Fractional CO2 laser ablation has grown in popularity as an alternative for some to plastic surgery. What do physicians want to know about this technology?
Treating Specific Conditions:
1. DeepFx is best for vertical lip lines, deep wrinkles, acne scars. It goes deep and stimulates more collagen and ablates more tissue for more tightening.
2. Reliants ActiveFx is better for more superficial pigment and more surface textural problems
3. For Stria (Stretch Marks): Use ActiveFx: 80-100 mj, density 1-2. Use Density 2 for thicker Stria. (Note: Do NOT use the DeepFx for Stria.)
4. For Melasma: Medical experts don’t recommend treating Malasma at this time. (See below for current thoughts or changes.) This may change. Melasma is a whole topic an issue by itself.
5. Tattoos: DeepFx might be good for resistant Tattoos that have resisted other treatments.
Fractional C02 Laser Treatments: Pre-Post Treatment Tips;
1. Use mild moisturizers to avoid acne flare-ups.
2. You don’t have to use aquaphor or vasoline. Mild moisturizers are good enough (personal communication from company reps).
3. Be circumspect of the Lanolin in the Aquaphor.
4. Using Aveeno Water Gel can get you one less day of downtime!
5. Post TotalFx Care: Use “Soaks” every 3-4 hours. (What type of soaks? Saline Soaks (saline and gauze)? How long do you soak every 3-4 hours?)
6. Post Care: Cold ice packs or chilled air cooler for 30-45 min after treatment.
7. Valtrex for all patients. (One case of disseminated herpes on the face is not good.) Might use Acyclovir since it costs much less (Four Dollars at Walmart!).
8. Check all patients by phone the next day, this makes you both feel better.
9. Don’t give pain medications after treatment. If they have pain, you want to know about it and see them. They should not have pain for more than a few hours. Prolonged pain suggests infection: bacterial, viral, or fungal.
10. Pliaglis can be mixed with cetaphil cleanser or cetaphil moisturizer. 90% Pliaglis and 10% cleanser or moisturizer.
11. Experts worry about possible Lidocaine toxicity so excercise care. Compounded Lidocaine works as well or better than Pliaglis. Pliaglis costs $60 per treatment. Compounded Lidocaine costs about $6 per treatment.
12. Experts do NOT routinely prescribe oral antibiotics unless indicated for an acne outbreak. Keflex 500 mg TID, Doxycycline 100 mg BID, Erythromycin to prevent outbreaks.
13. Sunscreens: Use everyday after skin is healed up. Wear hat and stay out of sun until healed.
14. Use a good UVA blocker as further protection.
Fractional C02 lasers can produce great results if used correctly like any technology, it’s not perfect.
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