Fraxelated laser was recommended to me a few years...
Fraxelated laser was recommended to me a few years ago by a dermatologist and was told it would be perfect for me. I have rolling scars that are 20 years old and still red.
Thought about it lots and decided to try this procedure at age 33, I am caucasian too in case anyone is wondering. Had a small test patch done a few months ago, as I had Artecol (not Artefill) done 10 years ago that went lumpy, and I was worried that stimulating new collagen around the PMMA microspheres (that are no doubt still there) might make me look lumpier again, as the lumpiness has gone down over the years. What a traumatic experience that was, let me tell you.
So with the test patch, I stayed swollen for a few weeks, the circular area that was treated was visibly raised for this time, and I could see little brown dots three weeks later from where the laser penetrated. I thought these were permanent but after using retin-a for a few days they flaked off :) The swelling went down by week 4 and I thought the test patch was a success with no negative side effects.
First treatment five weeks ago, used a setting 45/10 and only one pass because I swelled so much. Iced within minutes of treatment to ease inflammation and to reduce chance of post inflammatory hyper pigmentation. Iced on and off and used Asprin and aquaphor for following three days to try and lessen the swelling I experienced after the test patch. Seemed to work. The clinic gave me quite a bit of Alyria Glycolic Exfoliating creme (2) for free to use after day three to help those brown dots shed off faster, worked great. Was pink for 5-6 days and I can say that three weeks later the indented spots were less red and my overall skin color was more even which was a pleasant suprise in itself since I have had these red spots for 20 years. So my skin looked kind of like it glowed in these weeks. I also noticed the indents weren't as deep so happy with how the scars responded. The only negative was that the technician did my entire eye area and it seemed from week 3 to week 5 that the wrinkles around my eyes were more in number and deeper than they were before, and reached down my cheek. I figured that the heat dried out the skin so I did facial steaming to try to get the moisture back in, and bought Shiseido WrinkleResist24 eye cream to see if it might help. It did a tiny bit but the lines are still deeper when I smile than they were before, and visible when I don't smile and that is something new, they used to disappear once the smiling stopped. I was always told I look much younger than I am, people guess mid 20s. So I took further action and started taking borage, krill, and flax oils to moisturize from within. I googled "palomar 1540 dry skin" and "palomar 1540 wrinkles" and some things came up about fat loss that freaked me out a bit. But it was unclear whether it was the same palomar laser I used or the Palomar IPL laser, there seems to be a LOT of stories related to fat loss with IPL lasers of all brands. And people say it just gets worse and worse over months and months. In at least two of these stories, the people were actually burned and blistered immediately following treatment - I did not have anything like this, so it makes me wonder if maybe the technician used settings that were too high.
These stories also reminded me of the fact that ice/cold causes fat loss - kids who eat lots of popsicles get dimples, and the new treatments for muffin tops use cold to permanently melt the fat. So I am wondering if some of these poor people slept on an ice pack overnight or something, and if maybe I overdid the ice a bit myself, even knowing the correlation to ice. I didn't leave it on too long but did put the gel ice pack on directly for 5 minutes at a time. SO DON"T OVER-ICE PEOPLE. Here is how to ice to prevent permanent fat loss in you face: "Don't put the ice pack directly on your skin, and 10 minutes on, 10 minutes off." I also wonder if some of these people didn't use SPF 30 for even very short (5 minute) sun exposures for the following 2 months, as the new collagen is really delicate. This could explain why some people who got Fraxel (a similar laser) ended up with a permanent orange peel texture? You are also NOT supposed to use a physical exfoliator for at least one week after the procedure, but I guess a chemical one like glycolic acid (in my case anyways) is ok after day 3. Just my thoughts.
Decided to go with a second treatment after the first one, and asked they avoid the eye area this time just in case and I explained I thought it dried the area out. They said that yes the treatment can dry skin for a few weeks after. I was happy with the results on the scarring so far, so felt comfortable proceeding on the scarred areas. And even with the wrinkles, to me they are more "acceptable and normal" than a lumpy spotted face, so a trade off I can live with. This time settings were 58/10 and 2 to 4 passes depending on the area. Took tylenol beforehand in addition to the 45 minutes of numbing cream to make treatment more comfortable. I bruised quite a bit and I blame all the oils I was taking, I have since read these should have been discontinued a week prior, to reduce bruising. I also did not ice as much after since I didn't want cold-induced permanent fat loss in my face. So... 5 days after the prodedure... still pink but swelling is going down. Hope the pink goes away and I don't get any hyper pigmentation since as is evident by my acne scars, I am prone to post inflammatory hyperpigmentation. My face is still swollen so the wrinkles look ok. The only think I notice this time that I didn't before is the raised waffle pattern where you can see the tracks where the technician moved along my face. If I look really (REALLY) close, I see the areas the laser penetrated are indented and slightly pigmented. So small lines that are indented. And on my lower cheeks/jawline I see tonnes of tiny raised bumps. I seem to remember feeling these bumps the first time but not seeing them, and they exfoliated off after a few days with the exfoliating cream. I read some stories last night that these waffle imprints stayed after 6 months and 2 years for some people so I'm a little worried but if it's a trade for the scarring, and overall smoother skin with less redness so be it. The track lines are smaller than pores so not really worth mentioning, the waffle pattern is relatively much more noticable but still not a show stopper, it's not like I can't leave the house, the dots are smaller than my pores and smaller than my split pores due to the acne scarring.
So... I will post an update in a few days or weeks as I notice changes. I will let you know 1- if I stay pigmented as a result of the higher setting used, or if it clears up 2- how long the waffle marks and track lines stay 3- if the wrinkles in my eye area treated ONCE continue to get worse, like the stories of them getting worse and worse due to some weird fat loss 4- if I get overall fat loss in my face or some kind of damage that gets worse and worse over time in my cheeks and areas I was treated TWICE. 5-
My post treatment protocol includes vit c, oral hyaluronic acid supplements, borage/krill/flax oils, and enough protein and calcium in my diet.
Adding four photos taken five days after the...
Adding four photos taken five days after the second treatment. I really didn't notice much improvement (once the swelling subsided) until the third week after the first treatment, this is when I felt the redness improved and the scars filled in a bit. So will be interesting to post some more photos in a month or so.
And to clarify, the $375 cost I posted is per treatment.
Day 12: The microswelling went down noticeably...
Day 12: The microswelling went down noticeably today. Up until now the scarring plumped things up slightly and I felt if things could look this forever, I would be happy. Evenings were always worse for my scarring, the indents are always more noticable at night as those of us with scarring know. This evening I could see the indented scarring start to look much more depressed, but I remembered this happened from week 2-3 after my first treatment, and then things started to fill in again from weeks 3-5 until I got my second treatment, so not a concern for me.
Day 10: The indented track marks on my forehead and on front part of cheeks are starting to bother me since they don't seem to be filling in. Starting Retin-A to stimulate collagen as much as possible during this critical time, I think I'll get more out of this cream while things are generating already than waiting until after.
Day 14: Notice pinprick scarring on areas which used to be smooth (my jawline). The raised waffle imprint was most noticable for the first few days in this area in particular, and I had only two passes in this area instead of 3-4. I'm sure I have the pinpricks all over, but with the enlarged pores and scarring on other parts of my cheeks, it's not as noticable. Looks like enlarged pores but smaller, so not detrimental.
Day 15: The Retin-A seems to be helping the depth of the track marks and lightening the hyperpigmentation, especially of the track marks themselves, I have had a bit of peeling. That aside, this evening before going to bed, I noticed the track marks as in my 5th photo in other areas of my face besides the three areas I noticed before. Not happy about that, this is not as contained as I thought... Starting to freak out a bit, that this might be a sign that I didn't respond well to the higher setting, something is going wrong, this is just the start of damage showing itself, and I may be one of those people who posted reviews that things started going downhill after 6 weeks, one person said that at six months the damage started and kept getting worse for the next year and a half. What I am trying to say is: everything seems OK now, am very happy SO FAR with the overall look of my skin, I have that "glow", the hyperpigmentation I had on my scars has gotten a LOT less red, I can live with the track marks and pinpricks as they ARE NOW, the bit of hyperpigmentation from the laser is lightening, and even if permanent, is easily covered by make up, and I am very optimistic that the rolling scarring I went in for will continue to fill in over the next weeks and month. IFFF I hadn't read some of the other stories on here, I wouldn't be worried about a THING at this point. BUT since I have read some horror stories, and my indented pinpricks, I can't help but worry that the worst is yet to come. Someone else posted that people post great reviews for Palomar/Fraxel at the beginning, then they always come back to ask for help on how to reverse the damage, and there is nothing that can be done. This uncertainty not knowing if I am going to have a golf ball face in six months is going to cause me to worry until then. I have decided to start using Retin-A all over my face instead of just the three areas to help stimulate even more collagen and help these indents fill in, and thin the skin to make them less noticable at best. And let me tell you, even with winter coming, you won't catch me not wearing SPF 30 any time I am outside, even if just for walking to the car, to protect this baby collagen, since the sun destroys collagen, in case it will help prevent this golf ball/orange peel look. I will be vigilent for six months at least now instead of the two I was planning originally... I think it would be good advice to plan this treatment for the winter for anyone reading this, and still use sunscreen, since outings in the summer are inevitable, and it's really best to hole yourself up and just avoid the sun the first few weeks.
Will post some updated photos soon, but keep in mind the Retin-A is making my skin dry and the dried top layer makes things look smoother. From there on, it will be a few weeks at least before I post more photos, the Retin-A is going to make wreak havoc, make me red and peel for the first few weeks at least. Dropping my kids off to school is going to be fun, didn't count on having to go full bore with the Retin-A right now...
Keeping up with the post treatment protocol I posted originally. I am thinking about doing more hot yoga to further increase circulation to my skin and help the healing?
Today is day 18 since I had the treatment. Things...
Today is day 18 since I had the treatment. Things were looking GREAT up until day 10, on which I was in the sun for two hours in the middle of the day. I don't know if it is a coincidence or not, as I was wearing a nice coating of SPF 30, but I beat myself up that I should have worn my wide-brimmed hat as well... The next day my scars seemed to start sinking back in, to before the first procedure. I remember after the first treatment, before week 3, things seems to look worse before they looked better, so I told myself it's normal and no big deal, just wait it out. At 14 days the "microswelling" had gone down even more and I noticed the track lines not just on my forehead and frontmost of cheeks, but in other areas of my face as well. So instead of being in controlled areas, it appears this damage is all over. At this point I also starting to notice an all over "orange peel" look, as if I have huge pores I never had before, in areas that were smooth before. I started to positively freak out that I was not responding well to the treatment and not healing well. Continued to read more stories about things getting progressively worse and worse for some people, starting at 2 or 6 months and going on for two years, after having fraxel (a similar procedure), that people suspected DNA damage, so reading these stories did not help and put my stress level through the roof. Stress does not help the appearance of skin, or its healing for that matter. Was upset for a few days and decided yesterday (day 17) that I need to be as proactive as I can on this matter instead of potentially watching things get potentially worse. I think the stress a lot of us face in these situations causes us to stop eating. From the research I have done, when your body is under any kind of stress (we deal with both emotional and physical in these situations), it is SO important to counteract the stress by eating REALLY REALLY well, the natural chemical compounds in food help stress and healing. And apparently when you are stressed, and have increased cortisol, your body cannot and does not go into a certain state when you sleep that is critical to healing. I realize that chances are pretty good that I'm probably not one of the people who will get DNA damage - I understand some of these folks had other procedures done at the same visit all at the same time. BUT, that said, I feel there are steps I can take to not only be as proactive as I can about DNA damage, but these steps will probably help me heal as best as I possibly can, so win-win. Vitamins and minerals in supplement form are convenient, yes, but real foods are always better because they have not only vitamins and minerals, but enzymes and chemicals that work together in the body when you eat them together. So I am going to add some supplements but I don't want to take too many oral supplements, as some of them are way higher than the recommended RDA, so I will try to have a balance where I take some supplements but also concentrate on certain healthy foods that have not only certain vitamins but the great phytochemicals as well :) I also think it's very important during the healing period to get a good balance of the food groups, and not eliminate certain foods. I think experimenting with a low-carb diet during this time would be a bad idea.
I did a lot of research on foods that speed healing and prevent DNA damage. Why not try to take some control of the situation... So here is my new regimen along with why I am including certain things. It's kind of a vegetarian diet, I eat meat only a few times a week.
30 mins before breakfast: systemic enzymes. I read about these on the IPL damage message board, and a user found they were the only thing that got rid of the track lines and pinprick scarring. Systemic enzymes supposedly eat scar tissue, used widely in europe after surgeries to minimize scarring, have been used over 4o years there, with no negative side effects. If this helps my collagen fill in and eats the scar tissue from the track marks, I may get an awesome result.
Breakfast: egg + 3/4c oatmeal with a banana and 3 tbs hemp seeds + almond milk + B100 complex. Eggs are good for protein and omegas, I buy the omega eggs. Oatmeal has b vitamins which are good for wound healing. Hemp seeds are good for omega oils and are a complete protein equivalent to meat. Almond milk is a source of vitamin E and calcium which are both important for healing.
Snack: yogurt + berries + 1oz suflower seeds + 1oz pumpkin seeds. Yogurt has calcium and protein, the berries have those natural compounds that are so important, the sunflower seeds are great for Vitamin E, the pumpkin seeds are great for protein and zinc, both good for healing as well.
1 hour before lunch: systemic enzymes
Lunch: salad (spinach + tomatoes + onions) + 1cup chickpeas or beans + 2 tbs nutritional yeast + C0Q10. The salad has protein, vitamin A, and phytochemicals. The beans are for protein and antioxidants. Nutritional yeast contains nucleic acid (RNA/DNA), which is a building block for cell development, and supposed to help aging. It is also a form of protein. COQ10 helps with DNA Damage and antiaging.
Snack: one orange + 1/4 c soy nuts + chia seeds (1/2c) + hyaluronic acid (2). Orange for Vitamin C, good for wound healing and collagen production. Soy nuts contain a compound called gene stein which is good for dna repair. Chia seeds for protein and omegas. Hyaluronic acid to help collagen production.
Dinner: 1c Rice or Pasta, Vegetables, Protein (soy burger or beans or protein shake) + sacha inchi seeds. The carbs in pasta, esp before bed, are good for our mood and help us sleep. The idea with the vegetable is to get those phytochemicals. Brocolli or cauliflower (steamed to reduce effect on thyroid) would be a good choice. Protein for healing. Sacha inchi seeds for another protein source and they have omegas too. I figure if I get my protein from lots of different sources, instead of depeding on just one, my body will take to one or a combination and I'll get better healing.
Snack: almond milk + carrot + orange + protein shake. Almond milk and orange discussed before. Carrot for beta carotene and phytochemicals. Protein shake for protein.
2 hours after snack: systemic enzymes
Depending on the day, I might also take a multivitamin, and if I'm stressed, I may add holy basil (reduces cortisol levels) and/or herbal anxiety complex. Again, don't want to take too much stuff, only as needed.
Also as an update, I went back to the clinic today where I had the procedure done. I was told that it is not very common to get the track marks, but in their patients, who followed their recommendations, the marks healed after a few weeks. I was also told "no promises" but it was their experience that the patients who did get them had better results long term. they said some people are slower to rebuild that collagen that has been damaged, but that it was a controlled damage that we created on purpose so we could help the scarring. I was given a tonne of Glycolic Acid cream and told to start using this every night from now on, overnight if possible, and that with the one patient who had the worst track marks, and the others, it helped them fill in. They said they expected things to be filled in if I do this for six weeks. So they acknowleged the track marks, which is better than most clinics do from what I have read on here, yet they did not seem concerned that they would not fill in with time and proper care, and were nice enough to give me lots of this cream, probably half a jar of a level one and level two, these bottles are $60 and $70 each, I felt it was really nice of them to give me enough to last at least the six weeks. I was comfortable with their reaction and they have been doing this procedure with this machine for six years so I feel I am in good hands.
Between they glycolic acid cream at night and my AWESOME diet, I am optimistic I can heal great :) And I am thankful I am taking action now, I feel the sooner any problems are addressed (after waiting at least a week after the procedure, leaving your skin untouched), the better the outcome. I think it would be worst case scenario to start doing something 2 months or six months down the road when you could have helped it along when most of the actual healing was going on.
I am also going to look into some of the new over the counter creams that promise to reverse DNA damage. Will research specific ingredients though and look for those instead of relying just on claims. Retin-A is also on my radar as it is proven to help build collagen. So may have to work out some kind of rotation schedule.
Will keep updating. Took an updated photo of my forehead on DAY 16 which has the worst track lines, hyperpigmentation, and textural changes, will post that right now.
Will keep updating :) Send good wishes my way! Sorry my posts are so helter skelter, I don't have time to do any editing, but I want to get all the information out there.
Also might be worth to mention that exercise is a...
Also might be worth to mention that exercise is a form of stress on the body and adrenal glands, so I will be reducing the intensity of anything I do, so that not too much of my body's repairing effort goes to my muscles instead of skin... which really sucks because exercise helps stress levels and one night I was so stressed I just wanted to go for a hard run...
I am ecstatic and relieved to say I am starting to...
I am ecstatic and relieved to say I am starting to see some improvement over the really bad-looking last week. I was really stressed out and depressed during that time, worried that I was not healing well and scared of some of the horror stories I read about this laser and Fraxel. I think stress really does a number on your skin, and as soon as I changed my mindset from "helpless" to "going to do everything in my power to have a good outcome" things started to look up almost immediately. I can't put my finger on exactly what made the difference, it could have been the stress going away, starting my super-diet and supplements, and/or just that week two is a bad week and would have started looking better no matter what I did (as what happened after treatment #1, but I didnt notice track marks after that treatment, hence the panic).
Before I forget, I also stopped taking the krill and flaxseed oils, only because I didn't feel they were helping my healing at all at this stage of healing, good for my body overall, yes. This is also why I added some of the foods I did like chia, hemp, and sacha inch, because these have omegas as well, but in smaller doses (and natural form) than the processed supplements I was taking.
I can say the hyperpigmentation is REALLY lightening up now! And the BEST PART is the track lines are not only lightening up in COLOR with the lightening of the hyperpigmentation, but they appear to be FILLING IN as well. I haven't exfoliated very well for a few days so perhaps that dead layer of skin is hiding some of what I saw before, but I don't plan on exfoliating the peeling for a while (two weeks) to protect the baby skin forming underneath, kind of like a scab protects a wound.
I tried the cream my clinic gave me and left it on overnight but it was way too harsh and irritating so I am reacting now to everything else so going to take a break for a few nights from the glycolic acid, and I havne't used the Retin A for a few days either. I did create a rotation plan to try to get a bit of exposure to all these creams but I don't think I will be able to leave the glycolic cream on again overnight until I build up wayyy more tolerance. I got two "DNA repairing" creams that I have been using during the day.
So I'm not sure what is causing the turnaround, but it's looking good that I wont have these track lines for very long :) The only negative to doing sooo many things at once is that I can't pinpoint for anyone reading this what exactly helped me, but I feel treating this problem as early on as possible, while still in the earliest stages of healing with the greatest healing potential, is CRITICAL. I don't have time to experiment, I decided to hit it with everything I got.
Going to post some updated photos within the next few days. I still realize that some people said things were great at first then got progressively worse after two or six months, so I don't want to get my hopes up, but at this point I am very optimistic of a fantastic outcome... less redness where the scars were and the depressions filling in. So far it's looking really promising in both of these areas. And I promise to post updates after 2 months, 6 months, and two years :) I will keep my "worth it" rating as "not sure" until the six month mark just in case.
It has been just over a month since my second...
It has been just over a month since my second treatment. I have not been able to follow the diet I laid out as the increase in raw foods was irritating my stomach, especially the nuts and seeds. The Wobenzym also seemed to irritate my stomach so I have had to reduce the amount I am taking to 4 a day, 2 two times a day. Around this time of cutting back on my preventative actions I noticed a bit of the orange peel around the one eye they went up close to, and to make it worse, the depressed areas are kind of brown. I don't know if this is a late scab or hyperpigmentation or what. Also my forehead was looking really orange peely and I am really noticing the pinprick scarring all over my cheeks in areas that used to be very smooth and untouched by my acne scarring. So I started with strong copper peptides in hopes of helping the pricks fill in but that seemed to bring back all the old depressed areas of scarring that the laser seemed to help, so then I had old scars and now pinpricks so felt pretty defeated... This time was also the end of my birth control pill pack and I remembered after the first treatment there was a bad full week that then got better so I figured this may be a combination of a normal healing cycle and my hormone cycle. I stopped with the peptides in hopes I didn't undo the laser's benefit in that area altogether and have compensated the doctor-ordered reduction in "raw" foods to adding more supplements. So yes I tried to get them in my diet but I think I need more than what I am able to eat now. So starting last week I am taking Vitamin A + Vitamin E + 2 CoQ10 + B100 + Hyaluronic Acid + MSM + 2 Vit C + 1 tsp Flax Oil + 2tsp nutritional yeast. The MSM + VitC + Flax oil work in synergy together so I mix the yeast and flax oil in almond milk and drink it with my MSM and take the Vit C at the same time. So ya it's a lot of stuff but I am a poor healer in general and I am desperate for help here to fill in these pinpricks before it's too late and it becomes permanent. I have also decided to focus more on the Retin-A 0.1% than the glycolic acid since a) Retin A is well proven b) I am not sure of the concentration of the glycolic acid in my cream c) the glycolic acid seems to cause me irritation if I leave it on longer than 20 mins and this cream was designed to be worn all night and work all night, releasing the glycolic acid in bursts every 2 hours. I have also started with a 15% Vitamin C serum and an anti-aging/repairing SPF 15 day cream. I use the VitC serum daily and the Retin-A every other night, alternating with aquaphor mixed with 1-2 drops of bio oil to baby my skin so it can tolerate the high retin-a. Want to work up to nightly retina-a use... I also have a red light that came with my blue light for acne and have started using that for 7-15 mins a night for a few nights. Perhaps it is the addition of the Flax +MSM, VitC, Bio-Oil, red light, or Using more Retin-A again, or jsut that this "bad week" in healing or hormones is over, but my forehead is looking pretty much normal now! The track marks are filling in AND the orange peely look is pretty much gone.
So I am not going to change a THING I am doing now and hope that the pinpricks and track marks on my cheeks will follow suit. The hyperpigmentation is also 80% gone. So here's hoping a) the forehead stays the same b) the scarring fills in again c) the pinpricks fill in. It has been a really rough last week and a half and didn't want to post scared but I am feeling optimistic again based on how my forehead is looking.
At this point I feel that if you are a poor healer in general, like myself, even average cuts don't heal well on your body, then be prepared if you do this laser that you may not heal well from it without A LOT of help, IMHO.
And if I could go back in time I would apply the...
And if I could go back in time I would apply the copper peptides 2x a day for 3-5 days after the procedure starting 2 hours afterwords (I didn't have any open sores) since the procedure is technically a burn and the CPs really help scar free healing after a burn according to the research.
And to complete my statement "Perhaps it is the addition of the Flax +MSM, VitC, Bio-Oil, red light, or Using more Retin-A again, or jsut that this "bad week" in healing or hormones is over, but my forehead is looking pretty much normal now!" ... I should have also added that in the VitA + Vit E in there and specified VitC Serum since the VitC Supplements I have been taking the whole time.
I am happy to post that it has been 2.5 months...
I am happy to post that it has been 2.5 months since my last treatment and the orange peel look is not a problem anymore and the track marks on my forehead and cheeks are 85% filled in. I was driving myself crazy doing too much so I decided to focus on what is proven to rebuild collagen and that is the RETIN-A 0.1%. A point of advice to anyone in this situation, if your skin is irritated from doing too much, your pores will look HUGE and you will get the orange peel look and you will freak out. Taking a Benedryl instantly cured my orange peel look two times my skin was so irritated I needed to take it and it really took the stress off realizing it was not permanent. So I used the Retin-A every night for a month, and the improvement is obvious. I didn't use it on my chin because there is more movement there with smiling and you get more flaking and I still have bad track marks in that area, so I know it was the Retin-A that helped fill the rest of them and not anything else, say my diet or supplements. Yes 0.1% was irritating every night so the less I did to my skin the better, even switched to Cetaphil cleanser. After two weeks I could use my new Clarisonic Mia along with the Cetaphil so I'm not just putting the Retin-A on layers of dead flaking skin, and it would really work on the underneath. I am pretty content with my skin now, I can go out without makeup and not be terribly self conscious. It's not perfect, but I'm sure if I had had the full 5-6 treatments it would be. I would say that despite all the stress, the final results have been worth it. I saw a dermatologist yesterday and he doesn't see many indents at all and said the Vasculight to reduce redness would be all he recommends at this point, and the best part is I have to agree! I am going to keep using the Retin-A every night until my 6 months is up, and I am SO THANKFUL that I didn't end up some horror story. Will try to post pictures at some point. I would say improvement in previous scarring is 50-60%, most areas only had two treatments.
I give this rating because I feel the settings and technique used were appropriate. Hopefully I respond well as each person responds differently.
5 out of 5 stars