Posts Tagged ‘fraxel’
Melasma (chloasma) is hyperpigmentation or dark, irregular patches commonly found on the upper cheeks, nose, upper lip, and forehead. The patches can develop gradually over time or during pregnancy. Melasma can also develop when taking oral contraceptives or hormone replacement therapy medications. Melasma is thought to be stimulated by hormones, however exactly which hormones are involved has yet to be determined. The most important factor in the development of melasma is sun exposure,and without the strict avoidance of sun exposure, treatments for melasma are likely to be unsuccessful. Melasma can be permanent or disappear and reappear with each pregnancy.
Hyperpigmentation is the term used to describe any type of abnormal dark area of the skin, this includes melasma, freckles and sun spots. When we treat hyperpigmentation in the skin, it is important to understand that the melanocyte is not functioning properly, so it overproduces melanosomes and the excess melanin can not be evenly distributed among the keratinocytys. As the cells rise to the surface of the skin they cause over pigmented or dark spots. When the skin is exfoliated with AHA’s, chemical peels or microdermabrasion, the hyperpigmentation will appear lighter because some of the top layers of skin have been removed and the pigment is less dense (temporarily). The pigment is still there, it is just appears lighter and the melanocyte is still not functioning properlly, so in a few weeks as the top skin layers are replaced the pigment will appear dark again. Tanning will also further stimulate the melanocyte causing darker pigmentation to develop and Melasma will become worse. Hydroquinone works to suppress the melanocyte and is an excellent way to treat the pregnancy mask. For best results Hydroquinone can be used in conjunction with exfoliating treatments. I understand this description may be a little difficult to understand, so if I have lost you, you can come in for a consultation and I will use visual aids to better explain the cause and treatment for hyperpigmentation.
Melasma: My Personal Story
I have Melasma myself, on my upper cheeks and forehead. I first developed Melasma patches on my upper cheeks in my late twenties and later after giving birth to my second child I developed another large patch in the center of my forehead. I have successfully treated my Melasma, but I need to continue to maintain my skin so that it doesn’t come back. As a Medical Esthetician, I obviously have access to the best skin care products and treatments available. I can share both my professional and personal experience with treating Melasma. Using hydroquinone, and broad spectrum sunblock is absolutely necessary for treating and controlling Melasma. Even after successful correction of Melasma, the hyperpigmentation can reappear especially after sun exposure.
My Personal Skin Regimen
My personal skin regimen includes using the Obagi Nu-Derm system, with a 1/2 gram of Clear (4% hydroquinone) AM and PM. Initially I used a 1/2 gram of a .1% tretinoin ( Retin-A) every night, however I am now on a maintenance protocol and only use tretinoin occasionally. I also use a topical vitamin C and a broad spectrum sunblock containing Zinc oxide. I top it off with Jane Iredale mineral makeup SPF 20.
Professional Skin Treatments
I have had an Obagi Blue Peel, and Fraxel treatments. I personally felt I had better results with the Blue Peel. Fractional laser resurfacing and Blue Peels are ideal when treating deep or resistant Melasma.
Although I have corrected my Melasma, I still need to continue to maintain my skin to keep the Melasma under control. In addition to the topical products I previously mentioned, I try to have a light chemical peel every 4-6 weeks. The chemical peel I have found that gives me the best results treating pigmentation, is a custom chemical peel.
Obagi Nu-Derm System
This is correction after using the Obagi Nu-Derm System. This is a prescription strength skin system and is only available at medical skin clinics. Treatment protocols vary depending on skin type and condition.
Obagi Blue Peel
This is an example of deeply pigmented Melasma.
After treatment with Obagi Nu- Derm & Obagi Blue Peel
It is important to precondition with the Obagi Nu-Derm System and Retin-A before having a Blue Peel. I recommend preconditioning for a minimum of 6 weeks or longer depending on how aggressively Tretinoin is used. Patients that are better preconditioned get a better result. It is also necessary to continue to use the creams after peel to prevent Hyperpigmentation & to maintain healthy skin.
Custom Chemical Peel for Melasma
The Custom Chemical Peel I use is a light peel that can be repeated as often as every 4-6 weeks, compared to the Obagi Blue Peel which is a deeper peel necessary for treating deeper pigmentation. I have decided to not include details of my protocol for this custom peel. It is proprietary information that I don’t wish to share with others in the industry. If you would like to learn more, you can schedule a private consultation. I can tell you that with this peel, I will usually get light peeling for 2-3 days. The peeling is minimal and I would not consider there to be any “down-time”, you can still go about your regular routine. You just don’t want to schedule a peel less than a week before any major event like a wedding. I make it a point to work with my clients and their social calendar, so that they look their best for any events.
Get Professional Treatment For Melasma
If you have Melasma call to schedule a free consultation at
Paradise Valley Skin Klinic.
Laser peels, also known as a laser resurfacing, is the removal of the top layers of the skin via focused laser light energy. Some types of lasers may penetrate into deeper layers of skin to provide correction at a deeper level. Fully ablative laser resurfacing is used to remove moderately deep lines, scars, birthmarks and enlarged oil glands on the nose (rhinophyma). Laser resurfacing is usually performed using a Co2 (carbon dioxide) or Erbium laser, both lasers vaporize superficial, damaged skin cells. Laser resurfacing is an outpatient procedure that usually requires local anesthesia, and often done at the same time as surgical procedures.
CO2 is thought to give the best skin tightening, unfortunately it also creates the most downtime, pain and risks of adverse side effects. Newer versions of CO2 lasers can use short pulsed light energy (ultrapulsed) or continuous light beams that are delivered in a scanning pattern to very precisely remove thin layers of skin with minimal heat damage to the surrounding structures.
Erbium laser resurfacing creates minimal burning of surrounding tissue allowing for quicker recovery time than CO2 resurfacing procedure. Recovery time from the full coverage CO2 resurfacing is up to two weeks, compared to about one week with an Erbium laser. Erbium lasers cause minimal side effects, such as swelling, bruising and redness. Those with darker skin are usually a better candidate for erbium laser resurfacing compared to CO2.
The Sciton MicroLaser Peel is partial to full epidermal peel ( typically, 20 – 50 microns). The Sciton Erbium Yag laser is used for MicroLaser Peels and has the capability to treat at depths as minimal as 10 microns to as deep as 120 microns (full resurfacing). Microdermabrasion generally only removes the stratum corneum (10 microns). This is a versatile procedure because the settings can be adjusted to control the depth of the desired peel, while a computer guided scanner ensures maximum precision and treatment uniformity. Because this treatment ablates deeper into the epidermis, it is perfect step between microdermabrasion and full resurfacing.
Fractional Laser Resurfacing
Fractional resurfacing procedures have gained in popularity because their delivery systems dramatically reduce downtime compared to full coverage resurfacing. Fractional laser skin resurfacing treatments can utilize the same energy of an ablative resurfacing lasers, while providing the safety of non-ablative laser treatments. As a result, patients can undergo a corrective procedure, without the down -time. Fractional laser treatments target only a fraction of skin at a time, leaving the surrounding tissue intact, allowing the skin to heal faster. Fractional laser procedure are usually done in a series of treatments. Fraxel, ProFractioal and Ultrapulse (Active FX) are the most widely used fractional laser treatments.
ProFractional is a Fractional Erbium Ablative laser.
Active FX, Deep FX and Total FX
The UltraPulse fractional CO2 (10,600nm) laser system is capable of offering the full range of fractional resurfacing. The Active FX and Deep FX are both part of the UltraPulse Fractional laser, they are however separate handpieces that work differently. Patients are often confused by before and after photos, assuming they represent an Active FX treatment, when they may actually show results from a Deep FX or Total FX treatment.
DeepFX offers a small, deep spot microablative treatment
ActiveFX offers a large, superficial spot treatment.
Total FX is a treatment that combines both the DeepFX and ActiveFX.
Fraxel currently has four fractional systems.
Fraxel re:fine® treatment—for prevention and maintenance
This is the most gentle option, and is a cosmetic procedure that treats minor skin damage, with little to no down time.
Fraxel re:store® treatment—for mild to severe skin damage
The original and most popular Fraxel treatment, this treatment is used to resurface damaged skin and treat wrinkles around the eyes, acne scars, surgical scars, age spots/sunspots, melasma and Actinic Keratoses. There is minimal downtime , usually redness and some swelling. Most return to regular activities within a day or two.
1500nm Erbium laser
Fraxel Restore Dual uses both 1500nm Erbium laser and 1927 Thulium fiber laser
Fraxel re:pair® treatment— for the most severe skin damage
This is the most aggressive Fraxel treatment, it tightens skin, corrects severe damage, wrinkles, irregular texture, age spots/sunspots, sun-induced redness. There is increased downtime with this treatment, most return to routine activities after a week.
Fraxel Repair 10,600nm Co2 laser