FRACTIONAL CO2 LASER SKIN RESURFACING

Fractional CO2 laser skin resurfacing is one of most preferred treatments for skin rejuvenation and treating the signs of ageing. It is the best skin rejuvenation treatment in Chandigarh for laser toning and skin tightening. Fractional CO2 laser or laser facial skin rejuvenation is one of the latest advances in the anti ageing treatments. The CO2 laser is the laser with the longest wavelength. It can be used safely for people with darker skin tone with appropriate settings. It gives optimum results when performed by an expert dermatologist.

MECHANISM

1. 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 scanner.
2. 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.
3. Multiple vertical microscopic three-dimensional small columns of coagulated and necrotic tissue are created and are referred to as microthermal/microscopic treatment zones (MTZs).
4. Each MTZ is substantially surrounded by undamaged skin. Thus, only fraction of the skin (fractional) is exposed to light (photo) to thermally damage or destroy (thermolysis) small treatment zone and hence named Fractional Photothermolysis (FP).
5. The MTZs induce a wound healing response consisting of rapid eipthelialization, tissue repair through neocollagenesis, and dermal remodelling from the surrounding viable tissue.

PATIENT INFORMATION:

Patient should be well informed about the following facts -

• Realistic expectation of the outcome: 50-95% improvement (depending on the condition being treated & results vary from patient to patient) and there’s no complete elimination. Multiple (2 to 6) sittings may be required at 1 month gap.
• Postoperative sequelae, side effects, and complications.
• Postoperative sun protection for 3 to 6 months.
• Younger the patient, lesser the number of sessions required for skin rejuvenation.

PREOPERATIVE WORK:

• Medical Tests: CBC, blood sugar etc.
• Ancillary preoperative procedures: These are done 6-8 weeks before laser ablation.
• Consent and photographs.
• 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.
• 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.
• Stop shaving and removal of excess hair etc. just before laser skin rejuvenation treatment.

PROCEDURE:

• Gloves and goggles
• Topical anesthesia (TA) - Cream is applied under occlusion for 1-2 hours before the procedure.
• Preparation for the laser
• The parameters of the laser are set.

SEQUELAE OF FRACTIONAL LASERS:

USUAL EVENTS: Transient edema, erythema, localised urticarial, punctuate bleeding, discomfort, flaking, crusting, and bronzing.

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 and religiously.

ADVANTAGES:

• Good to excellent aesthetic results.
• Simple office procedure.
• All signs of Photo ageing, aging skin, fine/moderate/severe wrinkles, skin laxity (skin toning & tightening) can be treated at one time.
• Can be combined with scar revision, face lift etc.