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The following information should cover all the topics presented in your question.
"In laser resurfacing, sometimes called "laser peel," a carbon dioxide
(CO2) laser is used to remove areas of damaged or wrinkled skin, layer
by layer. The procedure is most commonly used to minimize the
appearance of fine lines, especially around the mouth and the eyes.
However, it is also effective in treating facial scars or areas of
uneven pigmentation. Laser resurfacing may be performed on the whole
face or in specific regions
"All resurfacing treatments work essentially the same way. First, the
outer layers of damaged skin are stripped away. Then, as new cells
form during the healing process, a smoother, tighter, younger-looking
skin surface appears. Laser resurfacing is a new method being used by
plastic surgeons to remove damaged skin. Because it is new, there are
no long-term data on this technique. However, a number of studies
using microscopic examination have shown that the physical changes
that occur to laser-treated skin are essentially identical to those
that occur with either dermabrasion or chemical peel."
Carbon dioxide or YAG lasers (YAG is the type of crystal that is used
to generate the laser) are often used for resurfacing procedures.
* removing superficial wrinkles
* tightening your skin
* evening out pigmentation (colouring)
* smoothing rough skin
* improving the look of shallow acne or chicken pox scars
"Pulses of laser light can be used to treat skin lesions such as port
wine stains and spider veins. These lasers can also be used to remove
the colour from tattoos and do not seriously damage the surrounding
* Little if any bleeding
* Less post-operative discomfort than other procedures.
"For superficial or medium resurfacing, the laser can be limited to
the epidermis and papillary dermis. For deeper resurfacing, the upper
levels of the reticulas dermis can also be removed. Varied penetration
allows treatment of specific spots or wrinkles."
* Discomfort from the treated area until it has healed
* Swollen skin that may ooze for the first 7-14 days after treatment
* Skin redness that may last for 6-12 weeks
* Scabs forming as part of the healing process
* An obvious lightening or darkening of the treated skin may occur. Patients
with olive skin, brown skin or black skin may be at increased risk for
* Individuals who have taken accutane in the past 12-18 months or are prone to
abnormal (keloid-like) scarring or those with active skin infections on the
treatment area may not be appropriate candidates for this procedure.
* Potential for scarring or burns from the heat of the laser energy.
* Laser resurfacing can activate herpes virus infections ("cold sores") and,
rarely, other types of infection.
"The final result from laser resurfacing may take several months to
fully appear. Laser won't completely remove all facial flaws or
prevent you from aging. Lines that occur as a result of natural
movements of the face - smiling, squinting, blinking, talking, chewing
- will inevitably recur. Laser facial resurfacing generally isn't
suitable for treating the neck, or very deep wrinkles, sagging skin
and extra fat."
Information above is from:
BUPA - Laser Resurfacing
"A short pulse (30 nanoseconds-3x10-9) of intense red light (694.3
nanometers) emitted by the ruby laser is selectively absorbed by the
melanosome or the tattoo ink located in the epidermal & dermal skin
layers. Pigmented lesions are all made of an over abundance of
melanosomes in the skin. The ruby laser energy causes the melanosome
or tattoo ink to fragment into smaller pigment particles that are
removed by your body's immune system."
* Age spots
* Café au lait spots
* Moles & Warts
* Pigmented lesions
* Port wine stains
* Mongolian spots
* Skin discolorations
"Age spots" usually require only one treatment. Conditions, such as
Nevus of Ota, freckles, and other superficial skin discolorations also
can be removed in one or two treatments. When more than one session is
required, treatments should be spaced four to eight weeks apart to
allow your body's natural immune system to remove the maximum amount
of pigment or ink particles in between sessions. In the case of
tattoos, amateur tattoos usually require three to five treatments
while professional tattoos may require six or more treatment sessions.
Fading of the tattoo will continue in between treatment sessions as
more ink is removed by your body."
"In darker skinned people the area treated by the laser may become
lighter (or occasionally darker) than the surrounding skin for a
period of months. Eventually this area will almost always be restored
to its original color. Scarring is most unlikely."
From Advanced Dermatology Center for Laser and Cosmetic Surgery
LASER HAIR REMOVAL
"Laser hair removal works by sending a beam of laser light to a group
of hair follicles with enough power to disable or destroy the root,
but not enough power to harm the surrounding skin. This process is
called selective photothermolysis. It is selective because it targets
only the hair and not the skin. Photo means light and thermolysis
means destroying with heat."
Types of lasers used for hair removal
* Alexandrite- such as the Candela GentleLase Plus. The Alexandrite laser has a
versatile range of spot sizes which means that it can be customized to treat
hair with different degrees of coarseness. It can also be used for a range of
skin types. The Alexandrite lasers are fast. They can do a male back in 30-40
* Ruby- such as the EpiTouch or the Epilaser. Best suited for people with
lighter skin. The ruby laser can be used at a lower power on darker skin
types. It is good for smaller areas because it has a small spot size. The
Ruby laser for hair removal provides a comfortable treatment."
* Diode - such as the Coherent Light Sheer. The Diode laser features a longer
wavelength which gives it an advantage of treating a wide range of skin types.
* ND, and LP ND Yag- such as the Candela GentleYag and the Altus Cool Glide. The
ND Yag laser is considered to be especially useful in treating dark or tanned
skin. It can also treat coarser hair well."
There are several factors that a laser technician can often control to
customize a treatment for efficacy, safety and comfort:
* Pulse length- long pulsed lasers are considered safest.
* Fluence- Selection of energy levels can be varied for skin type.
* Delay- The time in between pulses of light affects how much the skin and hair
follicle are allowed to cool off
* Spot Size - Affects the speed and penetration of the laser. A larger spot
penetrates deeper. A good selection of spot sizes helps the technician reach
the hair at the depth at which it grows.
* Cooling- The surrounding skin may be protected by a gel, spray or cooled tip
pressed against the skin.
"The ideal candidate for laser has dark hair and light skin. The
laser will not work on people with red, white, gray or true blond
hair. The hot laser light will also be attracted to the melanin in
the skin, so people with suntans, or dark skin types are at more of a
risk for discoloration of pigment and other side effects."
From Hair Lasers.com
"Complications from laser hair removal are rare. Bleeding during the
laser treatment is extremely rare, as is the possibility of infection
resulting from treatment."
Side effects from laser hair removal include, but are not limited to:
* Darkening of the skin (hyperpigmentation). This is usually a temporary
condition, but in rare instances, is long lasting or permanent.
* Lightening of the skin (hypopigmentation). This is of special concern with
people who have darker skin. Laser hair treatment is more successful on fair
skin, but darker skin can also be treated.
* Blistering and scarring. These rarely occur.
* Changes in the skin texture. These rarely occur.
* Crusting or scabbing. If this occurs, it's temporary.
* Hair changes. New hair growth may be finer and lighter in color. In some
cases, new hair may grow in areas adjacent to the treated areas. This can be
successfully treated with additional laser treatments.
From the Mayo Clinic
"LED Skin Rejuvenation is the interaction of light, delivered through
Light Emitting Diodes (LEDs), to activate cell receptors causing them
to produce collagen or multiply. LEDs offer a totally natural,
non-ablative method for skin rejuvenation. The light from the LEDs
interacts with cells and stimulates them to produce new collagen and
* Yellow light LEDs are used for photo-rejuvenation.
* Blue light LEDs are used in the treatment of acne.
* Red light LEDs are used for PhotoDynamic therapy.
* The main benefit is a reduction in the appearance of fine lines, wrinkles,
freckles, brown spots, scars and the amount of redness.
"Treatments are progressive. Typically treatments are spread over
several months. The number of treatments and the treatment times will
vary depending on the problem being treated, the amount of surface
area treated and the area treated. As full correction approaches,
treatment intervals can be expanded to three to six month intervals.
Since the skin continues to age, maintenance treatments will be
"Treatments are less expensive than other light based therapies. LED
Skin Rejuvenation does not rely on thermal energy and the related
tissue trauma to effect change. Therefore, patients are not subject to
the variables associated with wound healing. LED Skin Rejuvenation can
be administered alone or in conjunction with other treatments. It is
highly complementary with other skin treatments such as Botox and
dermal fillers as well as non-ablative laser and IPL treatments."
See LED Skin Rejuvenation
INTENSE PULSED LIGHT (IPL) OR PHOTOREJUVENATION
"A broad spectrum of light is transmitted through a small, smooth,
transparent handpiece which is gently placed over the skin. Cut-off
filters in the handpiece change the wavelength range allowing it to be
optimized for different applications and skin types. The light
penetrates the tissue and is absorbed by either the blood when
treating vascular lesions or the melanin when treating pigmented
lesions damaging them. The body's natural processes then remove the
injured tissue giving the skin a more even and youthful appearance.
IPL Skin Treatments using Photorejuvenation often consist of full-face
treatment or treatment of isolated body areas like the hands or chest.
The treatment regimen typically consists of:
* Four to six treatments administered at three week intervals
* Broad spectrum light in the visible and near infrared range, from 515 nm up to
about 1200 nm
Uses: (This appears to be the best treatment for "redness" of the face!)
IPL (Intense Pulsed Light Treatments) have the following indications:
* "Reduction in Erythema or redness of the face, neck or chest including the
medical condition called Rosacea. A 75%, or higher, reduction can be seen
after 5 treatments with the benefits continuing up to 12 months after
the treatments. Additional maintenance treatments can extend this period.
* "Flushing (sporadic redness) of the face, neck and chest. IPL remains one of
the only effective treatments for this condition that causes embarrassment to
many individuals. Flushing occurs with stress or alcohol consumption and can
be dramatically reduced 75%, or more, after 5 treatments."
* "Photoaging or Sun Damage is skin that has fine wrinkles, freckling, irregular
pigmentation, coarse or rough appearance, large pores and a dull texture. IPL
has been shown to visibly reduce these skin characteristics creating skin that
is brighter and more youthful in appearance.
* "Pigmentation Problems (Brown Age-Spots, Melasma or Pregnancy-Mask) are
characterized by uneven brown skin pigmentation. IPL treatments can
significantly reduce this uneven pigmentation.
* "Acne Scarring may be visibly improved with IPL treatments that induce
Collagen formation in the dermis."
* "Post-Surgical Scars can be lightened with IPL treatments that specifically
target vessels in the forming scar tissue. Stretch Marks that are red or
purple in color can be faded using IPL.
Advantages of IPL over Other Existing Treatments and Procedures
"IPL has the following advantages over other skin rejuvenating
modalities including Laser Skin Resurfacing, Dermabrasion, and
* "IPL/RF are the only effective treatments for redness or flushing of the
face, neck and chest. Other modalities have not proven as effective or risk
skin damage and potential scarring."
* "Substantial visible improvement with no down-time. No bruising, no crusting,
no weeping skin means clients can return to work or activities in as little as
30 minutes. IPL treatments are performed as an office treatment using a
topical anesthetic gel.
* "IPL treatments can be performed safely on non-facial skin of the neck, chest,
hands, back, arms, abdomen and legs - areas where it?s unsafe and unwise to
use harsh chemicals and some Lasers."
Information above is from Beverly Hills Plastic Surgery
"Post-operative discomfort is almost nonexistent. After treatment with
most light systems, the treated skin may appear a little flushed and
capillaries may seem to be more visible. The flushed look soon fades
away, and the capillaries appear to vanish, leaving the skin looking
OVERVIEW OF Micro Dermabrasion vs. Dermabrasion
"The main difference between the two skin treatments is that
microdermabrasion exfoliates only the top 10-15 microns whereas
dermabrasion exfoliates thicker skin layers. Dead cells and used
microdermabrasion crystals are then vacuumed back in the device,
leaving the skin cleaner, smoother and shinier. Microderm abrasion,
unlike dermabrasion, can also be performed at a beauty center or at
home, using a personal at-home microdermabrasion system. This home
micro derm abrasion kit replaces the spraying-and-vacuuming device
with your own fingers to massage the skin with specially formulated
fine powdered foam or cream. A typical microdermabrasion treatment
performed at a clinic takes between 30 and 60 minutes, depending on
the surface of the skin treated. In order to achieve the desired
results, you may need 6 to 12 treatments, performed around two weeks
apart. Dermabrasion, on the other hand, requires significantly more
time since it is a surgical skin resurfacing technique.
"Microdermabrasion is a skin-freshening technique that helps repair
facial skin that takes a beating from the sun and the effects of
aging. The plastic surgeon uses a device like a fine sandblaster to
spray tiny crystals across the face, mixing gentle abrasion with
suction to remove the dead, outer layer of skin. As with other skin
rejuvenation techniques, more than one treatment may be needed to
reduce or remove fine wrinkles and unwanted pigmentation."
Micro abrasion can improve appearance of acne-prone or blotchy skin,
remove fine scars or wrinkles, rhytides, milia or sebaceous
hyperplasia and minimize enlarged pores. Sun damaged skin or uneven
texture may also improve as a result of microdermabrasion treatment.
* Microdermabrasion is the least invasive dermatological procedure (compared to
dermabrasion and laser resurfacing)
* More affordable than surgical skin care treatments
* Available as home microdermabrasion systems and kits
* Can be performed on all skin types
* No side effects and it is effective on all skin types and colors
* Unlike dermabrasion or laser skin resurfacing, takes no more than 30-60
minutes and can
be successfully used on the face, neck, chest and hands.
* Microdermabrasion does not require anesthesia if performed at a beauty salon
or physician's office (unlike microlaserpeel and dermabrasion)
* For best results, you may need around 10 microdermabrasions. This means time
* Limited effectiveness. Because the procedure is so mild, it cannot cause
severe changes in skin appearance. Micro abrasion is effective on mild age
spots, large pores, superficial acne scars and fine wrinkles, but it cannot
treat deeper scars or wrinkles.
* In the rare instances that equipment is not properly sterilized or handled,
hyper-pigmentation and infections may occur.
To read about Crystal vs. Diamond (Crystal-Free) Microdermabrasion, see
Most of the above text is taken from:
"Dermaplaning is used to treat deep acne scars with a handheld
instrument called a dermatome. The dermatome resembles an electric
razor and has an oscillating blade that moves back and forth to evenly
"skim" off the surface layers of skin that surround the craters or
other facial defects."
"Dermabrasion is a mechanical procedure that uses a power driver, a
hand-held device equipped with a rotating metal wheel, a diamond
fraise or a wire brush to remove the top skin layers. This type of
skin abrasion requires general or local anesthetic, depending on the
skin area being treated.Before treatment, the treated area is cleaned
with antiseptic cleaning gel. The doctor then starts the skin-peeling
process using the rotating wheel until the desired depth of the dermis
(skin) is reached."
"Dermabrasion and dermaplaning help to "refinish" the skin's top
layers through a method of controlled surgical scraping. The
treatments soften the sharp edges of surface irregularities, giving
the skin a smoother appearance. Both dermabrasion and dermaplaning can
be performed on small areas of skin or on the entire face. They can be
used alone, or in conjunction with other procedures such as facelift,
scar removal or revision, or chemical peel."
* improve the look of facial skin left scarred by accidents or previous surgery
* to smooth out fine facial wrinkles, such as those around the mouth
* to remove the pre-cancerous growths called keratoses
* Dermaplaning is commonly used to treat deep acne scars.
"Neither treatment will remove all scars and flaws or prevent aging.
Most surgeons won't perform treatment during the active stages of acne
because of a greater risk of infection. The same may be true if you've
had radiation treatments, a bad skin burn, or a previous chemical
"Dermabrasion and dermaplaning may be performed under local
anesthesia, which numbs the area, combined with a sedative to make you
drowsy. Sometimes a numbing spray, such a freon, is used along with or
instead of local anesthesia. General anesthesia may be used in more
severe cases. The amount of skin involved and the depth of scarring
will determine the length of time involved in the procedure and the
number of procedures performed."
In dermabrasion: "the surgeon scrapes away the outermost layer of
skin with a rough wire brush, or a burr containing diamond particles,
attached to a motorized handle. The scraping continues until the
surgeon reaches the safest level that will make the scar or wrinkle
In dermaplaning: "the surgeon uses a hand-held instrument called a
dermatome. Resembling an electric razor, the dermatome has an
oscillating blade that moves back and forth to evenly "skim" off the
surface layers of skin that surround the craters or other facial
defects. This skimming continues until the lowest point of the acne
scar becomes more even with the surrounding skin."
Side Effects of both procedures:
* Black skin, Asian skin, and other dark complexions may become permanently
discolored or blotchy after a skin-refinishing treatment.
* People who develop allergic rashes or other skin reactions, or who get
frequent fever blisters or cold sores, may experience a flare-up.
* If you have freckles, they may disappear in the treated area.
* The most common risk is a change in skin pigmentation. Permanent darkening of
the skin, usually caused by exposure to the sun in the days or months
following surgery, may occur in some patients. On the other hand, some
patients find the treated skin remains a little lighter or blotchy in
* You may develop tiny whiteheads after surgery. These usually disappear on
their own, or with the use of an abrasive pad or soap; occasionally, the
surgeon may have to remove them. You may also develop enlarged skin pores;
these usually shrink to near normal size once the swelling has subsided.
* Some individuals develop excessive scar tissue (keloid or hypertrophic scars);
these are usually treated with the application or injection of steroid
medications to soften the scar. The surgeon may then treat the skin in a
number of ways, including ointment, a wet or waxy dressing, dry treatment, or
some combination of these.
It can take as long as six to twelve months until the pigment has
completely returned to the skin so it's important to protect skin from
the sun during the healing process."'
The above is taken from Plastic Surgery.org
Some Q & A from R.S.B. Dermatology, Inc. & Cosmetic Surgery Center
Why are more and more surgeons performing laser peels instead of
dermabrasion? - "The dermabrasion procedure requires skill and
experience to perform well. Additionally, dermabrasion poses a health
risk to operating room personnel as the patient's blood is aerosolized
and remains in the room for hours. Furthermore, lasers can precisely
remove skin layer by layer."
What are the advantages of dermabrasion? - "Dermabrasion typically
costs less than laser peel. Healing is usually faster than laser peel
with reduced risk of prolonged redness."
What are the disadvantages of dermabrasion? - "Some surgeons believe
that laser peeling results in more tightening of the skin than
dermabrasion. Dermabrasion requires significantly more surgical skill
to perform well."
MEDICAL NEEDLING (also called Collagen Induction Therapy)
"Medical needling is a procedure that has been used for the last three
or four years. It involves using a roller to which are attached dozens
of fine, very sharp medical quality needles. Rolling these firmly over
the skin causes dozens of fine holes to be cut into the deep layers of
the skin which helps to stimulate new collagen growth, improve the
skin texture and reduce the appearance of scarring and fine to
moderate lines. Usually the procedure is performed with local
anaesthetic being injected into the treatment area. People may either
use "Laughing gas" or have light sedation. Once the area is numb the
roller is firmly rolled over the skin multiple times. This causes some
short term bleeding and a slightly raw bruised appearance. The
procedure generally takes approximately half an hour to perform. The
patient has their face cleaned, a light antibiotic ointment is applied
and the patient is then able to go home."
"These minute injuries to the dermis result in the start of the
wound-healing cascade. The punctures begin the wound-healing cascade,
which causes the body to produce its own collagen, even in pen- and
postmenopausal women. Because the body produces its own collagen,
there is no rejection. This is a medical procedure preformed with the
aid of either a topical or local anesthesia. The patient will
experience little or no pain. If treating the entire face, neck and
décolleté, some physicians prefer conscious sedation."
Medical needling has been used with success on
* facial lines
* traumatic and surgical scars
* stretch marks
* lax and photo-damaged skin on face and chest
* post burn and ice pick scars
"A crucial part of the treatment is the preparation of the skin prior
to the procedure with topical vitamins A and C. This significantly
reduces down time and patient discomfort. It is very important that
the patients continue using the topical vitamins for at least 6 months
post procedure to ensure the production of healthy collagen and
elastin. We have experience that the results are vastly inferior and
that patients experience unnecessary discomfort when not following
"One cannot stress how important it is that patients know how to take
care of their skin in the first 72 hours post needling. As the skin
has lost its barrier function, the surface of the skin feels dry and
can even feel rough for the first few days. It is important to keep
the skin hydrated....The aim is to prevent any scabbing. Sun exposure
should be avoided until the skin is healed. Remember that a skin cycle
in an older, sun-damaged person may take at most 50 days!
The advantages of this procedure, according to Dr. Fernandes, are that
it does not damage skin; skin becomes thicker with more than a
400-percent increase in collagen deposition; any part of the body can
be treated; needling can be performed on all skin types, even
Fitzpatrick IV and V, without fear of hyper- or hypopigmentalion; and
there is no risk of demarcation lines. Results show that medical
needling is a less costly, safer alternative to laser resurfacing.
"It is not recommended for those with active infections, chronic skin
disorders, blood clotting problems, poor healing, a clear-cut keloid
diathesis, or skin malignancies."
"Ultrasound is considered in terms of four categories: First is
thermal. Heat is generated into the deeper tissues and especially the
collagen, and the benefits derived from this. Second is the
mechanical. High-speed vibrations act on the tissue like a micro
massage. Third is cavitation. Countless microscopic oxygen droplets of
oxygen are generated from the vibration process. Fourth is biological,
which include blood vessel dilatation, improved blood flow and
circulation, improved lymph flow and muscle relaxation."
"Ultrasound facilitates the effectiveness of other skin treatments
since deep cleansing, exfoliation and moisturizing is improved.
Ultrasonic vibrations penetrate deep into pores and hair follicles to
break up old, dead cells, secretions and oily blockages. Also, skin
metabolism is increased which causes lymph flow to increased which
causes waste products to be removed more rapidly and effectively. The
more waste products removed the better penetration and absorption of
your skin care products. Deep tissue micro massage improves skin tone,
softness and texture. Stretch marks, fine lines, and sun-damaged skin
are improved through infusion of collagen or vitamins into the skin."
"The result is younger looking skin with better elasticity and
texture. Treatment sessions take about 30-45 minutes and clients
report feeling immediate tightening and softer, smoother skin."
From Maya MedSpa
Iontophoresis and Sonophoresis
These techniques are used to help in the delivery of topical
ingredients to the skin.
"The Ionzyme-DF machine uses "sonophoresis" (low frequency ultrasound)
and "iontophoresis" (galvanic current) to enhance the penetration of
intensive, medical-grade products deeper into the skin where the
higher levels of Vitamin A and Vitamin C can work effectively to
change skin cells on a molecular level."
"Where photo damage has become established, the replacement of these
vitamins can be facilitated with the use of iontophoresis and
sonophoresis. Up to 400% better penetration (compared to simple
topical application) can be achieved with iontophoresis. By using low
energy ultrasound, up to 4000% better penetration can be achieved, but
unfortunately only small areas may be treated this way. Wrinkles can
actually be safely "melted" away."
"The skin of the neck is difficult to treat with surgery and this case
demonstrates the important role that iontophoresis of vitamin A and C
has for rejuvenation of skin. The lower part of the neck skin was
wrinkled and was treated for three months with iontophoresis of
vitamin A and C twice a week for 20 minutes with the Environ® IONZYME
DF 1998 machine. The photograph was taken three months after
completion of the treatment. The skin is now smooth without any
intervening surgery. The use of iontophoresis of vitamin A and C can
also be used to reduce scars and the author believes gives better
results than dermabrasion. Dermabrasion thins the skin and results in
an artificial looking surface whereas iontophoresis of the skin
nutrients actually makes the skin thicker, healthier and more
From "Maximising skin care with the use of advanced skin penetration
techniques," by Dr. Des Fernandes
I believe I have covered all the bases for you. However, if you need
additional clarification, please don't hesitate to ask. I'll be happy
to help further if I can!
Search Strategy included all the terms outlined in the question