Newsletter December 2007 – laser resurfacing

What are my options for laser resurfacing
and acne scar revision?

There are many laser (and tissue tightening) treatment options that claim to improve acne scars or provide facial rejuvenation by reducing fine lines and wrinkles. To make it simpler for you understand, we provide as much information as possible so that you can make an informed decision about the option that’s right for you.

Treatments for wrinkles, sun damage and general rejuvenation will depend in large part on the severity of the condition. We see all types of rejuvenation candidates from those that have very mild crow’s feet lines to those that have deep folds and lines in their skin. These two types of patients will need very different treatments to achieve the desired results.

Acne scars present in many forms: pitted, rolling, boxcar shape, and atrophic (raised). In most cases, we have found that acne scarring responds best by using invasive treatments rather than non-ablative (no downtime, non-invasive). While we do provide non-invasive procedures for very mild acne scar cases, we observe the best results when utilizing invasive downtime laser procedures.

Below you will find a list of many of the laser (and non-laser) treatment programs for wrinkles and acne scars:

Fractionated laser resurfacing (Fraxel, Pixel, etc.)

Fractionated treatments stimulate new collagen in the dermis to improve texture without disrupting the stratum corneum (outermost layer of the epidermis). The treatment produces small, vertical, microscopic columns of tissue damage. When these microscopic columns of tissue fall out after treatment, they are replaced by tissue (new collagen and elastin). Although many providers of this treatment claim there is no downtime – in our research and experience, the downtime and recovery is similar to the Erbium MicroPeel. Pricing for this procedure generally runs in line with or is more expensive than Erbium MicroPeels.

More About Laser Resurfacing

Laser Resurfacing Before and After Pictures

CO2 Laser Resurfacing

This is the “gold standard” in the industry for being able to deliver dramatic outcomes for rejuvenation and acne scars. Along with the dramatic results also comes higher risks and prolonged downtime. The treatment entails an extended recovery period (2-4 weeks of downtime), an increased risk of infection, the requirement to wear a facial dressing during recovery, and experiencing prolonged erythema (redness) and swelling that may intermittently persist for several weeks. The procedure usually requires general anesthesia and is the most expensive of the laser resurfacing options.

Plasma Technology

This is a newer treatment that does not ablate or remove layers of the epidermis. The concept is that the treatment transports nitrogen plasma energy into the dermis to stimulate collagen without creating a wound to the skin (epidermis). The procedure has minimal to no downtime. This procedure is not FDA cleared for the treatment of acne scars and is priced somewhere in the middle of the laser resurfacing options profiled here.

Fractionated Erbium/CO2

This treatment involves using the concept of fractionated technology described earlier with the ablative (invasive CO2 and Erbium) wavelengths, also described earlier. The idea is to combine the best of the fractional approach (not disrupting the epidermis by taking out only microscopic columns of tissue) with the best of the ablative wavelengths – Erbium and CO2 – which are the most traditional invasive wavelengths for resurfacing the skin.

Erbium MicroPeel

The Erbium laser MicroPeels resurface the skin in the same way as a CO2 laser but with less downtime. Unlike CO2, which is typically performed only once, the Erbium laser achieves excellent resurfacing results using multiple procedures. The procedure removes the top layers of the epidermis and simultaneously delivers thermal energy into the dermis to stimulate new and existing collagen. It produces a new layer of skin cells and generates results not only on the surface but also in the underlying tissue (dermis). Because it is less invasive than the CO2 there is no need for a facial dressing and downtime is typically between 4-5 days.

Long-Term Results Matter: Patient Satisfaction Insights

At Celibre, we continue to rely on the Erbium laser MicroPeel for predictable, consistent patient outcomes for wrinkles and acne scars. We like the technology because it has been around for many years and is “tried and true.” We believe that there are other options on the market that may be of value. We also believe it is important to wait for research and controlled, independent studies that detail long-term outcomes and patient satisfaction beyond six months.

Dr. Kaplan has been performing Erbium and CO2 procedures for many years and now has switched exclusively to the Erbium resurfacing because of the excellent results and limited downtime. We encourage consumers to do research when investing in their appearance. Consider long-term outcomes, recovery, photos of actual patients (not manufacturer photos), and independent research. Exercise caution when considering the number of recommended treatments and assessing the suitability of the treatment for your specific skin type and condition.

Our team would be pleased to offer a complimentary consultation to address your skin care goals. A good starting place is to gather information and view before and after photos of Celibre patients in our photo gallery.

At Celibre, we stay at the forefront of research and best practices so that we may offer the most appropriate and effective laser and injection treatment plans for our valued patients. Please give us a call to learn more about laser and injection treatments.