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Whitish bumps after any resurfacing laser treatment can be several things. The most common are milia. These are retention cysts after injury to the skin and will generally resolve on their own without any scarring other other problems.

Rarely and more seriously whitish bumps can also represent either fungal infection or bacterial infection. In these cases, medical treatment is necessary as scarring can occur. It is best to have the physician who performed your treatment examine your face as soon as possible to determine the best course of treatment, if any. If they are milia, there is no way to avoid getting them, but they tend not to be a long term problem.

Labels: Fraxel, Laser Peel, Laser Resurfacing

Melasma is probably the most common pigmentary abnormality in women. The average age of onset is in the early 30s. Almost half the sufferers from melasma have family members who also have melasma. This condition most commonly starts during pregnancy, but it may also start before or after pregnancy. Much less commonly, it can be seen in males. Melasma is more common in women with darker skin types, and more time spent outdoors during pregnancy is associated with an increased risk of melasma. Inreased maternal age at first pregnancy and multiple pregnancies both increase the risk of melasma. Birth control pill use is another factor that has been associated with the onset of melasma.

The treatment of melasma can be difficult. Sun avoidance is imperative. It's the ultraviolet A that makes melasma worse, and many sunscreens do not block Ultraviolet A well. No sunscreen works as well as shade. Bleaching creams containing hydroquinone have been the mainstay of melasma treatment in the past, and these are still used today. TriLuma is currently used as a prescription bleaching creams, but it has some risks due to the fact that it contains a relatively powerful topical steroid.Lasers have come to play a bigger role in the treatment of melasma, and we have had success with both the Fraxel Restore and the Medlite NdYAG laser. However, it's important to understand that there is no treatment that works all the time, and sometimes nothing will work.

We have found that the combination of Creams, Laser, Peels and Sun avoidance works best. There is no one treatment out there that by itself is supreme.

Labels: Fraxel, Medlite, Melasma

Stretch marks are very difficult to treat.  They form when a person grows quickly, gains weight rapidly, or is pregnant.  The skin stretches so quickly that the elastic tissue in the skin actually tears.  That is why stretch marks don't go away when the person loses weight or is no longer pregnant.  There seem to be genetic factors that make some people more prone to stretch marks than others.

Fractional resurfacing is the treatment of microscopic columns of skin within the treatment area.  It doesn't treat all of the skin at once, which could create a large wound, rather it treats a fraction of the skin at a time.  The skin in these fractional zones then heals from the untreated adjacent skin.  Ablative fractional resurfacing, with the carbon dioxide laser, appears to be the best treatment option for stretch marks.  At the very least you should get some fading and blending into the surrounding skin, and in some people (with multiple treatments) they may go away completely.  Fractional lasers that do not use carbon dioxide will give you more subtle results, and will require many more treatments.

Labels: C02, Fraxel, Laser Resurfacing, Scars, Stretch Marks

Is there a difference between the UltraPulse CO2 laser /Fraxel repair /Pixel /Mixto/DOT lasers? I'm confused by all the different names and think the doctor will try to sell me on whatever machine he has- without it necessarily being the best for me. How can I know I'm doing the best treatment?

There are a lot of laser devices out these days and you do have to do your homework to keep things straight. There are basically 3 categories of lasers: 1) Fully ablative that includes CO2 and Erbium lasers, 2) Fractional Ablative lasers that include Mixto, Fraxel Repair, Lumenis Total Fx (these are both fractionated CO2), Pixel, DoT and others, 3) Fractionated non-ablative lasers such as Affirm, or Fraxel Restore

The main difference between these categories is the amount of downtime that goes along with them. The Fully ablative lasers require 1 treatment and will require 2-3 weeks to heal and possibly some redness beyond this time frame. The fractionated ablative CO2 lasers usually only take 1 treatment and reduce the healing time to about 1 week. The nonablative fractional lasers require 4-5 treatments but only have 1-2 days of redness for healing.

The other main consideration is results and what the treatment is for. A basic rule is that the more aggressive the laser, the better the results and the more the downtime. All lasers are indicated for wrinkles, acne scars, pigmentation, and sun damage. For wrinkles, more aggressive treatments are better.

This is some basic information to help you along. The other questions you should ask are what are my options. If the practice only offers one laser and one laser for everything then you should be wary. If options are presented to you with variable results and healing times then it is reasonable. Any serious laser practice will offer options or combination treatments. For example, our practice has multiple lasers for various applications so that we can offer options to patients depending upon their needs and lifestyle (healing time tolerance).

In terms of the CO2 laser, it is not the machine that is important, it is the kind of experience that your doctor has in dealing with the machine. CO2 machines are powerful and they do give wonderful results. But your physician has to have experience in the use of the particular machine.

Labels: C02, Fraxel, Laser Resurfacing