| Dr. Ally-Khan Somani is Board Certified in Dermatologist by the American Board of Dermatology. Here the doctor has answered some common questions Bizymoms visitors have about Cosmetic Dermatology.
Q. What is the difference between ablative and non-ablative laser treatment?
A. The difference between ablative and non-ablative lasers is the type of laser used. Ablative lasers are more aggressively absorbed in the skin either removing a portion or the entire top layer of sun damaged skin or by vaporizing tiny columns of tissue during the treatment. Non-ablative lasers are less aggressively absorbed. Ablative lasers typically deliver significant results in a single treatment vs. 4-6 treatments with non-ablative lasers. Non-ablative lasers range from treatments like Laser Genesis, with 0 days of downtime per treatment to fractional non-ablative lasers with 2-4 days of downtime per treatment. Ablative lasers typically have slightly longer downtime per treatment ranging from 3-7 days depending on the degree of treatment.
Q. How does the Fraxel laser treatment work?
A. First, Fraxel is a term often misused – sort of like Kleenex. Fraxel is just one brand of fractional laser manufacturer – in our practice we use a new fractional YSGG laser (Pearl Fractional) from Cutera. All fractional lasers, ablative and non-ablative, work through the same basic mechanism. Fractional lasers work by creating very small laser lesions with large areas of surrounding untreated skin. Each small lesion heals quickly, but the effect on collagen (wrinkles, scars, photodamage, etc.) is cumulative from all the small lesions.
Q. What are the advantages and disadvantages of the Fraxel laser treatment?
A. The advantage of fractional treatment is the ability to perform aggressive treatments for significant collagen stimulation without significant downtime. Fractional ablative lasers, like Pearl Fractional, fractional CO2 and fractional erbium, do this in typically 1 treatment. Fractional non-ablative lasers typically require 4-6 treatments.
Q. How soon can patients see results after the Fraxel laser treatment?
A. Most fractional non-ablative lasers do not have visible results until about the 3rd treatment. Minimally ablative lasers, like Pearl see results in a single treatment but typically require 2 treatments for best results. Fractional ablative lasers typically see results after a single treatment. In all cases, the skin continues to improve after treatment with the best results in collagen stimulation occurring several months after the final treatment.
Q. What skin conditions can the Fraxel laser treatment treat?
A. Fractional lasers can treat texture, wrinkles, pigment and scars (both surgical and acne).
Q. How does laser treatment help to lighten or completely remove unsightly birthmarks?
A. Both pigmented and vascular birthmarks can be targeted with various types of lasers. I would always recommend that pigmented birthmarks or lesions be first evaluated by a board certified dermatologist to ensure that these lesions are not malignant or at risk of developing into melanoma. As a dermatologist, I do not recommend that pigmented nevi (moles) be removed with a laser, instead these lesions should be surgically excised if they must be removed.
Freckles, sun-induced spots on the chest and arms and patchy areas on the face and body can be readily removed with only a few treatments using an intense pulse light (IPL). In my practice I use the LimeLight or Accutip to help fade away these lesions. Vascular birthmarks (hemangioma, Port Wine Stains etc.) and lesions can also be targeted with various lasers (see below).
Q. What are Telagiectasias and how can laser treatment help?
A. Telangiectasias are small veins typically found on the nose, cheeks and legs. Lasers treat these veins by selectively targeting the blood in the vein. The laser targets and heats the blood in the vein permanently removing the vein.
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