Affirm CO2: Great results from wrinkles to acne scarring!


The Affirm CO2 Workstation from Cynosure, Inc. (Westford, Mass.)
provides micro ablative treatment with a wide-range of settings for “incredible flexibility.” I schedule everything from superficial wrinkle treatments to deep CO2 laser resurfacing – but with minimal recovery time ranging from one to five days.
Acne scarring, pigmentary disorders, skin texture, surgical scars and traumatic scars can also be improved with this next-generation micro ablative technology.
I think we’ll even be able to treat photodamage, such as actinic keratoses.
Treatment is effective because micro ablative resurfacing creates microchannels, leaving normal skin between these channels, therefore you have much faster healing than was possible with older ablative CO2 devices, which basically ablates the entire skin surface. Furthermore, since the Affirm is CO2 based rather than erbium or non-ablative, you are bound to achieve much better results and some noticeable skin tightening due to collagen rejuvenation which we were not able to really observe with erbium micro ablative lasers.
The current trend is definitely toward CO2 lasers for micro ablative treatments. We can achieve 70% to 80% of the results we previously attained with ablative CO2 lasers, but with a much shorter recovery time and less likelihood of complications such as hypopigmentation, occasional infections, and scarring. These adverse events should be extremely rare, if not non-existent, with micro ablative CO2.
For superficial wrinkles, three or four sessions may be required with the Affirm CO2, spaced two to three weeks apart. Topical anesthetic is used for patient discomfort, which is really adequate for a majority of these treatments and eliminates systemic risks from anesthesia. However, for really deep treatment, we might use some regional nerve blocks. After a series of treatments for superficial wrinkles, I virtually achieve full clearance of the wrinkles. Patients are red and puffy for about one day. Results should last several years.
More aggressive treatment parameters may lead to more dramatic outcomes in fewer sessions with the trade-off of a longer downtime period of up to five days approximately. For acne scarring, depending on scar depth, four to six sessions may be necessary, again at two to three week intervals. Patients can expect anywhere from 60% to 80% clearance. There is probably two days of downtime with redness and swelling. However, the results are likely permanent.

Article by
New York Dermatologic Surgeon