Acne Scars

Fractional erbium fibre treatment is completed as a series of treatments. You’ll need frequent and multiple treatments for the optimum results. Normally, minimum 3-4 treatments at the gap of around one month are recommended to achieve maximum results. However, the number of treatments can vary from individual to individual and their optimum goal.

Our Fractional erbium fibre laser, a 1565 nm wavelength device, is completed without a disposable tip to the laser. It is completed with a single pass to the skin treatment area, unlike the 6 to 8 passes required with Fraxel, which may increase the level of patient comfort compared to earlier laser technologies.

It is a fast and easy treatment.  Usually, it takes a very short duration to complete one session of the treatment.  Dr. Nivedita is extremely concerned about patient comfort. Patients at Dr. Nivedita Dadu’s Dermatology Clinic receive topical numbing before the treatment which makes it easier for the patient to tolerate. You might feel tingling sensations during the treatment.

Yes, there is some downtime with our fractional erbium fibre laser.  For a typical treatment with this laser, skin is minimally swollen for a few hours, and mildly red for initial few days. In most of the cases, this treatment can be completed on a weekend, probably on a Thursday or Friday, so that the patient can return to work on the next Monday. Dr. Nivedita Dadu prescribes a topical medication to completely reduce the redness and it can be used immediately after the treatment. Patients can return to the daily routine/work by using make-up one day after the treatment. The post treatment care includes application of topical moisturizing cream and sunscreen with good SPF. The skin may feel mildly rough for about a week after treatment.

There are no significant side effects with the treatment and those that occur are predictable and mild in nature. This is a safe and risk-free procedure.  Every patient experiences mild redness on the skin and minor swelling after the treatment. The skin texture around 1 week from treatment may be rough, feeling like very fine sandpaper for a period of few days.

Fractionated CO2 lasers excel at treating deeper wrinkles, more severe textural changes, acne scars, and surgical or traumatic scars.

The fractional CO2 laser takes the Co2 laser beam and fractionates, or pixellates that beam into thousands of tiny little shafts of light.  These small shafts of light pierce into the deeper skin layers.  Then the skin repairs these small shafts by removing the old skin cells damaged by Sun and replaces it with new skin. The collateral heat damage also helps in shrinking the existing collagen.

You should keep it in mind that the fractional CO2 laser treatments are customizable as per your skin’s specific needs. Depending on the treatment the downtime may be longer or shorter. The deeper the focus of the treatment, the better the results will be.  Some patients decide to have only 2-3 treatments which are not as deep so that they can prevent a lot of downtime.  

The complete results of the treatment can be witnessed with in a few months and there are also some visible changes immediately after the treatment. The skin may need couple of weeks to completely heal it and your skin might look slightly pink. The skin would begin looking smoother and less blemished. And when the skin heals completely it will return to its normal colour, less wrinkles, faint scars and more radiant skin.

The feeling might be similar to that of sunburn within a day of the treatments. An Ice pack or frozen peas can be used every once in a while after the treatment. The skin will feel red and tender for almost a week and will turn pink in the consecutive week. The healing, actually, depends on the focus of the treatment. If it does deep penetration, it will take longer to heal. Make up can be used to make your skin look normal and hide the pinkish colour. However, you should keep a buffer of around a month for attending social functions like weddings, reunions, family get-togethers. It takes longer for the large treatment areas such as arms and legs.

No, you will need to take the rest of that day off to ice and care for the treated area. In case of lighter fractional CO2 treatments almost a week will be needed as social downtime. And if the treatment is deeper, around a fortnight will be required for healing.

The number depends on the extent of your sun damage, scarring and on how much downtime you can accept. If you can tolerate a minimum of a week of downtime, you would generally need fewer fractional CO2 treatments.

Reasons not to do a fractional laser treatment may include use of medications that increase photosensitivity, use of anticoagulants (some are fine), use of Retinoids in the 6 months, chemotherapy, history of difficult healing or scarring, history of bleeding disorders, and pregnancy, keloidal tendency . You should also inform your treating doctor about any history of herpes or facial warts.

An experienced dermatologist with good clinical knowledge in lasers can help you avoid any complications. And complications are rare. But here is a list of some of the possible complications of fractional CO2 laser treatments:

1. Pain. Most people feel very little pain during treatment due to the measures discussed above. Rarely there is mild discomfort for the first day after laser.

2. Redness. A pink colour may persist for a couple of weeks or more after the laser surgery. In rare instances, it may last around a month. This is more common in patients who have a history of flushing and blushing easily or who already have dilated vessels on the surface of the skin.

3. Wound Healing. The CO2 laser causes a superficial wound to the skin that takes approximately a week to a fortnight to heal. The superficial injury on the outer skin layers may cause swelling (mild to moderate). Peeling is common but crusting is rare. After the treatment of the surface, it will be sun-sensitive at least for a month.

4. Pigment Changes. You may get increased or decreased pigmentation on the skin as it heals after the treatment. This is exceptional and usually takes place in darker skin tones.The pigmentation may occur between couple of weeks after treatment. Hyperpigmentation usually fades in couple of months, though rarely pigment changes can be everlasting.

5. Excessive Swelling. Immediately after the laser surgery, you’ll have swelling on the skin. Although, it is a temporary and within a few days will be healed.

6. Scarring. There is a very small chance of scarring. This includes hypertrophic scars or, very rarely, keloid scars. Keloid scars are the thick and raised formations on the skin. One should follow the instructions of the dermatologist given for post-operative care to minimize the risks of scarring. The patient history of critical healing shall be discussed with the doctor before the treatment. And last but not the least, do not pick!

7. Eye Exposure. There is also a risk of harmful eye exposure to laser surgery. A protective eyewear is required to keep the eyes closed and unharmed.

8. Depression or emotional difficulties even if the procedure is successful.

9. Since every patient is an individual, you may not respond exactly the way other patients do. You also may not be completely happy with the effects of treatment.

10.  Infection. Occasional infections can occur. Diabetic patients may be put on oral antibiotics to reduce the chances of infection.