Are there any CO2 lasers that effectively treat wrinkles on the knuckles & hands?

Question

Are there any CO2 lasers on the market that can successfully treat wrinkles on the knuckles & hands?

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

A combination approach will give the most improvement. Hands can be improved with fillers very easily, and I love combining this with fraxel laser to tighten and improve texture. Belotero and Radiesse give natural looking results.  I suggest seeing a cosmetic dermatologist with expertise in hand rejuvenation to go over the recommended timeline.  Best, Dr. Emer.

Martin Ray, MD · Answer

Dear sunshine247,
Wrinkles on the knuckles and hands are often the neglected area in rejuvenation programs. Many people will invest time, energy, and money in their face, neck, and chest treatments only to realize that the sun-damaged skin on their hands and arms have become the age giveaway.
Hands and arms are best treated with a combination program that includes an anti-aging skin care program, dermal filler, IPL, and  CO2 laser. The skin of the hand is very thin and thus deserves special attention. Aggressive CO2 could easily cause full thickness skin injury, resulting in scarring, hyper-pigmentation, or loss of pigment. Low power, fractionated CO2 can provide amazing results. An experienced treating physician can ensure a safe, comfortable, effective treatment. I recommend a skin care program for at least 6 weeks to get the skin ready, dermal filler to support the tissues, and then IPL - if sun damage pigment is part of the issue - or CO2, if pigment and skin tightening is required.
The lasers I use are the Palomar 500 IPL and the Deka SmartXide CO2. I remain confident in these lasers delivering exceptional results. ZO and SkinMedica are two companies that offer excellent de-pigmentation/anti-aging skin care products. Radiesse also provides nice results and is a non-HA filler that's approved for hand treatments. If an HA filler is used, the quality of the skin will need to be factored in when determining the appropriate product. Good luck from Vancouver Canada.

Are there any CO2 lasers that effectively treat wrinkles on the knuckles & hands?

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