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If you’ve been doing any laser research recently, then you’ve probably come across the term “FDA-approved”. We hear this phrase over and over in our industry as it is meant to give credibility to the latest and greatest cosmetic laser technology. But, what does the term really mean? How does it impact your decision to have a certain treatment or procedure? Or should it?
First let us inform you that almost every laser manufacturing company and every laser practitioner that uses the device will tell you that it is “FDA-approved”. This tells you that the device has met certain requirements of the FDA—the United States Food and Drug Administration. It does not tell you, however, how effective the device is at treating a particular condition.
What are the requirements of the FDA for approval? They can vary, but for the most part, for a laser, the manufacturer must submit an application to the FDA stating that they intend to market the device to treat a certain condition. They also must submit one or more clinical trials done where the laser proves safe and effective in treating the skin condition indicated in the study. Only after these requirements have been met will the FDA approve a device.
So, what’s the issue? Well, the FDA-approval process has a couple inherently large flaws. First, the physicians who perform the clinical trials for the devices are generally compensated to do so by the device’s manufacturing company. They often get to use the device for free, and as a result, they are naturally biased to demonstrate positive results. This problem isn’t just in the medical device industry…it happens in all areas of medicine. Anything that needs approval by the FDA, including medications and vaccines.
The second problem is that approval is more reliant upon device safety than treatment efficacy. Take this example: if a clinical trial for a laser demonstrates that only one out of 10 people treated with it showed improvement and none of the 10 had any side effect or harm from the device, then that may still pass FDA standards. This means that the manufacturer could advertise the device as being “effective” for the condition, even though the rates of success in the clinical trials were very low. Unfortunately for consumers, the FDA looks more closely at safety than it does at efficacy.
This brings us to our final point: FDA-approved is a misnomer. The FDA simply grants “clearance” to a device. Clearance to the manufacturer to market it and sell it for use on the public. The FDA doesn’t even recognize the term “FDA-approved” because it implies that it approves of the use of a device for a particular condition. Nothing could be further from the truth. Instead of advocating for the use of the device for a condition, the FDA simply allows it to be used. Advocating and allowing are two very different things, and patients need to understand the difference when considering a treatment with an “FDA-approved” device.
No matter the semantics, the term “FDA-approved” is widely used and accepted by most laser practitioners and patients. It is important, though, to understand what that term really means. It is more of an indication of the safety of a device rather than its efficacy.
This is where consumer research and education become so important. You simply can’t rely on advertising to tell you if something works or not. You need to ask questions, be informed and learn all you can about your condition and the device that you are considering for treatment.
Pore size is partly determined by genetics. Some have large pores and some have small. Pores ize is also affected by age and generally older patients with less pliable skin will have larger pores. There are options to help improve the appearance of large pores and lasers are one.
At Celibre Medical, we use more than one laser to help improve pore size. Ultimately, stimulating the production of new collagen using heat from laser treatments is key to keeping the skin healthy, firm and elastic – all of which will contribute to improving pore size. To stimulate the production of collagen we use the Sction Profractional (fractional resurfacing) laser, the Palomar Q-Yag V (q-switched Nd:Yg) laser and the Quantel Medical Aramis (Erbium Glass) laser. All will help in the process of renewing skin via collagen stimulation.
Skin care products are also very important for the reduction of pore size and we encourage patients to consider either Retin A or Glycolic acid products during and after their laser treatment program.
Your eyes say a lot about you. They can reveal your emotions, your level of attentiveness, as well as the amount of sleep you had last night. Your eyes are a focal point of your face and whether you realize it or not, they communicate a wealth of information to those around you. It’s no surprise that the eyes are a top cosmetic concern for patients like you. One of the most common questions our patients have is about improving the wrinkles around the eyes.
Your eyelid skin is extremely thin and delicate. This is why it’s one of the first areas of your face to be adversely affected by age. It thins just like the rest of our skin, so it’s quick to sag, crease, droop and wrinkle. If you’ve researched eye rejuvenation at all, you know that products such as Botox, Dysport and fillers like Restylane and Juvederm can all help reduce the signs of age around the eyes. But sometimes these treatments aren’t enough. To really repair and rejuvenate the eyelid skin, laser resurfacing is necessary.
Here at Celibre Medical, we offer Sciton Profractional laser resurfacing around the eyes. This treatment works by precisely creating thousands of pinpoint, microscopic perforations in the skin. The laser energy does this by heating the skin by targeting water within the skin cells. By carefully creating these microscopic wounds, we force the body into healing, which produces new collagen and healthier looking skin. A specific technique we use is called “coagulation”, and just like it sounds, it heats up the tissue around the area of the laser injury. This second type of injury is more indirect, but it creates a tightening effect, especially in the thin skin under the eyes. The overall effect after treatment is tighter, firmer, younger and smoother looking skin under the eyes.
Fractional laser resurfacing is a great tool for dramatic improvement of eyelid wrinkles. It is often combined with other treatments (like Botox, Dysport, Restylane) to enhances results! There are risks involved in treating the sensitive and delicate eyelid skin with powerful lasers, so make sure that your laser practitioner is expertly trained and has plenty of experience to ensure the safety of your eyes as well as fantastic results.
Polycystic Ovarian Disease (PCOD) is a devastating medical condition that is on the rise. The National Women’s Health Institute reports that it affects one out of every 10 women of childbearing age. While no one is exactly sure what causes PCOD, we know that it causes major hormonal imbalances. Women with PCOS have too much androgen (male hormone) and insulin (regulates blood sugar). These two factors cause the major symptoms of PCOD: infertility and menstrual problems, obesity, acne, skin changes (skin tags and darkening of the creases), as well as thinning hair on the scalp and excess facial hair (hirsutism).
Although there is no cure for PCOD, treatments are aimed at restoring the normal balance of hormones and fertility. Often, these treatments can’t help some of the physical symptoms of PCOD, especially excess facial hair. Women with PCOD struggle to control excess, coarse, dark facial hair, which can negatively impact self-esteem, confidence and the ability to function personally and professionally.
Clinical research has shown that treating PCOD patients with laser hair removal (along with other therapies) can be extremely effective and helpful. Laser hair removal offers hope and encouragement to women with PCOD because it helps them feel more feminine and less self-conscious. And the results are permanent!
If you’re suffering with PCOD or know someone who is, laser hair removal can be life-changing. As with any laser hair removal treatment, make sure your laser practitioner is experienced and skilled and has the right equipment for your skin color.
Laser Hair Removal Before and After Photos
Many patients don’t realize how quickly and effectively class IV medical lasers can completely resolve spider veins without any downtime. Red, purple and blue spider veins are all treatable with lasers. Even darker skin types may be safely treated for spider vein removal with long-pulsed Yag lasers.
For most spider vein removal patients, a treatment plan of 3 to 4 is average. If a patient has very large areas or large veins being treated, a series of six laser treatments may be recommended for optimal results. Patient compliance with post-treatment recommendations is critical in enhancing and maintaining spider vein removal results. In most situations, patients are pleased to see obvious progress after each and every spider vein removal treatment.
Class IV medical lasers are a good option to consider for the removal of spider veins and 3 to 4 laser treatments is a very realistic estimate of how many visits it will take to accomplish the goal.
Keloid scars are a difficult problem to have. If you suffer with keloids, you’ve probably asked at least one doctor what can be done to help. We’ll bet that you were told that they are hard to treat. While this is true to some extent, treatment of keloids is not impossible. However, it’s important for you to understand that complete removal may not be the end goal. Often, the treatments for keloids help shrink or soften them, making them less noticeable.
What makes a keloid hard to treat is that there are two different components that people with them don’t like: the raised, firm texture and the color. There really isn’t one single treatment that can simultaneously tackle both these features, so keloid treatment usually occurs in phases, depending on what bothers you the most.
If the color is what you dislike most, we can use our pulsed dye laser to help with this. However, these lasers target the blood vessels in the keloid, so they only work on red colored scars. Brown colored keloids can be more difficult to treat. At Celibre Medical, we’ve experimented with a few different solutions and we can try one of those that may work best for you.
If the texture is what bothers you the most, steroid injections can help soften and flatten out the scar. These work by breaking down the keloids dense, tough, fibrous tissue. Everyone responds differently to steroids, so the exact number of injections that you will need to see improvement can vary from person to person.
Here at Celibre Medical, we have extensive experience treating keloid scars. We have found through our years of experience that no two are exactly alike. We focus on creating a unique, individualized treatment plan using a variety of tools to help your keloid look as much like normal skin as possible.
* Removing Scars Before and After Photos
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
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.
