Excellent treatment for pore size and texture, diffuse erythema, rosacea, poikiloderma, scares. Unique microsecond 1064 nm laser procedure is safe for any skin type and tanned skin, comfortable with an excellent safety profile. The optimum result varies individually.
This procedure differs from other procedures performed with this lasers in that the cooling provided by the handpiece is not used. When the face is being treated, it is typically divided into four regions. Similar size areas can be treated when treating the neck. One section at a time is treated.
Holding the handpiece approximately 2 cm from the surface of the skin to be treated, the handpiece should be continuously moved over the area being treated. The goal is to provide back and forth passes over the area resulting in even distribution of the pulses. It is common to make repeated left to right motions of the handpiece with a small amount of movement in the perpendicular direction to avoid immediately going back over the same area.
Motion of the handpiece should be at a rate to avoid the stacking of pulses.
By evenly distributing the pulses, the heat buildup will be uniform and comfortable without localized uncomfortable hot spots. If too much time is spent in a small area, or the handpiece is moved too slowly, the patient tends to become uncomfortable.
Each region of the face is typically treated with 2,000 to 6,000 pulses. Conditions such as diffuse erythema tend to respond to 2,000 pulses and greater while other conditions such as fine lines in the perioral region take more pulses ( such as 4,000 to 6,000 ). In addition, some areas, such as the every 100 pulses ( when the pulse counter reaches a count that ends in "00" ).
After an area has been treated, treatment can begin on the next section with the same technique.
Extreme caution should be used when treating near the eyes, taking care to avoid ocular damage from the laser light. Patient eye protection appropriate for the treatment should be used. The laser beam should always be directed away from the eye and only applied to the skin outside of the orbital rim. Skin at the edge of the orbital rim can be pulled away from the eye, while the eye shield is held in place, so that it can be treated outside the orbital rim.
As treatments in the ocular region ( below the eyes, the bridge of the nose and the temples ) require special care, it is often convenient to treat those areas first before moving on to the other areas. Sensitive areas such as these and just beneath the nose or over the beard area may require the use of less pulses or lower fluencies for some patients.
Erythema is a common immediate reaction seen from this treatment and often appears as the pulse count limit for a particular area is being reached. This typically resolves within 2 hours but can last longer.
Treatment of full face up to 7,000 pulses.
The patient should either wear a clear or white protective mouth guard, or be instructed not to open his or her mouth when Treatments are performed near the mouth, in order to avoid accidental exposure of their teeth to the laser beam.
OTHER CONSIDERATIONS :
The patient will feel a gentle warning of the skin in the section being treated in addition to a small sensation where the laser pulses are being applied. Once they become accustomed to the feeling, they typically find the Treatments to be comfortable. A report from the patient of discomfort is an indication that pulses need to be spread out better or that its time to move to another area.
No special post-operative care is usually required.
Treatment intervals of 2 to 4 weeks are commonly used for a total of 4 to 6 Treatments.
Conduct a patient consultation complete with medical history prior to treatment.
Discrete facial telangiectasia should be treated as discussed in the CoolGlide Laser Vascular Treatment Guidelines.
Remove all make-up from the Treatment site.
Clean and shave the Treatment site prior to treatment.
The use of topical anesthetic ( such as EMLA ) is not recommended for these treatment as patient feedback is important, and, with proper technique, it is not required.
No gel is required.
An optional addition to the procedure, that has been reported to increase patient comfort, is to spray a light mist of spring water on the face prior to the beginning of the Treatments and repeating that occasionally as needed during the procedure.
Some physician make this non-ablative Treatment part of overall skin care regimen along with topical retinoids, topical vitamin-C, sun protection, and/or microdermabrasion.
In some instances, these treatments could result in reduced hair growth. This should be considered prior to treating areas ( such as over a man's beard ) where reduced hair growth may be undesirable.
Pre-operative photographs should be taken in a standardized format ( setting and patient position ) prior to the initial treatment for future reference.