your results; an important part of your satisfaction is a complete understanding of the basic nature of your problem and how and why our treatments can help along with their limitations.
If you’re considering laser resurfacing and you’ve started doing your research, chances are you may have come across some confusing terminology. Laser resurfacing is immensely popular today, but not all procedures or devices are created equally. This wasn’t true when it first came out; but today, you do have several options to choose from. At Celibre Medical, we have a few different types of resurfacing lasers. This helps us better tailor a treatment that perfectly fits your needs.
Laser resurfacing is a term that broadly describes a procedure in which a laser is used to injure the skin in a controlled manner. The goal of resurfacing is to produce younger-looking, tighter, fresher, improved skin texture and tone. It is a procedure that can help many skin conditions including acne and traumatic scarring, aging skin, fine lines and wrinkles, and improve pore size.
Laser Resurfacing Before and After Pictures
Traditional laser resurfacing was first introduced in the 1990’s and involved the use of the CO2 (carbon dioxide) laser. It was a deep and aggressive resurfacing procedure that removed the entire top few layers of skin. It required general anesthesia, had a very long recovery period of several weeks and unfortunately, carried the risk of numerous side effects such as infection and permanent changes in the color of the skin (lightening or hypopigmentation). Despite all of this, many people saw incredible results from these procedures and laser manufacturers began to develop technologies that could give similar results without all the downtime and potential risks.
Out of this effort came fractional laser resurfacing. The term fractional is exactly what it sounds like. The beam of laser light is divided into many smaller, individual beams. Imagine shining a flashlight through a colander…it’s the same concept. This allowed for some (not all) of the skin to be damaged by the laser. And by leaving those small “islands” of normal skin right next to the damaged areas, the healing times were drastically reduced to days instead of weeks. At the same time, fractional resurfacing reduced the risk of complications and unwanted side effects compared to traditional full field resurfacing.
Most laser resurfacing procedures are ablative, which means that they remove all or a portion of the skin. Laser researchers began wondering about ways to build lasers that simply use heat to do the same thing as ablative lasers, but not actually remove skin. With this research, non-ablative laser technology was born. Non-ablative lasers can also be fractionated, but they produce small columns of thermal energy in the skin. This works to stimulate collagen but has no downtime after treatment.
If you’re wondering which type of laser can give you the most dramatic results in one treatment, it is still the full ablative CO2. Ablative fractionated treatments are good, but you still may need more than one depending on how aggressive it is and what your underlying skin condition is. Non-ablative fractionated treatments produce the least impressive results (per treatment), so a series of treatments is always recommended, but many people like the option of having no downtime, so they accept them as a good alternative.
At Celibre Medical, we offer both fractional ablative laser resurfacing (with a downtime of 5-7 days) and fractional non-ablative procedures (with no downtime). The Sciton Profractional is our fractional ablative laser and the Quantel Medical Aramis and Palomar Q-Yag lasers are what we use for our non-ablative procedures.
Each treatment offers its own benefits and limitations. In a free consultation, we can help you decide which of these is right for you. Remember, it isn’t just the device that matters! The expertise, skill and knowledge of the person using the device matters too!
If you have a brown birthmark, you’ve probably heard of q-switched lasers. But you may not realize that this is not a specific type of laser or the name of a single laser. Rather, q-switching refers to the way a laser delivers light energy to the skin. Q-switched lasers achieve very high peak powers by using very short bursts of light, making them a group of lasers designed for this purpose. This is possible because the q-switch is an amplification system that shortens the length of time of a single burst of light (the pulse width). For q-switched lasers, the pulse width is measured in billionths or trillions of a second!
Think about the strength of a pulse of laser light in this way. It’s kind of like swinging a baseball bat. If you swing slowly, a longer pulse width, the baseball doesn’t go very far when hit. But if you swing very fast, a short pulse width, and hit the ball, you can generate more power to send the ball much farther and at a faster speed.
So, why do we need a laser with this much “pop” for birthmarks? It comes back to our intended target, excess melanin in the birthmark. The Q-switched laser perfectly absorbs the wavelength of melanin, and we generate power with a short burst of light to break up excess pigment-containing cells. This combination of short bursts of high powered light is what makes (permanent) removal of brown birthmarks—or any darkly pigmented spot—with q-switched lasers the gold standard.
Not all brown birthmarks can be completely removed with these devices and not every q-switched laser is safe to use on any skin type (color). Although we’d love to see your brown birthmark completely disappear after treatment, this result isn’t always possible. Sometimes, we are only able to fade it significantly. At Celibre Medical, we only use specific q-switched lasers that are safe for every skin color. Not every practice does this, however. You need to be aware of this specifically if you have a darker skin type (Hispanic, Asian, African), and make sure that you ask about which q-switched laser would be safe to use on your skin type.
While they may not be a perfect answer for all pigmented birthmarks, q-switched lasers offer you the best chance at getting rid of your brown birthmark. Or at the very least, fading it significantly.
Poikiloderma is a term that is used to describe sun damage (photo-aging) on the face, neck, and chest. This skin condition is represented by red and brown discoloration and also a slightly rough texture in the sun exposed areas of the neck and chest. The redness is a result of superficial vascularity as a result of sun exposure. The brown discoloration is also a form of sun damage and may give a mottled appearance to the skin.
Because class IV medical lasers are very specific and effective in what they treat – both colors are treated with two different lasers. Pulsed dye lasers treat the red pigment whereas Q-Switched YAG lasers treat the brown discoloration. Besides fading or resolving the discoloration, these lasers also stimulate collagen which leads to improved skin texture. There is no downtime with these types of laser treatments.
Poikiloderma photo (courtesy of eMedicine)
On the practitioner’s side, various factors affect the delivery of laser treatment care, including communication style, training, experience, time constraints, empathy, and teaching skills. Similarly, on the patient’s side, basic health habits, existing health conditions, the ability to follow instructions, motivation to improve, and psychological health all play a role in determining the effectiveness of treatment. It takes a good mix of both sides for healthcare to go right. It takes a good practitioner and a good patient. All too often, patients expect this relationship to be too lopsided and forget they’re responsible for how successful their treatments are.
Cosmetic medicine is no different. A crucial part of having a successful procedure is understanding what a procedure can and cannot do for you and having the correct expectation for your treatment. This process begins with an excellent practitioner who will take the time to discuss a treatment thoroughly and answer all your questions, as well as provide you with all appropriate treatment options. However, it is then your responsibility to understand and process that information and form realistic goals and expectations for your procedure.
Sometimes, this isn’t easy. We live in a society with a quick-fix mentality. We want what we want when we want it. But medicine doesn’t always work like that. Many problems, even cosmetic ones like acne and melasma, are chronic and incurable. And if you don’t understand this before you start treatment, then you’re setting yourself up to be very frustrated and unhappy.
At Celibre Medical, we put an emphasis on patient education. To us, this is the key to helping you establish reasonable, realistic expectations. This means that we make it a priority to spend more time with you up front to prevent unpleasant or unhappy conversations down the road. We will take the time to explain your condition, your treatment options along with the risks and benefits of each, in addition to your expected costs and time for recovery. We want to be your partner in your treatment process not a bystander.
Despite this, there are still no absolute guarantees for your treatment plan. We don’t hide this fact or sugarcoat it for you. And we are more than happy to tell you no. We won’t do something that isn’t in your best interest or wouldn’t benefit you. We believe that this is delivering the highest quality of care, and this is something that we absolutely will guarantee!
If you’re confused about the terminology of leg veins, you’re not alone. Many people use the terms spider veins and varicose veins interchangeably, but the truth is that they mean very different things.
If you think of the veins in your legs like a tree, you have very large vessels deep inside your leg that carry blood back up to your heart. Medium-sized veins enter into those large veins, resembling branches branching off from a trunk. These are closer to the skin’s surface of your leg. Next, coming off those are the very small branches and twigs which are the small veins in the skin itself.
Varicose Vein (Pacific Vein Center) Spider Veins
Understanding how blood is supposed to flow in the legs is key to comprehending why varicose and spider veins occur. It flows inward and upward from the smaller veins to the larger ones. Now, remember that most of the time, this process must occur against the pull of gravity. To fight the constant “down and out” pull, each vein contains a series of one-way valves that keep the blood moving in the right direction.
Varicose veins occur when the valves fail in the medium and larger sized veins. This causes them to fill with blood, swell and enlarge and bulge out on the surface of the skin. Varicose veins look swollen, blue and spongy. They are usually several millimeters to a centimeter (or more) in diameter. They can also be painful. Most people with varicose veins will tell you that they can become inflamed, tender to the touch and ache. This usually happens after a long day of standing or prolonged activity.
In contrast, spider veins (also called telangectasias) are very small, only 1-2 millimeters in diameter. They manifest as red, blue, or purple clusters, often forming mats resembling spider webs within the skin. They are flat and generally don’t hurt. Lastly, spider veins do not have “feeder” veins like varicose veins do.
Most people who have varicose or spider veins generally don’t like them. Luckily, there are effective treatments for both these problems, but they are different. Knowing which type of vein issue you have is important.
Vascular surgeons are generally responsible for evaluating and treating varicose veins. Surgical vein stripping is an effective procedure, but may leave scarring. Lasers can be used for varicose veins, but the procedure is very different from laser treatment of spider veins. Healthcare providers can effectively use internal, endoscopic lasers to heat and seal off larger internal veins that are not functioning well.
Treating larger varicose veins is crucial for the successful treatment of smaller spider veins because they are the constant blood supply that keeps the surface open and visible. Spider veins respond very nicely to both sclerotherapy (injections) and external laser treatment. Sometimes, a combination of both treatments is necessary to completely get rid of them. Deeper, larger, blue veins tend to do better with sclerotherapy and smaller, more superficial red veins respond well to laser.
Understanding the differences between the types of veins you have will help you choose a treatment plan. Finding the right provider with the right knowledge, skills, and equipment is essential for safely, effectively, and completely eliminating varicose veins and spider veins.
