Skin Rejuvenation

Fractional Laser

Fractional laser treatments can lead to dramatic improvements in the skin. These lasers deliver energy to columns of skin which stimulate skin cells to contract and to produce new collagen. Because the laser leaves behind small bridges of untreated skin, the healing time is reduced. These lasers reduce wrinkles and fine lines, and can also help to soften deeper lines. They also noticeably improve skin tone and texture. Fractional lasers can also treat scars, including acne scars. Multiple treatments may be required to achieve optimal results. Most people continue to see improvement for up to six months after the procedure. Results of these fractional laser treatments can be maximized with proper skin care both before and after the treatment. Our skilled aestheticians and clinicians can help you devise the appropriate skincare regimen to complement your procedure.

Young woman receiving skin rejuvenation treatment

Young woman receiving skin rejuvenation treatment

Affirm™ Multiplex Laser (Nonablative Fractional Skin Rejuvenation)

The Affirm™ Laser offers fractional non-ablative skin rejuvenation. This means that this device is able to stimulate collagen and improve fine lines, skin texture, and acne scars over time with a series of treatments, yet still have minimal downtime associated with the procedure. The Affirm™ has been shown to be a safe and effective way to rejuvenate the skin.

MultiPlex technology enables the sequential emission of two wavelengths in one pulse from the same delivery system. Since lower individual energy levels can now be used during treatments, discomfort is minimized and recovery is accelerated. This produces faster, more effective results when compared to single-wavelength technologies.

A series of four-to-six treatments is recommended for optimal results. Treatments are typically spaced one month apart. We apply a topical anesthetic mask 20-to-30 minutes prior to treatment. This mask will help to minimize any discomfort during treatment.

Contraindications:

  • Use of Accutane within the past year
  • Sun-tanned skin
  • If patient is taking certain medications that cause sun sensitivity

Total FX LaserActive FX & Deep FX (Ablative Fractional Resurfacing) 

Laser Treatment

Laser Treatment

Active FX can improve the appearance of fine lines, wrinkles, scars, dark spots, and other irregularities on the face, neck, and chest. By removing sun damage with fractional technology, it stimulates the formation of new and healthy skin and new collagen. This provides greater elasticity and support, which results in more youthful, firmer, tighter skin. Your skin will not only look healthier, but it will actually be healthier, too. Significant results can be seen with just one treatment, though some patients require several to achieve their goals. Compared to older CO2 lasers, Active FX has much less downtime and aftercare. In one week, you can see noticeable results that used to require three or more weeks of healing!

For those needing a deeper treatment, the Deep FX portion of the fractional CO2 laser can be used either by itself or in conjunction with the Active FX peel (Total FX). The more aggressive settings penetrate to the lower part of the collagen layer to repair deep lines and wrinkles, acne scars, and scars from surgery or trauma.

Patients should expect seven-to-ten days of downtime when undergoing Deep FX or Total FX.

As it is important that patients have complete understanding of the procedure, expected results, and associated downtime with these procedures, we recommend a consultation with the physician who will be performing your procedure prior to scheduling Active FX, Deep FX, or Total FX.

General Procedure: The Total FX fractional CO2 laser procedure is done in the office. It generally takes about one hour to do the entire face, and less time if we are focused on specific areas. A topical anesthetic mask is applied to the skin to insure your comfort. Most patients describe the pain of the procedure as tolerable.

Recovery: The skin will appear red and swollen immediately following the procedure. Cool air and compresses are used immediately and ointment is then applied to soothe the skin. Our staff will guide you on how to care for your skin during this period of recovery and will teach you how to use our post-procedure kit. The skin will turn brown over 24-to-48 hours and slough over the next four-to-seven days. Make-up and sunscreen/moisturizer can then be used. Patients generally return to work in four-to-seven days. The underlying skin will appear pinker and healthier. This pink appearance usually completely fades in seven-to-ten days and is easily covered with make-up. Continued improvement in wrinkle correction, skin tightening, and texture from the fractional CO2 laser can be seen even up to two years following the procedure.

Laser Hair Removal

Laser hair removal is used to permanently reduce hair growth. At The APDerm® Center for Cosmetic Services, we use both the Gentle Yag and GentleLase Laser. The laser energy is transformed into heat, which destroys the hair follicle and leaves the surrounding skin unaffected. The skin is further protected during treatment with a cooling device. Both devices are FDA approved to safely treat fair skin as well as darker skin types. Most people require six-to-eight treatments. Patients should avoid electrolysis, plucking, or waxing four weeks prior to having a treatment. Patients should avoid sun exposure and self-tanner before and after laser hair removal treatments and should apply a sunblock with SPF30 or above.

Gentlelase Pigment Peel

The Gentlelase Pigment Peel is used to treat brown discolorations/freckles and also helps to stimulate collagen growth. Pigmentary changes occur with age or as a result of overexposure to the sun’s damaging ultraviolet rays. The Gentlelase Pigment Peel is able to fade pigmentary changes caused by sun exposure. This procedure is usually done over larger areas such as back, chest, arms, hands, and legs.

Prior to treatment, a numbing cream is applied at our office allowing the Gentlelase Pigment Peel to be very comfortable. A series of two-to-three treatments is usually recommended to effectively clear the skin of brown pigment.

Patients should avoid sun exposure six-to-eight weeks before and after laser treatments.

Contraindications:

  • Use of Accutane within the past year
  • Sun tanned skin
  • If patient is taking certain medications that cause sun sensitivity

Intense Pulsed Light

Intense Pulsed Light is used for the treatment of brown and red discolorations in the skin. The IPL treatment also encourages collagen growth, exposing a more youthful appearance to the skin. This treatment is used over the face, neck and chest. For best results, a series of treatments is recommended. On average, four-to-six treatments spaced out three-to-four weeks apart. The double cooling hand piece allows for a very comfortable and quick treatment with minimal down time.

Patients should avoid sun exposure six-to-eight weeks before and after XPL treatment.

Brown Laser

The brown laser is used to reduce and remove brown discolorations in the skin such as age spots, freckles, and various birthmarks. Brown discolorations or melanin can be present in the skin due to various factors. Some types are present at birth, but most occur with age or as a result of overexposure to the sun’s damaging ultraviolet rays. Our lasers are specifically designed to target dark concentrations of melanin in the ski, destroying the unwanted pigment and removing or lightening the lesion. For some lesions multiple treatments may be needed.

The Laser Pigment Peel uses our brown laser at lower energies to treat the entire face. This setting helps to rejuvenate the skin, stimulating collagen production while also helping to fade overall brown discolorations caused by sun damage. A microdermabrasion is recommended 10 days after this treatment. This helps to remove the pigment more efficiently and speeds up the recovery process. For best results, multiple treatments may be necessary.

 

Purple Laser

This laser (Varia laser) can be used for hair removal in darker-skinned individuals. It can also be used at higher levels to treat unwanted facial and leg veins. This laser also stimulates collagen, and thus can be used for laser toning. It penetrates deeply, helping to soften deeper wrinkles and acne scarring. We recommend a series of four treatments, each done one month apart.

Red Laser

The Vbeam (Perfecta) Pulsed Dye Laser by Candela is used to treat a number of skin conditions that result in redness of the skin. Conditions such as poikiloderma (discoloration of the face and neck related to long term sun damage), redness and broken capillaries caused by acne and rosacea, port wine stain birthmarks, strawberry hemangiomas, warts, and scars and stretch marks. Face and leg veins respond very well to the Vbeam laser. The Vbeam laser also helps to rejuvenate the skin while reducing redness. At the APDerm® Center for Cosmetic Services, this treatment is called laser toning. A series of treatments is recommended. Our laser toning treatment can also be used in conjunction with topical photosensitizers (this is called Photodynamic Therapy or PDT). The laser PDT toning treatment is used at low energies with topical ALA to treat brown spots, roughness, fine lines, redness, and reduction in symptoms of acne.

The Pulsed Dye Laser delivers an intense, but gentle burst of light into selectively targeted areas of the skin. The epidermis is protected by Candela’s exclusive dynamic cooling method which sprays a cooling mist onto the targeted area of the skin maximizing comfort and protecting the skin during treatment. A consultation is recommended prior to laser treatments. In most cases, a series of treatments may be necessary for optimal results.

Patients should avoid taking aspirin or other blood thinners prior to treatment. Sun avoidance is recommended post-treatment to prevent darkening of treated areas.

PDT for Acne

  • Photodynamic therapy, which entails the use of a photosensitizing topical medication in conjunction with exposure to red or blue light as a treatment for acne, can be quite an effective treatment.
  • This procedure is a good alternative to many acne treatments to include isotretinoin. (Accutane) and oral antibiotics.  Some researchers have shown it to have similar effectiveness to these more traditional treatments.  This type of treatment generally requires multiple sessions to achieve such results.
    • When you arrive, we scrub the skin, apply the medication (Levulan ) and let it sit for about an hour prior to exposing your skin to the OmniLux light source.   You then need to avoid the sun and bright lights for 48 – 72 hours after the procedure; Most patients find it to be quite easy to tolerate.
    • Variable duration of clearance – sometimes years!
    • This is a cosmetic treatment, not covered by insurance. We recommend you plan on at least 4 sessions over the course of 2 – 3 months.

PDT for Actinic Keratosis (precancerous lesions on the skin)

  • Photodynamic therapy, which entails the use of a photosensitizing topical medication (Levulan Kerastick) in conjunction with exposure to red or blue light as a treatment for precancerous lesions of the skin is an excellent way to address these lesions efficiently and effectively.
  • This procedure has been done for many years now in our office and can be used to treat problem areas on the scalp, face, ears, chest, arms and even the legs (in separate sessions).
    • When you arrive, we scrub the skin, apply the medication (Levulan (ALA)) and let it sit for 1 – 2 hours depending on the treatment plan and site to be treated prior to exposing your skin to the OmniLux light source.  Most patients experience minimal discomfort with the procedure.
    • Patients treated with PDT need to avoid both the sun and all intense light sources for about 48 – 72 hours after the procedure.  After this, the recovery generally proceeds quite quickly.
    • Most patients require 2 – 3 sessions to achieve notable and durable clearance of their actinic keratosis.
    • Ask your APDerm® provider if this treatment is right for you.  Most insurance plans cover these treatments.

What is Microneedling?

It is a form of Collagen Induction Therapy (CIT). CIT creates controlled injuries underneath the skin’s surface. The injury induces the body to respond through the formation of new tissue. The skin plumps and thickens in response to this stimulus, ultimately reducing the appearance of scars, fine lines and other skin texture changes. In addition to inducing collagen, the channels made from the micro-needles allow topical gels and creams to be absorbed more effectively through the top layer of skin.  Most cases need four-to-six treatments, each spaced at two-to-six week intervals. You may require a series of sessions to obtain your desired outcome.

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Who is a good candidate?

Who is a good candidate?

Who is a good candidate for Microneedling?

Any patient with:

  • Fine lines or moderate wrinkles, uneven texture of the skin
  • Moderate skin laxity (looseness)
  • Diminished texture, tone, color, no ‘glow’
  • Atrophic (depressed) acne scars
  • Stretch marks
  • Traumatic scars
  • Sun damage

Who is NOT a good candidate (contraindications)?

Any patient with:

  • Keloid scars
  • Scleroderma, collagen vascular diseases or fungal infection
  • Immunosuppressed
  • Pregnant or nursing
  • History of severe eczema
  • Psoriasis and other chronic conditions

Relative contraindications that can be managed through the procedure:

  • History of Herpes Simplex infections (can be managed with medication prescribed before first procedure)
  • History diabetes
  • Presence of raised moles or warts on the targeted area (can be avoided)

What happens during the procedure?

APDerm® uses the Eclipse MicroPen™ system and it allows for controlled induction of the skin’s self-repair mechanism by creating micro “injuries”, which triggers new collagen synthesis. The procedure is performed in a safe and precise manner with the use of the sterile Turbo Safety Needle Cartridge head. The procedure is normally completed within 30-60 minutes, depending on the required treatment and anatomical site.

Are there side effects?

After the procedure, the skin will be red and flushed in appearance in a similar way to a moderate sunburn. You may also experience skin tightness and mild sensitivity to touch on the area being treated. The skin’s redness will diminish greatly after a few hours following the treatment. Within 24 hours, the surface of the skin typically appears and feels more normal. After three days, the skin is often healed and your normal appearance fully restored. For the first three days, it is important to avoid sun exposure and sweaty activity.

Is it painful?

Numbing cream is applied prior to the treatment to minimize any pain that is felt during the procedure. All of our patients thus far have found it to be quite tolerable.

Is there downtime required to recover from the procedure? What is the aftercare?

Expect redness or even pinpoints of bleeding on days one-three after the procedure. By day two, most patients look like they have a sunburn and they may be dry. The skincare regimen noted below will help soothe the skin. The skin is usually fully recovered by day four after the procedure.

If you have any signs or symptoms of a cold sore, please call immediately so that we can prescribe you an antiviral medication.

Avoid sweaty gym workouts/exercise, hospital settings where you might be exposed to an infection, dirty jobs (like cleaning the bathroom, etc.) for three days after the procedure.

No MINERAL SUNSCREEN or MAKEUP (containing Zinc or Titanium) for two days after the procedure, try to avoid the sun during this time and use a hat instead of SPF.

No VITAMIN C Serum or RETINOIDS for four days after the procedure. No GLYCOLIC ACID for four days after the procedure.

MEN: Avoid shaving for three-four days after the procedure (may start shaving when skin does not feel irritated anymore).

What are the skincare regimen recommendations after microneedling?

Wash with a gentle cleanser such as Cetaphil® or CeraVe® Hydrating Cleanser (available at local drugstores)

Apply Hyaluronic Acid Serum every two-three hours for the remainder of the first day and continue through the next two days.

Starting on day four, apply SkinMedica® TNS Recovery Complex® (purchase at our office) once a day.

How many sessions should I expect to need?

For Facial Rejuvenation/Collagen Stimulation: Plan 3-5 sessions, each 2-4 weeks apart
For Perioral (around the mouth) wrinkles: Plan 5 sessions, each 2-4 weeks apart
For Acne Scars: Plan 3-6 sessions, each 3-6 weeks apart
For Stretch Marks: Plan 3-6 sessions, each 4-6 weeks apart

 

***Results vary between individuals.

***New Patients MUST attend a consultation prior to getting treatment.

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Day of microneedling

Day after microneedling:

Day after microneedling

17 year old female – day of microneedling:

17 year old female – day of microneedling

Day after microneedling:

Day after microneedling