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ActiveFX CO2 Laser Skin Resurfacing

Laser

Introduction

The fine wrinkles on the face have been treated in the past by dermabrasion and chemical peel. These methods were associated with significant long-term pigmentation change and have not been favoured by most plastic surgeons. From 1994 the carbon dioxide laser has been used for the treatment of facial wrinkles. Lip lines are removed in a precise, rapid, bloodless fashion achieving excellent and permanent cosmetic results. Crows feet, lower eyelid wrinkles, and glabellar frown lines can be softened or eliminated It has also been shown to be effective in treating acne scarring, pre-cancerous and benign skin lesions as well as superficial benign pigmented lesions.

The UltraPulse, which produces pulses of laser light, rather than a continuous beam, has been shown to lessen the risk of scarring. However for fine lines the down time associated with MaxFx laser resurfacing is not for everyone and IPL systems often disappoint.

The UltraPulse Encore has broadened the applications for CO2 laser technology. This laser not only delivers superior tissue effects when treating moderate to deep wrinkles, but in performing an Active-Fx with the system's CO2 Lite feature, addresses fine lines and uneven pigment. By producing a controlled superficial laser peel the Active-Fx with CO2 Lite improves skin tone and surface imperfections with only minimal downtime. For the first time we can now treat the neck, chest and back of the hands.

What can be done

The procedure is carried out under local anaesthetic. The outer layers of skin are removed using the laser. The underlying skin is stimulating into contraction and this tightens the skin and produces a more youthful appearance. Although the ActiveFx treatment has only been available since 2005 it seems that the changes are likely to be long lasting. Studies have shown that the treatment produces a PERMANENT CHANGE in the skin with return of some of the elasticity. The production of new collagen within the skin restores a youthful texture.

Recently new developments in the technology allow us to offer treatment for established burn scars. Often two or three sessions are required, and the benefit in suitable patients is more pliable scarring, better texture and colour.

What are the consequences?

The majority of the wrinkles on your face will be improved. Initially you can expect a 20% reduction in wrinkles with a maximum improvement by eight months after the treatment. Some patients feel that the results at one month are better than at three months after the treatment. The reason for this is that at one month there will still be a minor degree of swelling. This then decreases before the new collagen synthesis has begun. At four to six months after treatment the new collagen synthesis has progressed and there is an improvement in the texture of the skin. This increased collagen synthesis continues for at least four years. All patients develop a transient erythema (red skin), similar to sunburn, which will take from one to three months to fade. If your upper lip is treated then it is possible that you may loose some lip pigment at the margin. This is usually easily covered up with make up. The appearance of the face often looks worse at three days following treatment.

What are the limitations?

Deep wrinkles will not be corrected by an ActiveFx treatment. Remember that the ageing process continues and factors such as smoking can accelerate the deterioration of the skin. A number of patients have had second treatments with no increased risks or complications. This can be particularly helpful for acne scarring and deeper lines. Further treatment sessions can be carried out from two months after the first.

What are the risks?

There is a small risk that INFECTION could complicate the procedure. You can minimise this risk by taking a five day course of antibiotics. There is a minute risk of scarring. Any patient with a history of cold sores must take a course of antiviral therapy (in the form of tablets) prior to the treatment. This must be continued after the operation for a total of one week. It is vital that you inform your surgeon of any past history of cold sores. Some patients do not tolerate the anti-cold sore tablets. An alternative, Bromelain (an extract of the Pineapple plant, taken at 250mg three times per day) has been reported to be equally effective. The laser treated area maybe different to the surrounding skin either smoother or paler. It often improves with time but it may be necessary to use make-up indefinitely. It is partly caused by change in the texture of the skin and partly due to the deposit of new collagen. The collagen is necessary to build up the wrinkle and rejuvenate the skin. This is your own collagen that is generated in response to the laser treatment.

What you should do before the procedure?

It is important that your skin is in the best condition possible prior to the treatment. Your surgeon may provide you with a programme of skin care that you must follow very carefully. Male patients should shave the same day prior to treatment and avoid shaving the treated area for five days. You cannot be treated if you have been sunburnt or used a sun bed within the previous week.

What can you expect at the time of your procedure?

Immediately after the treatment your face will be dressed with 50:50 Ointment or antibiotic cream. Most patients feel uncomfortable but have minimal pain. Your face will feel like you have had bad sunburn. It will be moist and will take three to four days to heal. Occasionally it may take longer. You will then be left with erythema (red skin), similar to sunburn, which will take from one to three months to fade. This redness can be disguised under make-up. At three days after the treatment itching can be a problem. This is best treated by a short course of 0.5% hydrocortisone at night. This is available over the counter at a pharmacist. It is quite safe for use for four weeks but most chemists will not sell it for use on the face.  If you are having your neck treated please wear clothing that will allow discrete exposure of your neck as far as your shoulders and collar bone.

What you should do when you go home

Apply 50:50 Ointment to the face five times per day and a thick layer at night to last until the morning. Wash the area each morning with simple soap and water, but do not pick off any crusts. Leave them to separate. Continue this regime until healing is complete, usually 4 days. You may use 50:50 Ointment at night, but try to move to less greasy products over the following month. It is important that you avoid exposing the treated skin to ultraviolet light (sunshine). A sun block must be used every day (for at least six months after the treatment) once the skin has healed and it is advisable to use sun block make-up. This must be strictly adhered too to prevent the skin becoming pigmented and blotchy.

Your new look

The final result from laser resurfacing may take up to eight months to fully appear. However, once the pink-ness fades, patients usually notice a significant improvement in the quality of their skin and a fresher, smoother appearance. Make up sits much better on the skin. It's important to understand that your results will be long lasting, but not permanent. Remember, your new skin is not immune to the effects of ageing. In the months and years following your laser treatment, your natural facial movements will eventually cause any "expression" lines to recur. As with other methods of skin rejuvenation, laser treatments can usually be repeated. However, by protecting yourself from the sun and following a skin-care regimen recommended by your plastic surgeon, you can help maintain your rejuvenated look. After the first six months have passed you will need to acclimatise the skin. You may find that the skin is very pale. This in part will be due to a thickening of the skin in response to the laser treatment. Also protection of the skin by sun block limits the return of skin pigmentation. If this is a problem, then reduce the protection factor of the sun cream or moisturiser to fifteen. Do not go any lower than factor 10. Remember to maintain the benefit from the treatment the skin must be protected from the effects of smoking and sun exposure.

Conclusion

Although the benefits of Laser Skin Resurfacing are rewarding, it is still not like a quick trip to the beauty salon! A prospective patient must understand that laser treated skin needs time to heal. In my experience, most patients will experience some minimal discomfort for a couple of days following the treatment. More importantly, the appearance of the treated skin may be altered for several weeks following the procedure. Most patients will appear as if they have had bad sunburn by the second or third day. This effect may last for up to a month. If you have a job, or social obligations, that place you in the public eye, this is an important consideration. Regardless of who does your procedure, this healing process is a result of the depth of the wound created, modified by the individual patient's inherited ability to heal.

After Care Instructions