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 Cosmetic Medical 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. ActiveFx is better for pigment and more superficial textural problems
3. Stria (Stretch Marks): Use ActiveFx: 80-100 mj, density 1-2 (use Density 2 for thicker Stria). Do NOT use the DeepFx for Stria.
4. Melasma: Experts are not sure it will work. They do not recommend at this time. They are doing test spots and experimenting with it. Melasma is a whole topic unto itself. Look for a specific article about this in the future.
5. Tattoos: DeepFx might be good for resistant Tattoos
Pre / Post Treatment Tips for Fractional C02 Laser Treatments:
1. Mild moisturizers 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 everyone. One case of disseminated herpes on the face is not good. Can we use Acyclovir? It costs less, much less (Four Dollars at Walmart!).
8. Call all patients by phone the next day, this makes you both feel better and lessens complaints.
9. Don’t give pain medications after treatment. 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 acne outbreak: Keflex 500 mg TID, Doxycycline 100 mg BID, Erythromycin can be used to prevent most acne outbreaks.
13. Sunscreens: Use everyday after skin is healed up. Wear hat and stay out of sun until healed.
14. 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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