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Laser Skin Resurfacing

Massachusetts Dermatology Associates offers its patients on the North Shore, MA fractional, non-ablative laser skin resurfacing with the Palomar Lux 1540 laser.    This laser is effective in improving and rejuvenating skin texture and softening the appearance of scars (including acne scars).

Frequently Asked Questions (Laser Skin Resurfacing):

Who should consider treatment with the Palomar Lux 1540 Fractional Laser?

Those with a desire for a minimally invasive procedure to improve the following conditions:

  • Sun damage (shallow wrinkles treatment, fine lines treatment, crow’s feet treatment, aging skin treatment, melasma treatment)
  • Scars (acne scar treatment, surgical scar treatment, and traumatic scar treatment)
  • Stretch marks (striae)
  • Skin texture and tone issues

Is the Palomar Lux 1540 effective for laser acne scar removal?

We have had very good success with acne scar treatment using the Lux 1540 laser.    We call this “acne scar treatment” instead of “acne scar removal” because it is important to have realistic expectations and we find that the notion of  “acne scar removal” is not realistic.   There is no available method to completely remove acne scars without a trace, but our acne scar treatments with the Lux 1540 do a great job of reducing acne scars and helping them blend in better with the rest of your face.   If you are looking for laser acne scar removal, in many cases the Lux 1540 can get you most of the way there.

A word of advice:  If you have active acne, make sure it is under good control before attempting acne scar treatment.  The total cost of laser acne scar treatment will be higher if you need more laser treatments down the road.

Many patients often combine acne laser treatment with a chemical peel for acne scars, and some patients alternate visits between chemical peels and laser treatments.

Important Note:   If you have recently been treated with isotretinoin (Accutane), it is strongly recommended that you hold off on laser acne scar treatment for at least 6 months after you finish your treatment, since paradoxically, laser acne scar treatment immediately after Accutane treatment can make scarring worse.

Is the Palomar Lux 1540 effective for melasma treatment?

The Lux 1540 (in combination with aggressive sun protection, a topical pigment corrector, plus or minus chemical peels) can be a helpful tool to reduce the annoying facial hyperpigmentation of melasma.

Many patients often combine melasma laser treatment with a chemical peel for more effective melasma treatment, and some patients alternate visits between chemical peels and laser treatments.

Warning:  If you are hoping for longterm results with the Lux 1540 for melasma treatment, you must be zealous about sun protection.   Sun exposure after laser treatment (even through window glass) can result in melasma recurrence.   Wearing sun protection and continuing with a topical pigment corrector (under your dermatologist’s supervision) may be very helpful in locking in your gains.

What visible results can I expect from the Lux 1540?

  • Softening of fine lines/wrinkles and improvement in scars, stretch marks, melasma, and rough skin texture.
  • NOTE: The 1540 does not “erase” the above conditions but often results in significant improvement.

Who should not get treatment with the Lux 1540?

Those with a desire for a single treatment session that completely corrects their concern may be disappointed with the gradual improvement achieved with a series (often 3-4) treatments with the Lux 1540. Additionally, patients who have had significant sun exposure or have used self-tanning products 4 weeks before their scheduled treatment or who plan for significant sun exposure in the 4 weeks after treatment should reschedule.  Patients who are pregnant and those who have been treated with Accutane (isotretinoin) within the past 6 months should not be treated with the Lux 1540.

How does the Lux 1540 work?

The Lux 1540 delivers light as an array of microbeams which creates columns of coagulated tissue within the skin. Creation of the columns starts a natural healing process that forms new, healthy tissue.  Remodeling results in improvement in wrinkles, scars, stretch marks, and melasma.   Since the outer layer of skin (stratum corneum) is left intact, the treatment does NOT create open wounds and there is little downtime.

What is the difference between the Lux 1540 and Fraxel lasers?

The original Fraxel laser was the first fractional non-ablative laser for facial rejuvenation and was developed in 2001.

The Lux 1540 is a newer generation of fractionated laser.

There is no consensus regarding which treatment (Lux 1540 vs Fraxel) is more effective.    A few potential advantages of the Lux 1540 over the Fraxel:

  • The Fraxel requires blue dye to mark skin before the procedure; the Lux 1540 does not require this dye.
  • Lux 1540 sessions are said to be less painful by many patients than Fraxel treatments.
  • The cost of Lux 1540 sessions is generally less than the Fraxel.

See Wendy Travis’s discussion comparing Fraxel to Lux 1540.

What areas can I have treated?

Resurfacing can be applied to most areas of the body including the face, chest, arms, and hands.

What are the side effects?

While most patients tolerate the procedure very well, there is often mild discomfort. We suggest application of a topical anesthetic to the treatment area one hour before the first treatment.   In subsequent treatments you may choose to use or forgo the topical numbing agent.   You can expect some swelling, redness, warmth, or tightness in the treated area, which usually fades within a few hours of treatment but in some cases can last for a few days after the procedure (especially around the eyes).   Light peeling/flaking can occur in some patients 2-3 days post-treatment (DO NOT PICK/RUB/SCRATCH).   Blistering or acne flares after treatment is rare but can occur.   There is also a risk of (usually temporary, but rarely permanent) darkening or lightening of skin in treated areas, particularly in patients who do not adhere to strict sun protection.  Although scarring and infection is a possibility with any laser treatment, the chance of such an occurrence happening with the Lux 1540 is very low.  Most patients who have this procedure to their face on a Thursday or Friday are ready to return to work on Monday.

How many sessions will I need, and how long will the effects last?

On average, 3-4 treatments are needed to achieve desired effects, spaced at 3-4 week intervals. Visible improvement usually occurs after 2 to 3 months although it can take up to nine months to see the full benefit after treatments.  The results are often long-lasting but the duration of their effects varies significantly among patients

Is treatment with the Lux 1540 ever combined with other treatments?

Very often treatment with the Lux 1540 is combined with the Palomar IPL to offer synergistic treatment that results in maximal color and textural improvements (see scientific paper describing this combination). Additionally, the Lux 1540 may be combined with chemical peels in order to maximize acne scar treatment or melasma treatment.

Ask your dermatology provider about these combinations.

How shall I prepare for my treatment?

Arrange your calendar so that you have approximately 48 hours after the treatment to stay indoors and consider taking this time off from work if you are concerned about the appearance of potential redness and swelling.   If you have a history of cold sores, you may be prescribed an antiviral medication to start taking the day before your treatment.  Avoid the use of topical retinoids (e.g. tretinion) for 1 week prior.  Do not get any significant sun exposure in the 4 weeks before your treatment session.  On the day of treatment, please try to arrive with clean skin, the treatment area free of any makeup, lotions.  Wear comfortable clothes to your appointment.

What is the procedure like?

You will sit reclined on a chair and the laser operator will apply laser pulses over your skin in a series of passes.  You will feel a “hot rubber band sensation.”  Please let us know if the discomfort is severe.  You will be given goggles to wear during treatment (even with the goggle you might see flashes of bright lights, which is normal).  The treatment usually lasts approximately 20-30 min per body area treated.

What can I expect and what shall I do after the procedure?

  • Immediately after your treatment you may place a cold pack over the treatment area to help reduce any redness,swelling or discomfort. A moisturizing sunscreen will then be applied.   During the first 24 hours after treatment, your skin will experience a wide range of changes. This will vary from feeling mildly sunburned, sensitive, warm, swollen or even tight.  In some people the skin may also appear pink or red.  Avoid hot tubs, whirlpools, saunas and excessive sweating for 24-48 hours or until the redness has subsided.  Some “puffiness” around the treated area may linger on for a few days.  Sleeping with your head slightly elevated can help minimize facial swelling.  Cool washcloths are helpful at home to reduce post-procedure discomfort.   A deeply moisturizing product will be helpful during this time period.  Nonetheless as the skin surface is left intact and undamaged there will be no oozing or open areas.   You may shower the day of your treatment.  Do not scrub or exfoliate skin and gently pat your skin dry.  Do not use skin exfoliants, retinols, tretinoin, alpha-hydroxy acids (AHA’s), or bleaching creams during the first 2 weeks after treatment.   After 24 hours, make-up can be applied to cover any noticeable skin changes.     We strongly suggest that you remain completely out of the sun for the first 48 hours.
  • Over the next few days, it is quite common for the skin to appear slightly bronzed after the treatment. This too can be covered with make-up. In some patients we may feel the need to use higher settings.  As a result, in these patients there may be some mild peeling or flaking in addition to the redness for 3-4 days after treatment.  Using a moisturizer will help reduce the appearance of any dry flakes.
  • During the first two weeks after treatment (and in between treatments), the skin is remodeling and it is very important to minimize sun exposure and avoid tanning creams. Use sunscreen with at least SPF 30 and broad spectrum UVA protection.   Sun exposure in this period of time may cause longstanding (sometimes permanent) hypopigmentation or hyperpigmentation.  Even after finishing your laser treatments, we recommend that you continue to use SPF 30 or higher on a daily basis as part of your regular ongoing skincare routine.

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