fractional resurfacing lasers: erbium lasers
“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT
BESIDES ERBIUM LASERS, WHAT KIND OF FRACTIONAL LASERS ARE THERE?
There are two types of fractional lasers:
The more gentle and more superficial erbium fractional lasers
The more aggressive fractionated CO2 lasers
In general, the erbium lasers treat more superficial changes and are better for younger patients (under 50), mild to moderate acne scarring, and fine wrinkles. The CO2 systems are better for older patients, deeper wrinkles, some skin tightening, deeper acne scarring, and other scars. The fractional CO2 lasers can treat more deeply, but they also can require more downtime than the erbium lasers.
“Amazing plastic surgeon: they call him “the magician” for a reason. My facelift is the best according to all my friends. Thank you, Dr. Patel R. Alderton 57 Yrs Old Facelift and Neck Lift – London, England
WHAT ARE FRACTIONAL ERBIUM LASERS BEST FOR?
These erbium glass fractional lasers treat the following:
“I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.” D. Gull Highly recommended for eye lift surgery – Salt Lake City, UT
HOW DOES FRACTIONAL ERBIUM RESURFACING WORK?
The erbium laser creates tiny “microthermal” zones (think pixels) deep into the skin which the skin repairs by pushing out the old sun damaged skin (the tiny pixels) and replacing it with new skin. Each treatment replaces about 15-20% of the sun damaged, scarred or wrinkled skin. It triggers the body’s natural healing process accelerating the production of collagen and new, healthy skin cells. 1,000-2,000 microthermal zones per are created each centimeter squared. The depth of penetration of the erbium lasers is less than that of the CO2 lasers.
CAN I HAVE ERBIUM TREATMENT WITH OTHER COSMETIC TREATMENTS?
HOW LONG DOES THE ERBIUM LASER TAKE TO WORK AND WHEN WILL I SEE RESULTS?
HOW LONG DO THE EFFECTS OF AN ERBIUM LASER LAST?
That depends on how well you protect your skin from the sun and your genetic aging process. If you apply sunscreen and wear sun protective clothing, your skin will look good longer than if you are tanning, including tanning booths, or spend a lot of time outdoors. If you are careful with your skin, your skin may continue to look good with annual maintenance treatments.
HOW ARE ERBIUM LASER TREATMENTS PERFORMED?
You need to arrive about 1 hour before your treatment. You or a technician will cleanse the treatment area and then apply a numbing cream to the area to be treated. Then you just relax, read, or listen to music, while the numbing cream takes effect. Many patients like to put the anesthetic cream on the face before they leave home so they are ready to be treated by the time they arrive to the clinic.
After about 45 minutes, the numbing cream will be removed. No gel is needed for treatment with the newer Erbium lasers. The skin is cooled using the amazing Zimmer cooler and the laser treatment is commenced.
WHAT IS THE PROCESS FOR ERBIUM EYELID TREATMENT?
Patients should try to arrive with a clean face, including all eye cosmetics, and you should inform your clinician if you have any permanent makeup before beginning the treatment. Numbing eye drops are placed in the eye to aid in the insertion of a contact lens-like eye shield to protect the eye. The shield fits comfortably within the eye.
The eye treatment is then performed on the upper and lower eyelids. Erbium eyelid treatment may be performed at the same time as Erbium face treatment. Remember, it is normal like all areas treated with the Fraxel, to some swelling and redness for 2-3 days after the treatment.
WHAT DO I DO PRIOR TO MY ERBIUM LASER TREATMENT?
- Stop use of Accutane 6-12 months before any treatments
1-2 Week Before Treatment:
- Buy several bags of ice packs/frozen peas
- Buy Cetaphil or another gentle cleanser
- Stop use of Asprin, Advil and Aleve if possible. Tylenol is ok.
- Stop use of all Retinols/Retin-A
- Stop Renova, Tazorac, “anti-aging” products
- Stop use of all glycolic acid treatments
- Avoid sun exposure 2 weeks prior to your treatment (use sunscreeb)
- Stop minocycline, doxycycline and tetracycline
- Stop waxing
- Stop abrasive scrubs and microdermabrasion treatments
- Call your doctor if you have a history of cold sores- you may need a prescription for Valtrex or Famvir to begin the day before your treatment.
Day of Treatment:
- Eat a meal 1-2 hours before your treatment – this prevents feeling jittery with the numbing cream
- No caffeine for 4 hours before your treatment
- Wear comfortable/ washable sweats or clothes
- Arrive with no make-up or eye contacts
- Bring a wide brimmed hat to your appointment to wear after your treatment.
- Are you pregnant or breast feeding? If so, you are not a candidate at this time
- Tendency to hyperpigment? We will start you on a hydroquinone bleaching cream about four weeks prior to your treatment.
WHAT WILL I LOOK LIKE RIGHT AFTER TREATMENT AND WHAT IS THE HEALING TIME?
- During the first 24 hours after treatment, your skin may feel as though it is sunburned. Ice packs or frozen peas are used 5-10 minutes per hour for the first 5-6 hours after the treatment.
- Please apply a moisturizer (see the section on “which moisturizer should I use after laser treatments” for suggestions) four times a day to the treated skin, and more often if the skin feels dry.
- Your skin will look very red immediately after the treatment and will fade over the next 1-3 days. Usually you can go back to normal activities including work, with make-up, within 1-3 days (we will estimate for you). Occasionally, the redness may take longer to resolve. Make-up can be worn to reduce the red. Rarely, bruising may develop, which can take up to two weeks to resolve. Allow 2-3 weeks for weddings, reunions, family pictures, etc just to be safe.
- Within a few days after each treatment, a “bronzed” look to the skin is common, which can last 1-2 weeks. Your skin may flake and exfoliate a little. Use a moisturizer three to four times a day to the lasered areas: this will help reduce the appearance of dry flakes. Remember, it will take several treatments to obtain optimal results.
INSTRUCTIONS FOR CARE AFTER ERBIUM LASER TREATMENT
- Ice for ten to fifteen minutes every hour for the next 5 – 6 hours to reduce swelling. Use a bag of frozen peas covered with a thin clean cloth/towel.
- Avoid scratching or rubbing the treated skin – do not put adhesive dressings over treated areas.
- Men may shave 1-2 days post-treatment but be gentle. Best to use an electric razor for the first few days!
- Avoid all saunas and hot tubs. Showers can be taken, but avoid hot water and direct shower spray to treatment area for 3 days following treatment. You may, however, shower and get the face and treated areas wet the day after the treatment.
- Avoid strenuous exercise for 48-72 hours (this includes all yoga, especially the upside down, inside out Bridge-Lion pose.
- Avoid alcoholic beverages for 24-48 hours.
- Sleep with 1-2 extra pillows at night to keep head raised for the two nights.
- Avoid direct sunlight for a minimum of 4 weeks after your treatment and wear a sun block with 10% zinc or titanium for the next 4 weeks. If actively outdoors, you should reapply your sunscreen every 2-4 hours and wear a wide-brimmed hat
- Do not use any retinoid, Retin-A or glycolic products for 1-2 weeks following the procedure. Do not use any non-prescription creams without checking with us first.
- Refrain from any chemical peel treatments or microdermabrasion (or deep facials!) for 4 weeks post-procedure.
CAN I GO BACK TO WORK AND ACTIVITIES IMMEDIATELY?
No, you will need to take the rest of that day off to ice and care for the treated area. You can go back to all of your activities, including exercise when your doctor approves it, usually 1-7 days after your laser treatment. Swimming in a chlorinated pool is not advised for 1-3 weeks. You may exercise outside with a full brimmed hat and with a high-quality sunscreen with 10% zinc or titanium.
HOW MANY TREATMENTS WILL I NEED?
HOW LONG WILL THE RESULTS FROM THE ADVANCED IPL PHOTOREJUVENATION TREATMENTS LAST?
ARE THERE ANY REASONS NOT TO BE TREATED WITH ERBIUM LASERS?
ARE THERE ANY MEDICAL OR COSMETIC SIDE EFFECTS?
WHAT ABOUT ALL THE DIFFERENT NAMES OF LASERS PEOPLE TRY TO
SELL ME LIKE FRAXEL, THERMAGE ETC.
SELL ME LIKE FRAXEL, THERMAGE ETC.
Properly used, a knowledgeable and proficient surgeon can make each of these lasers perform well. It is the results that count. Don’t worship false gods (mixing metaphors).
Always review before-and-after photographs of patients treated for the same condition as you (by your surgeon!), or talk to other patients who have had treatments. Medicine and surgery are best practiced with a thorough knowledge of anatomy, physiology, pathophysiology, knowledge of different wavelengths of lasers, and the effects and
side-effects of the same. And experience!
HOW DOES THE ERBIUM LASER WORK ON SAGGING SKIN
This laser does NOT work well for sagging skin: we have better alternatives that include other lasers and also surgery.
HOW DOES THE ERBIUM LASER WORK ON WRINKLES?
ARE THERE ANY SIDE EFFECTS?
The main side effects are mild, temporary swelling, redness, an accentuation of the brown spots, crusting, and an occasional bruise or small superficial blister (like a sunburn blister).
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CONTACT DR. PATEL
Do you have questions or need more answers?
Dr. BCK Patel MD, FRCS
Salt Lake City, Utah 84106, USA
(801) 413-3599 (phone/text)
Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
Saint George, UT 84790, USA