CO2 lasers are the gold standard!!

In our practice we are very happy with the Active FX fractional CO2 laser. It provides our patients with most of the benefits of the CO2 laser without the downsides. However, no laser will be as successful at obtaining the fabulous results of a well done CO2 laser. But then again, those patients suffered from long recovery periods and very obvious hypopigmentation ("bleaching") problems.

When you are deciding on what laser to use, you have to ask yourself 3 questions:

1. What level of results do I want?
2. What downtime can I tolerate?
3. How much do I want to pay?

Light therapies (BBL, IPL, etc.) are cost-effective, short downtime procedures. However, they require multiple trips, are very operator dependent, and can cost a lot after a while.

Fractional technologies (erbium and CO2) can provide more significant improvements, but have levels of recovery measured over 4-10 days. Patients usually need one or two treatments, but the treatments are significantly more expensive.

Full ablation technologies (erbium and CO2) create the best results but have downtimes in the 2-3 week range with long-standing redness. They are painful enough to often need IV sedation and a trip to the OR significantly raising the cost of treatment. One treatment is usually all that is necessary though.

I hope this helps you.

For more aggressive rejuvenation, more focus is now being directed to the myriad of laser treatments now available which can essentially dial in depth of penetration and very closely define downtime while still providing dramatic results. An example of this is the new fractioned lasers which can essentially treat facial aging using a grid pattern which leaves normal skin in-between treated areas. The result is less downtime and much faster healing.

One of the lasers that is showing a significant amount of promise in this area is the Lumenis ACTIVE FX laser. This device delivers a grid treatment pattern using the pulsed carbon dioxide laser leaving normal, untreated areas in-between. The results so far have been dramatic and even show promise in treating acute and chronic scars.