Skin Rejuvenation - Fractionated CO2 Laser

Skin rejuvenation or laser skin resurfacing is a treatment to photo-rejuvenate and reduce photo damage, open & large pores, and textural changes on your facial skin. Fractional CO2 laser is one of the latest advances in the skin rejuvenation treatment in Chandigarh. The CO2 laser also known as laser facial skin rejuvenation has the longest wavelength. It can be used safely for people with darker skin tone using appropriate settings. Fractional CO2 laser treatment gives optimum results when performed with an expert dermatologist.

Mechanism:

  • Laser energy in ablative fractional lasers like Fractional CO2 Laser is fractionated either optically (by subdividing the conventional bulk laser beam into many microscopic beams) or through the scanner.
  • This pixelated form of energy passes vertically downward into the skin as microscopic channels and is absorbed by target chromophore water in the tissue (epidermis and dermis), to generate heat, which then thermally damages or destroys it.
  • Multiple vertical microscopic three-dimensional small columns of coagulated and necrotic tissue are created and are referred to as microthermal/microscopic treatment zones (MTZs).
  • Each MTZ is substantially surrounded by undamaged skin. Thus, only a fraction of the skin is exposed to light (photo) to thermally damage or destroy (thermolysis) small treatment zone and hence named Fractional Photothermolysis (FP).
  • The MTZs induce a wound healing response consisting of rapid eipthelialization, tissue repair through neocollagenesis, and dermal remodelling from the surrounding viable tissue.

Indications:

  • Photo ageing
  • Sun damaged skin
  • Skin rejuvenation
  • Large pores/Open pores,/li>
  • Textural changes, thinning of skin and visible thin blood vessels (telangiectasias) as in the case of prolonged steroid creams usage induced atrophy.

Contraindications:

  • Keloidal tendency
  • Infection
  • Connective tissue disorders

Patient selection:

  1. The fairer the patient, the better the results of the skin rejuvenation treatment in Chandigarh. Though it gives great results for people with darker skin tone using appropriate laser settings along with required skin care & precautions.
  2. Emotionally balanced with realistic expectation.

Patient information:

Patient should be well informed about the following facts:

  1. Realistic expectation of the outcome - 50-95% improvement (depending on the condition being treated & results vary from patient to patient) and not complete elimination. Multiple (2 to 6) sittings may be required at 1 month gap.
  2. Postoperative sequelae, side effects, and complications.
  3. Postoperative sun protection for 3 to 6 months.
  4. Younger the patient, lesser the number of sessions required for skin rejuvenation.

Preoperative work:

  1. Medical Tests: CBC, blood sugar etc.
  2. Ancillary preoperative procedures: These are done 6-8 weeks before laser ablation. Consent and photographs.
  3. Preoperative preparation (cream programme) to prevent or reduce postoperative adverse reactions. It is advised to use sunscreens, topical creams 4-6 weeks before the surgery.
  4. Preoperative medications (Oral & Topical): To be started 15 days before the procedure and to be continued for the next 7-10 days post the surgery.
  5. Stop shaving and removal of excess hair etc. just before laser skin rejuvenation treatment.

Procedure:

  1. Gloves and goggles
  2. Topical anesthesia (TA): Cream applied under occlusion for 1-2 hours before the procedure.
  3. Preparation for the laser.
  4. The parameters of the laser are set.
  5. Technique for skin rejuvenation/Laser resurfacing: The laser is set in desired mode and its parameters are set to moderate-to-high density of MTZ/cm2 along with high energy in a small circular or square geometrical shape. Skin surface is laser impacted once or twice depending on the indication to be treated.

Postoperative Management:

  1. Total sun avoidance for 7-10 days and sun restriction for the next 1-2 weeks. Patient is instructed to use broad-spectrum sunscreens every 2 hours once the crust falls and reepithelialization is completed (7-10 days).
  2. Proper skin care
    a. Antibiotic creams & other serums are prescribed by our dermatologist to be used immediately after the procedure for the first 7-10 days till flakes or crusts are gone. Patient is encouraged to wash the face repeatedly followed by application of antibacterial ointment. Reepithelialization process starts and is usually completed in 7-10 days.
    b. Postoperative programme consisting of sunscreens, emollients etc. is usually started after 2-3 weeks when the skin is no more irritable and continued for the next 2-4 weeks.
  3. Oral medications are prescribed to reduce the post laser discomfort.
  4. Face is not covered with any dressing; only topical preparations as guided by the dermatologist are applied all over.

SEQUELAE OF FRACTIONAL LASERS:

  1. Good to excellent aesthetic results.
  2. Simple office procedure.
  3. All signs of photo damage, textural changes and open pores can be treated at one time.
  4. The treatment can be combined with other treatments like scar revision, face lift etc.
  1. Usual events: Transient edema, erythema, localized urticarial, punctuate bleeding, discomfort, flaking, crusting, and bronzing.
  2. Side effects: Persistent erythema and post inflammatory hypo/hyper-pigmentation can happen only if the patient doesn’t follow post laser skin care properly including the use of a good sunscreen frequently & religiously.

Advantages:

  • 1. Good to excellent aesthetic results.
  • 2. Simple office procedure.
  • 3. All signs of photo damage, textural changes and open pores can be treated at one time.
  • 4. The treatment can be combined with other treatments like scar revision, face lift etc.
  • 5. ANTI AGEING/FRACTIONAL CO2 LASER SKIN RESURFACING