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Combining two different lasers in the same patient makes sense if the patient has multiple conditions to treat. The IPL is used to treat both solar lentils as well as blood vessels which are both present in patients with photo damage. In those patients I would do the iPL first and then the no ablative Fraxil or any no ablative laser like the Cynosure Affirm Multiplex. If a patient has persistent redness after any laser procedure, the IPL can be used two weeks after the laser procedure.
IPL and Fraxel repair can be performed on the same day. The lasers have different targets with IPL targeting blood vessels (redness) and pigment (brown) whereas Fraxel Repair targets water leading to improvement in fine lines and wrinkles. IPL should be performed first. - Dr. Keaney
Ideally, IPL and fractional laser resurfacing can be done either in the same session with IPL first, followed by fractional resurfacing or IPL in the first session, followed by a second session of fractional laser treatment. If IPL is done first, there is no time limitation on when the second treatment can be done. If IPL follows fractional laser, I would prefer if the skin is completely healed after the fractional procedure. After fractional resurfacing there will be some redness and crusting, which should be resolved before IPL.
Pulsed dye laser and Melaquin PM skin topicals can be used to reduce marks associated with the Fraxel laser skin resurfacing.
If you had Fraxel Repair, then you would wait until it healed fully before doing the Ultherapy so as not to rub over the raw skin, but Fraxel Repair has been done right after the Ultherapy as the skin is left intact immediately after the Ultherapy and its energy targets deeper tissue than the...
In my experience, there should be no reason why your diabetes should preclude you from receiving treatment with Fraxel. Your physician will likely want to know your recent A1c or a history of finger sticks to make sure that you are well-controlled enough for adequate healing, but other than that...