CO2 fractional laser

Skin contains a very high percentage of water, the fractional delivery of CO2 laser to the skins surface is attracted to the water molecules in the skin. This absorbs the laser energy creating heat - Selective Photothermolysis. The laser energy is applied to the skin in a fractional way, by creating longitudinal microthermal zones in the skin penetrating to approximately 2mm in depth through to the dermis. This thermal damage creates trauma to the existing cells in the skin thus promoting collagen formation. The space between the columns of intact epidermis allows the skin to trigger a faster healing response of the damage tissue achieving better results with less down time. As a result, production of new skin is stimulated within the dermis and epidermis. The delivery of CO2 produces 2 effects on the skin: 1. Ablation Effect: The high power of the laser emission releases over a short time for rapid ablation of the epidermis and first layers of the dermis. This is beneficial for layers of the skin with low water content. 2. Thermal effect: After the epidermal ablation the energy pulse spreads into the dermal tissue causing contraction of collagen in turn initiating collagen repair. The energy of the laser will be absorbed by the water (chromophore) in the skin to achieve the clinical end point of white dots where the laser has delivered. This shows the water has been absorbed and heat trauma has been achieved. This clinical end point shows the heat caused trauma to the tissue, increasing the temperature to approximately 70- 80°. This damages the collagen beyond repair. The body's immune system then picks up the damaged cells encouraging a fibroblast response to the injury in both the initiation and the resolution phases.Due to the spacing between each laser emission, the tissue in-between is spared from the trauma, resulting in a faster healing process. The objective in CO2 laser resurfacing, as opposed to pure erbium laser resurfacing, is to accurately ablate the epidermis while applying a controlled amount of heat to the dermis to induce collagen remodelling. The energy that is applied to a surface area of tissue is represented by fluence (J/cm2). For resurfacing, a high-energy beam with a very small spot size is applied to the skin with an ultrashort pulse duration (1000 ms). After each pulse, the tissue is allowed to cool for a time equal to or greater than the tissue thermal relaxation time before the next pulse is delivered. This prevents unwanted conduction of heat to adjacent areas. Once the epidermis has been ablated in this first pass, one encounters the dermis. The dermis has a lower water content than the epidermis, so at the same fluence there is less absorption of the laser energy. Therefore, multiple passes over the same area result in more thermal injury with less tissue vaporization. It is suggested that heat-related collagen denaturization leaves collagen fragments that stimulate new collagen deposition and directed migration of fibroblasts. In addition, the initial contraction from the heat, forces created partially by dehydration of the skin on first pass of the CO2 laser can assist in the alignment of the newly synthesized collagen.

At Dr Sknn, during the consultation a medical history including a physical examination will be performed including photographs. During the consultation there will be an opportunity to discuss any concerns, expectations, results, or questions you may have. Prior to the treatment any post treatment advice and risks associated with the treatment are discussed ensuring you fully understand them and a consent form is signed. Furthermore, if it is a new area being treated a small patch test will be performed in order to ensure suitability. If you are found to have a skin type of III+ then prior to treatment a topical application of serum may be needed for 4 weeks prior to treatment.

At Dr Sknn, safety and eligibility to treatment is of highest priority, prior to any treatment, as no one size fits all, a full consultation will be performed and if found suitable to the treatment, a patch test will be performed. After 48 hours post patch testing we are able to deliver the treatment following successful patch tests, please note that patch test may be extended if certain medications were found during your medical history, the patch testing may be extended to 2 weeks. Furthermore If you have a skin type of III+ then prior to treatment a topical application of product may be needed for 4 weeks prior to treatment.

Some of the pre-treatment advice is listed below. Please note that during the consultation you will be provided with a complete list. If you have a skin type of III+ then prior to treatment atopical application of product may be needed for 4 weeks prior to treatment. Do not use products containing retinol or strong AHA fruitacids on the treatment area prior to or during your skin resurfacing treatment,please stop using the products 5 days before, they can be restarted 5 days postthe treatment

Some of the post-treatment advice is listed below. Please note that during the consultation you will be provided with a complete list. If you have a skin type of III+ then prior to treatment a topical application of product may be needed for 4 weeks prior to treatment. Do not use products containing retinol or strong AHA fruit acids on the treatment area prior to or during your skin resurfacing treatment, please stop using the products 5 days before, they can be restarted 5 days post the treatment No hot baths or showers – tepid only. Skin should be keptdry for 3 days or until the skin normalises. If you can keep the skin dry for24 hours after treatment it will increase the treatment efficacy. Cooled boiled water can be used to wash the skin for thefirst 3 days post treatment if necessary.

The required number of treatments varies on multiplefactors, typically a course of treatments are required to achieve optimalresults. For Skin Rejuvenation, Wrinkles and Lines: A course of 3-5treatments is recommended, with each treatment delivered every 3-4 weeks. For Photodamaged Skin, Skin Hyperplasia and scarreduction: A course of 4-6 treatments isrecommended, each treatment delivered every 4-5 weeks.

During treatment the skin will be stimulated and will becomeslightly pink/red, it is a similar feeling to when you have been in the sun.The pinkness/redness can last for up to 48 hours depending on your skinsensitivity. Flaking may occur over the following days, do not pick orscratch the skin as this may result in infection or scarring

Some of the contraindications are listed below. Please note that during the consultation we will assess suitability for the treatment Age below 18 Pregnancy, recent pregnancy or breast feeding Suntanned Skins

Yes as long as you are over the age of 18 and have nocontra-indications. However the treatment will only be performed following aconsultation.

Treatments last anywhere between 15 to 45 minutes dependingon which treatment you have.

There is a slight tingling sensation and warmth during thetreatment however an anaesthetic cream is applied prior to treatment to reducethe sensation on the skin.

During treatment the skin will be stimulated and will becomeslightly pink/red, it is a similar feeling to when you have been in the sun.The pinkness/redness can last for up to 48 hours depending on your skinsensitivity. Additionally swelling and white spots/bumps will be present. Flaking may occur over the following days, do not pick orscratch the skin as this may result in infection or scarring Furthermore small squares can last up to 2 weeks and this isnormal.

There is a slight downtime with this treatment which lastsbetween 3 to 5 days, however, your skin surface can become dry and slightlyflaky as the new skin cells are stimulated in the deeper layers of the skin.Furthermore small squares can last up to 2 weeks and this is normal. Rednessand swelling may also be present.

Treatment intervals should be no less than 3 weeks, howeverdepending on the indication the recommendation for Skin Rejuvenation, Wrinklesand Lines is every 3-4 weeks and for Photodamaged Skin, Skin Hyperplasia and Scar Reduction is every 4-5 weeks.

The area being treated will be thoroughlycleaned, marked and photographed, you will be provided with googles forprotection, an anaesthetic cream can be applied prior to the treatment.