Laser Skin Rejuvenation: The Latest in Wrinkle Removal Methods

The anti-aging breakthrough of the decade? That's what WebMD.com called Fractional CO2 Laser Skin Resurfacing. This latest form of facial rejuvenation is becoming the most popular of the wrinkle removal methods.

In a Germantown, Tenn., doctor's office, a 57-year-old woman never flinches, as years of living are vaporized from her neck. In fact, she chats through the procedure.

If she's like most patients, she'll return to work within four or five days, and in a week or two, she'll enjoy skin that looks significantly younger.

She's getting Fractional CO2 laser therapy, which is said to deliver the powerful results of the old carbon dioxide lasers -- considered the gold standard in laser wrinkle removal -- without the long down time and complication rate.

The treatment uses a fractionated laser beam that delivers thousands of tiny columns of heat deep into the skin, ablating (destroying) old skin cells and inducing new collagen formation. Unlike old CO2 treatments that caused significant skin wounds, open sores and crusting, fractional lasers leave surrounding tissue unaffected and intact allowing the skin to heal much faster.

It is "the best laser- treatment technology that I have ever seen," said Dr. Greg Laurence, owner of Germantown Aesthetics. A single treatment can lighten sun damage, lift fine wrinkles, reduce pore size, soften scars and tighten skin, he said. Patients continue to see additional improvements as collagen builds over the next several months.

Vickey Wright, 57, a registered nurse who lives in Olive Branch, Tenn., had fractional CO2 treatment in December. She said it removed freckles, age spots, discolorations, fine lines and wrinkles and tightened, to an extent, her droopy eyelids. "I'm thrilled," she said. Her resurfaced face has drawn the same type of comment repeatedly from people where she works: "They said my skin looked smooth and fresh as a baby's butt." Laurence offers the full-face fractional CO2 treatment with the Affirm laser from Cynosure for about $2,000. Patients may receive a topical numbing cream or an injection with local anesthetic. Intravenous sedation (twilight sleep) adds around $200 more. Most people pick two of the options, he said. Laurence is board-certified in family medicine and certified with the American Board of Laser Surgery. Wright had aggressive treatment that required sedation. For the first couple of days she had what looked like a bad sunburn. But the pain was tolerable and she took no pain medication, she said. She was given antibacterial creams and moisturizer and sterile mineral water to mist her face. The water makes skin feel better and may promote healing. She went back to work two days after the procedure. Her skin peeled a lot the first week and a little more for several days afterward.
According to information from the American Society of Dermatologic Surgery, fractional resurfacing can be performed on the face, neck, chest and hands. The most common side effects are redness and swelling, followed by outbreaks of acne or cold sores in less than 2 percent of patients. Neither produced long-term problems. However, an article published in May 2009 in Journal Watch Dermatology warns that the neck and eyelids are especially susceptible to scarring with the procedure. Factors that may raise the risk of scarring are aggressive laser settings and treating patients who have had prior ablative laser resurfacing, a face-lift or infection. Laurence said his practice has seen no complications so far. He does not use the laser on people with dark skin, which includes most African- Americans, because it can cause hyper- pigmentation, or dark spots, he said. Fractional CO2 laser systems began to be produced in number by several companies about two years ago. ActiveFX from Lumenis is a procedure performed by UltraPulse Encore CO2 laser. DOT Therapy is performed using the SmartXide DOT CO2 laser system. Such systems have a number of settings to customize the procedure. "You want a skilled person doing it. It's not something you want to take lightly," said Donna Ward, a registered nurse and aesthetic nurse specialist at Eden Spa & Laser in East Memphis, who has done more than 200 of the procedures there and elsewhere. Eden Spa began offering the DOT treatment in November.
"You can take off about 10 years," Ward said. "About half of patients get that result and the others get very noticeable improvement." Ward charges $1,000 for a facial treatment and uses numbing cream. The spa can't dispense medication, such as sedatives and pain pills. Ward asks patients to have their primary doctors prescribe a sedative. "The results are very predictable," said Ward. "A single tolerable treatment can address just about any facial skin problem." Ward said the treatment is very popular, and about 35 people are on her waiting list. "I would absolutely do it again," said Wright, who said she was prompted to get the resurfacing on her face after she lost 35 pounds. "It was kind of my reward," she said. "I'm not getting any younger. My body was looking better. Why shouldn't I have a better face, too?
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