Winter is the best time to have Laser Resurfacing. Winter skin is dry. Wrinkles and pigment are more obvious. Recovery from Laser Resurfacing is much easier in cooler weather.

Laser Resurfacing is unequivocally the best facial rejuvenation technique to remove wrinkles and to improve facial brown spots, as well as damaged and aged skin. In the past, the C02 laser has been the gold standard for laser resurfacing. Traditional CO2 Laser Resurfacing recovery, however, is difficult and has discouraged most patients from having the procedure.

Dr. Doherty and I have worked with Palomar Medical Technologies-a medical laser company with its manufacturing and world headquarters based in Burlington, Ma. Over the past four years, we have both worked with Palomar as they developed two Erbium Lasers: the 2940nm and 1540nm Fractional Erbium Lasers. Facial Resurfacing with these lasers achieves similar wrinkle removal results with about a third of the downtime of a CO2 laser treatment.

The Erbium® is a “Cool” laser and produces less heat than the CO2. Erbium can therefore be used on both dark and light skin types. With Erbium technology, there is less skin injury and recovery to nice new fresh pink skin is about five to seven days instead of the traditional three weeks associated with the CO2 treatments. Also notable is the fact that there are no demarcation lines. This means that there are no areas of loss of pigment and the skin texture and color is uniform throughout the face.

See the photos of results below. For more information on the procedure and a detailed article, click on the blog about Combined Laser Resurfacing.

Before and After Photo Combined Laser Resurfacing

Most recently two of these new techniques have been combined in one treatment and have produced the best laser resurfacing results with less down time and less risk of complications. This new technique is called combined laser skin resurfacing..

To better understand the significance of these new advances some technical knowledge of cosmetic laser skin treatments for cosmetic laser skin rejuvenation and past laser skin care technology is important.

The photo above shows the result of a full face CO2 Laser Resurfacing for wrinkle removal done 10 years ago using the Ultrapulse CO2 laser, a revolutionary advance in 1995. While the wrinkle removal results were stunning, CO2 laser resurfacing created a “burn wound” that took months of recovery and after a year often left the skin white or hypo pigmented. Because of the prolonged recovery, the need for general anesthesia, and other side effects most people today do not choose to have this effective wrinkle removing procedure.

Over the past three years the concept of Fractional Skin Rejuvenation or Fractional Laser Skin Resurfacing has evolved. With Starlux Fractional Skin Rejuvenation the laser beam, an erbium laser beam, is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. (See Figure Below.)

The small areas treated by the Starlux and Fraxel fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production to replace collagen damaged by aging and sun exposure. The new collagen produced by the laser injury “plumps” skin wrinkles. The intact skin between the micro treatment zones allows for much more rapid healing-3-4 days as opposed to 2-3 weeks for the older CO2, and enough pigment cells are left intact that hypo pigmentation does not occur.

The diagram above shows the progression of laser skin rejuvenation technology from the older CO2 on the left to the newest Starlux fractional ablative lasers which have just been released. The Fraxel laser and the Starlux 1540 are depicted in the 3^rd illustration under Non ablative fractional laser resurfacing.

Starlux Fractional Non Ablative Laser Resurfacing

To ablate means to “surgically remove”. The Fraxel and Starlux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of the Starlux 1540 non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are less dramatic than with ablative lasers.

However, the new Starlux 1540 fractional lasers are able to penetrate much deeper than traditional non fractional ablative lasers and we are discovering that deeper penetration of the laser produces a much more dramatic stimulation of new collagen formation which translates into a plumping effect on the skin. This is particularly useful in treating depressed acne scars.

Another diagram which helps explain the Starlux 1540 effect is the microscopic section of skin that has been treated with the Starlux fractional laser below.

In summary, the benefits of Starlux fractional non ablative laser skin treatments are:

1. Less down time- only pink skin for 1-2 days and a day or so of bronzing that can be covered with make up
2. Better new collagen production in the deeper skin layers causing skin plumping especially of acne scars
3. Fewer complications like hyper pigmentation (although with Fraxel there is a 15% incidence of hyper pigmentation (darkening of treated areas) especially in dark skinned people, but it is temporary.
4. Improvement in skin texture and possibly enlarged pores
5. Improvement in wrinkles (See Photos below of Lux 1540 Results)

Above-Before and after Starlux 1540 non-ablative fractional laser skin resurfacing, treatment-Photos courtesy of Palomar and Dr Dwight Scarborough

Starlux Fractional Ablative Laser Resurfacing

Recently several new Fractional ablative Lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. The Starlux fractional ablative lasers are depicted in the last or 4^th picture in the first comparative fractional laser diagram above.

The fractional ablative lasers remove the tissue in the micro treatment zone rather than just heating it as is done with Fraxel and the Starlux 1540.

The benefit of ablation is that more sun damaged, wrinkled skin is removed than with the Starlux 1540 or Fraxel, and better wrinkle removal and skin surface smoothing and textural improvement is achieved. This however comes at the price of some recovery time, redness and pinkness for 4-6 days. The Starlux fractional ablative lasers however require much less recovery time than the traditional non fractional erbium and CO2 ablative lasers which required weeks of recovery. Reliant, the company that makes Fraxel has released a new CO2 fractional laser called the Repair, Lumenis has released a CO2 fractional ablative laser called ActiveFX and DeepFx for Bridge Therapy, and Palomar has released the Starlux 2940, an Erbium fractional ablative skin resurfacing laser.

Impressive wrinkle removal and improvement in skin texture is achieved with the Starlux 2940 fractional ablative laser (see Photos of my patients Below).

Above: Before and after Starlux 2940 fractional laser skin resurfacing.

Combined Laser Skin Resurfacing-The Future of Laser Skin Resurfacing

More recently we have been combining a non-ablative 1540 or 1440nm Starlux laser treatment with an ablative Starlux 2940 treatment at the same procedure. The theory is that by combining the deep collagen stimulation of the non-ablative treatment with the more superficial ablative 2940 treatment the results would be better. In fact the results are dramatically better with the same reduced downtime achieved by the Erbium laser. In fact, the results are in many cases equal to the wrinkle reducing results of the traditional CO2 resurfacing without the hypo pigmentation, down time and risk of scarring associated with the CO2 laser. See the remarkable results below:

Before and After Photo Combined Laser Resurfacing

Before and After Combined Fractional Laser Resurfacing

The first non ablative fractional laser on the market was the Fraxel. The Starlux 1540 and 2940 are newer and improved fractional laser skin resurfacing technology. Combining these two new laser modalities into one combined laser skin resurfacing treatment provides the best resurfacing results I have seen in 14 years of doing laser resurfacing.

The field of laser skin rejuvenation is advancing rapidly and new technological breakthroughs like combined laser resurfacing occur frequently. The benefit to you is that better wrinkle removal results are possible with less down time and fewer potential side effects.

The applications of fractional laser technology are expanding to other fields like skin tightening and eventually to fat and cellulite removal.

For further information on the Combined Laser Skin Resurfacing with the Starlux fractional erbium laser for skin rejuvenation and facial aging read Save Your Face or contact me. In my practice I use the new Starlux 1540 Fractional Non ablative erbium laser and the Starlux 2940 ablative fractional laser for skin rejuvenation.

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Dr Seckel
978-369-4499

Concord, Massachusetts

Boston, Massachusetts

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