Is CO2 laser safe after a TCA Cross and punch excision?

Laser  is appropriate after TCA cross and punch excision. It will improve the appearance of the scars. We usually perform the laser 2 to 4 weeks post op. However, Vivace (mentioned in your question) is not a laser but is  micro needle radiofrequency. I suggest you discuss your treatment plan with your scar expert and if a laser is contemplated. Good luckJeff Rapaport MDRealself All-star

OK, you seem to know what is best for your scars so I will answer your question directly. It is fine to have Co2 laser done - if that is what you want. In my practice, I often combine treatments in the one day. Here is the logic. Excise with punch, the result? Scar tissue removed. Do not suture till after laser as I do not want the laser beam to hit my suture. Hence laser the surrounding tissue in manual small spot mode. TCA CROSS- this is self neutralising. Once frost occurs- tissue reaction is done. If needed I use a CO2 laser with a long focal distance - angle the beam. Then suture the defect caused by the punch excision. Dress as per post laser and post TCA CROSS emollients etc. Done. See patient in 4-8 weeks, target individual scars. The use of CO2 and TCA CROSS independently IMO does not make sense. It has no impact on the overall outcome of scar revision, but adds costs and morbidity to the patient. For example if one has Type 3 skin - PIH from TCA is seen in 100% of patients - this is transient say 3-12 weeks. Now if one has CO2 laser in 2-6 weeks post TCA, one has persistent PIH. Logic does not prevail. Scar revision, IDEALLY should be managed by one Specialist - pick one whom you are comfortable with. Remember, treat the scar type with methods, this will give you the best results possible. Dr Davin S. Lim . Brisbane. Australia.