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There is no contraindication to performing fractionated CO2 laser one day after subcision with PRP. Fully ablative, non fractionated, CO2 laser can be performed two to three weeks after subcision with PRP.Jeff Rapaport MD FAADRealself All-star
Most specialists will perform these treatments in the same sitting. Makes sense as the PRP will accelerate healing from lasers.The ideal treatment for acne scars will depend on the morphology of individual scars. For example, rolling scars are best treated with subcision, atrophic scars with fillers, pick-ice pick scars with TCA or Phenol CROSS/ Paint, box-scar scars with fractional laser/ modified TCA/ phenol chemical peels, hypertrophic scars with steroid injections/modulated fractional delivery. Energy devices such as lasers, microneedling RF and bipolar radiofrequency are other methods to treat ‘general’ scar types. For example devices can improve rolling-tethered scars as well as ‘deep - superficial scars’ such as broad ice-pick scars and broad box-car scars. Devices should be viewed as a method of scar revision, and rarely as a sole modality. Exceptions do apply- for example in patients with predominantly shallow/broad box-car scars and or superficial pits. Another factor that will determine the ideal combination of treatment is the skin type of patients. Skin typing used to determine the ‘skin colour’ of patients. Darker skin patients will require modifications to treatment parameters. This includes a lower percentage of chemical peels, conservative protocols for lasers and energy devices and in some cases pre and post treatment of skin to reduce but not eliminate the chances of PIH- post inflammatory hyperpigmentation- skin darkening. The very first step in scar revision is to accurately determine the subset of scars you have. This is best done with a real time examination. Factors such as animation (rather than static photographs) are frequently used to determine the amount of ‘deep scarring’ /anchored scars or tethering. Palpation or touch is also extremely important to determine the presence of dermal and subdermal fibrosis. Scars that have altered ‘texture’ either hard or soft (atrophy) are more challenging to treat compared to scars with ‘normal’ texture. In some cases the use of angled lighting can be employed to accurately map scar types. My answers given in the context of this question is a general plan given the limited information. For an accurate guide, one has to take into consideration factors such as animation, touch, feel, real time examination and most importantly subjective measures, namely patient expectations. A real time consult with a procedural dermatologist or plastic surgeon is required for the best accuracy- diagnosis. All the best, Dr Davin S. Lim, Dermatologist. Brisbane. Australia.
Thank you for your question and pictures. Laser resurfacing can be combined with eyelid surgery, though it is not a must. Different surgeons will have different practices. These treatments can either be done simultaneously or in stages, but again it will depend on the preference of your...
Thank you for your question and your photos. I’m not sure microneedling would be the best solution for you at this point. CO2 laser treatments might offer positive results. However, you have numerous issues going on at once, and this will require a careful assessment by an experienced, b...
Hello! Thank you for your question! Prior to CO2 laser procedure a topical numbing is left on for one hour which helps with the pain. There is some discomfort during the treatment, however we ensure that our patients are comfortable throughout the whole procedure. The sensation can best be...