Treatment Information
Client: 38yr old Male, Skin Type II
Area Treated: Back
Goal: Reduce pigmented lesions (freckles/moles) on back
Laser: Quanta Q plus C
Settings: 532 nm wavelength 3mm handpiece
Cooling: Zimmer Cryo Chiller
Duration: 5 minutes per treatment.  A series of 3 to 5 treatments needed to revise freckles and moles.

Fractional Co2 & Q Plus C Laser Pigmented Lesion Revision

Pigmented lesions, brown or black spots, and birthmarks are skin spots that are usually moles created from an excessive concentration of melanin in the skin. Melanin is what gives your skin its color and areas of high melanin concentration can be present at birth, caused by age, or overexposure to the sun. The most commonly treated lesions are solar lentigines (commonly known as sun spots), freckles, and birthmarks. Most pigmented lesions, when completely removed, will not return. However, excessive sun exposure and lack of sunscreen use may cause new lesions to occur. Pigmented lesions that change in size, border shape, and color that may itch or sting should be analyzed by a Dermatologist to rule out melanoma.

How does fractional Co2 laser pigmented lesion revision work?

The Quanta You Laser is a fractionated (pixilated) carbon dioxide laser and one of the best advances in non-surgical laser scar revision treatments. Co2 lasers have the longest wavelength of all the lasers currently on the market. A fractional Co2 treatment works by sending a laser beam deep through the layers of the skin, which creates tiny spaced columns in the skin similar to a polka dot print. The skin then repairs those tiny columns by pushing out the old skin and replacing it with new. By leaving the surrounding skin around each column intact, this leaves healthy skin available which aides in a faster and safer healing process. This healing process activates the skins stem cells and puts the body’s natural collagen and elastin production on fast-forward as well as regenerating the epithelial layer on the skins surface. This regenerative process of the skin reduces wrinkles, fine lines, scarring, dull skin, age spots, uneven coloration, skin laxity, and textural irregularities.

Who is a good candidate for fractional Co2 laser pigmented lesion revision?

The fractional Co2 laser scar revision is a safe and effective procedure for almost any skin type. However, the best clients are those with a light skin tone, skin types 1 through 3. Skin type can be determined during your free consultation.

Who should not get treated?

Because of the nature of this procedure, the healing process after can be very hard on clients that suffer from an immune system disorder. Anyone who scars easily should not attempt this procedure largely for cosmetic reasons. Anyone that has a pigmented lesion that has changed in size, border shape, or color, that may itch or sting, should be analyzed by a Dermatologist to rule out melanoma prior to treatment.
Clients who have connective tissue disorders, such as lupus erythematosus or Siogren’s syndrome may have an increases risk of complications and for this reason should forgo this treatment. Although the fractional Co2 laser scar revision procedure can be used to treat acne scarring, those with an active presence of acne are at an increased risk for infection. The presence of cold sores and herpes simplex can also increase complications during the healing process therefore an antiviral medication such as Valtrex should be taken prior to treatment to prevent an outbreak. Individuals currently taking Accutane or those who have taken it in the last 18 month should also refrain from undergoing laser treatments as studies have shown Accutane decreases the healing capability in the skin. Women who are pregnant and breast feeding should also forgo cosmetic laser treatments due to the use of topical anesthetic.

How long do fractional Co2 laser pigmented lesion revision treatments take?

The entire face can be treated in as little as 30 minutes. However, treatment time can vary depending on location of treatment, number of passes needed, and the use of topical anesthetic.

Does a fractional Co2 laser pigmented lesion revision treatment hurt?

The treatment feels a little like a “pins and needles” sensation.Topical anesthetic is applied prior to the laser treatment and a strong stream of cold air (a Zimmer cooler) is blown on the skin during the treatment to make it virtually painless. Minimal discomfort may be felt but overall the treatment is very tolerable.

What should I do prior to a fractional Co2 laser pigmented lesion treatment ? Two to four weeks before treatment:

  • Avoid sun exposure and this includes the use of tanning beds and self-tanners.
  • Those individuals with herpes simplex and prone to cold sores should start an antiviral medication prior to getting a Co2 treatment to prevent an outbreak.
  • Stop the use of Retinols/Retin A, Renova, Tazorac or any other anti-aging product.
  • If possible stop the use of Asprin, Advil and Aleve or any other anti-inflammatory. Tylenol is ok.
  • Stop the use of all glycolic acid treatments.
  • Stop minocycline, tetracycline, and doxycycline.
  • Stop waxing, abrasive scrubs, and microdermabrasion treatments.
  • Purchase several ice packs or frozen peas.
  • Buy Cetaphil or another similar facial cleanser.
  • Buy bleaching cream and start a regimen four weeks before treatment if you have a tendency to hyperpigment.

What should I do the day of treatment?

  • Be on Time: You will need the full amount of time for numbing the skin
  • Eat a Meal:  1 to 2 hours before treatment- this prevents a jittery feeling from the numbing cream
  • No Caffeine: You should not consume caffeine at least 4 hours prior to treatment.
  • Wear Comfortable Clothes and Shoes: Sweats and a button-up shirt work best.
  • Arrive without Make-Up or Contacts: Your face needs to be clean prior to treatment.
  • Bring a Hat: A wide brimmed hat works best to shield face from sun if treatment is during the day.

How much does a fractional Co2 laser pigmented lesion treatment cost?

Costs vary depending on where you live and the number of areas being treated. Full face treatments can vary between $1,500 – $4,000.

How are fractional Co2 laser pigmented lesion treatments performed?

You will arrive 1 ½ hours before treatment so your skin can be prepped. You will cleanse the treatment area and your technician will then apply topical numbing cream. Next, you will relax, read, listen to music, or watch TV while the numbing cream takes effect. After you numb for about an hour, the numbing cream will be removed and the treatment will commence. After treatment a topical ointment will be applied to treated area.

Can I go back to work and activities immediately?

No, you will need to take the rest of the day off to care for and ice treated area. If face is treated, it is recommended that you take off at least a week to allow the redness of your face to subside before going out in public again.

How many treatments will I need?

Results are dramatic giving you the biggest improvement with just one treatment. The fractional Co2 laser is the single best treatment for pigmented lesions and is effective in completely removing the lesion. However, individuals with extreme discoloration may need more than one treatment. Although lesion removal is permanent, excessive sun exposure can result in new lesions requiring another fractional Co2 laser treatment. A proper health and skin care regimen can ensure that your results last for years. Treatments can be repeated every 6 moths indefinitely.

Are there any cosmetic side effects?

Complications with the fractional Co2 laser are rare and every client’s skin is unique, but the following can occur:

  • Pain: Most people experience little pain during treatments and after. If mild discomfort occurs after treatment Tylenol is effective for it.
  • Redness: A pink skin color may persist for two weeks or two months after treatment. In rare cases it can last three to six months. This tends to be more common in clients who have a history or flushing and blushing easily or those individuals who have existing dilated vessels on the surface of the skin.
  • Wound Healing: The fractional Co2 laser treatment causes a superficial wound to the skin that takes approximately a week to heal. The outer layers of the skin may result in mild to moderate swelling. Ice packs can be effective for it. Crusting is rare but peeling is common. Sun sensitivity can occur for 4-6 weeks so it is recommended that you avoid the sun and wear sunblock.
  • Pigment Changes: There is a possibility that the treated area may heal with increased or decreased pigmentation. This is rare and occurs most often in darker skin clients and 2 to 6 weeks after treatment. Hyperpigmentation usually fades in 3 to 6 months, though pigment changes are rarely permanent. Bleaching cream can be effective for it.
  • Excessive Swelling: Immediately after treatment, some swelling of the skin will occur. This is temporary and will diminish over the course of a week.
  • Scarring: Although scarring is very rare, hypertrophic scars and keloid scaring can occur in very rare cases. This is why it is important to note any prior history of scarring, not to pick at skin after treatment, and to follow aftercare instructions carefully.

What areas of the body can I treat with the fractional Co2 laser?

It can treat areas on the face, including around the eyes and lips, and body parts including neck, arms, hands, chest, legs, back and areas prone to stretch marks.

Do I have to treat the whole area or can I treat just the problem areas?

Specific problem areas can be treated. However, it’s recommended that you consider treatment of the whole face and neck because all parts of the face age at the same time.

How soon will I see results after my fractional Co2 laser pigmented lesion treatment and how long will my results last?

Immediately following your treatment, your body will naturally start working to replace aged tissue cells with new ones. Shortly after your procedure (usually the first week) you will start to notice healthier, smoother, and younger looking skin. These results with continue to improve over the next 6 months. Depending on how well you care for your skin and your lifestyle, results can last for years.

What post-treatment care is needed following my fractional Co2 laser pigmented lesion procedure?

There is a list of post-care instructions that will be reviewed with you during your free consultation. Clients will also receive a copy of take home instructions the day of treatment. These instructions include proper times to ice the skin, apply ointment, a list of medication that is safe to take, and if and when to contact a doctor.
After treatment, it is important to take extra special care of your skin to help it heal quickly and safely. There are important precautions to take to protect your skin:

  • Food and Beverages: Drinking at least 640oz. per day will enhance the healing process by replacing fluids lost from oozing and help reduce swelling. A cold water mist can also be used to relieve burning sensation. Avoid alcohol, caffeine, and smoking as they will delay the healing process. Consume foods low in sodium and high in nutritional value. Consuming foods high in sodium will put you at risk for increase swelling and discomfort. Foods high in nutritional value will provide the vitamins, carbs, and protein that your body needs to promote healing and aid in the rejuvenation process.
  • Skin Care Products: All of the skin care products you use after treatment should be gentle and non-clogging. A very gently and inexpensive skin care products are: Aveeno, Cetaphill, and Neutrogena.
  • Sunscreen: According to the American Academy of Dermatology, it is very important to utilize proper and frequent sunscreen. Resuming sun activities are fine with sunscreen after the first 4 months of treatment. Wearing a protective hat is also recommended.
  • Moisturizer: Peeling and flaking is normal. You will be given a moisturizer along with your aftercare instructions. This product will be used until gone. After this, you need to continue using moisturizer during the remaining healing process. The moisturizer should be non-irritating and non-clogging so it can be used frequently without causing breakouts. You should apply moisturizer to your skin whenever it feels tight or dry.
  • Glycolic Acid, Retin-A, Scrubs, and Toners: Your skin will be very sensitive for the first month or so after treatment, so you should avoid products that might cause irritation. Make sure to read product labels prior to using them to prevent irritation.
  • Bleaching Creams: The use of bleaching creams (Hydroquinone) is not recommended while your skin is tender and should be discontinued until skin is healed.

How many fractional Co2 laser pigmented lesion treatments can I get?

There is no limit to the number of treatments. As long as you are seeing results and you wait 4-6 months after treatment, you can have treatments indefinitely. However, it is recommended that no more than 2 areas are treated at a time. Treating more than 2 areas at a time is not advised due to the potential toxicity of numbing cream used prior to the laser treatment.

What is the difference between a fractional erbium laser and a fractional Co2 laser?

They use different laser technology and have different wavelengths. One is an erbium laser and the other a Co2 laser. The Co2 laser a superior laser known as the “gold standard” in laser skin resurfacing because it penetrates the skin deeper, which is why you see such dramatic results after one treatment. The erbium laser does not penetrate as deep and requires multiple treatments.