Who is a candidate?

Good candidates for this procedure are people with sun damaged skin:  freckled, discolored, red, blotchy, or those with poor skin texture and/or large pores.  In addition, this is a very effective treatment for the redness or dilated blood vessels and flushing of rosacea.

Patients who are pregnant or who have taken Accutane in the last three months cannot have Photorejuvenation.  In addition, patients with pacemakers or defibrillators should not have treatments until the tan fades to minimize the risk of side effects.

What is Photorejuvenation like?

You will come into the room with a cleansed face (or body part) after having applied a topical anesthetic cream (not everyone needs the anesthetic, but it does make the procedure more comfortable).  The entire surface of the area to be treated (face, neck, chest, hands, arms, legs, back) will be covered with clear ultrasound gel and pulsed with the laser.  Although this sometimes feels like one small focal spot (similar to a rubber band snap) we target the entire areas for maximal response.  We also use a cold air device which helps to minimize discomfort as well as allowing us to safely provide higher intensity treatments.  We require all those in the treatment room, including the patient, to wear goggles or protective eye wear.  The procedure for the face takes approximately 20-30 minutes.

How does Photorejuvenation work ?

These are multiple wavelengths contained in the pulsed light.  Some are more effectively absorbed by pigment containing cells and others by small vessels.  The heat from the radiofrequency helps make the procedure more effective with less light, reducing the possibility for side effects, and also heats up the inner layer of the skin called the dermis to promote new collagen formation.

By slowly (over five treatments) eradicating cells that contain excess pigment, sealing shut small and unnecessary dilated blood vessels, as well as simulating collagen growth, the skin achieves a smooth, even-toned and healthier appearance.

What type of equipment is used?

We use the Aurora™ SR and SRA, manufactured by Syneron™ and the Xeo™ manufactured by Cutera®.  These are high-technology pieces of equipment requiring specialized training for use.

What desired results can be expected?

A typical result is 50-75% improvement after 5 treatments.  Sunspots and pigmentation fade and become less prominent, redness and dilated blood vessels are diminished, and the skin texture becomes smoother, less porous, and more radiant.  If you suffer from rosacea, you should have less frequent, less intense flushing episodes.

Typically five treatments are necessary to achieve this transformation.  Occasionally it can take more or less.  This is highly dependent on individual factors, such as skin type, degree of damage, use of concurrent skin care regimens, and sun avoidance.

Are there any negatives?

If there are a lot of pigmented spots, they will become slightly darker over the week following treatment and flake off.  This type of response is expected and can usually be concealed with makeup.

Immediately after a treatment there may be some redness and/or mild swelling, although usually this dissipates before you leave the office or within a couple of hours.  With the SRA hand piece (which stands for skin rejuvenation advanced) there is often 24 hours of mild swelling and redness.  Makeup can be applied immediately after a treatment.

Excessive heating of the skin can occasionally lead to “foot-printing” (stripes) which consist of areas that have been more improved in the laser tract pattern than the surrounding skin.  This happens very infrequently with the new generation elôs, which helps us predict exactly where we are at with the treatment due to tissue monitoring.  The side effect is also common if the skin being treated is tan or has recently been exposed to the sun and/or if the sun damage is severe.  This unwanted side effect can be corrected with further treatment.  This can lead to hypo- (too little) or hyper- (too much) pigmentation, which may be treatable with further laser, cosmeceutical, or prescription creams, and/or chemical peels, although in <1% of the cases this may be permanent.  There is an increased risk of this on tanned or naturally dark skin.  You may need extra treatments than those required by others if your skin is dark in order for use to be more conservative (gentler with initial and subsequent treatments) due to this increased risk.  It is also important that you let any tanning lotions fade and do not seek artificial tanning treatments for 3-4 weeks prior to the procedure.

Bruising is also uncommon, although the risk increases if you take aspirin products or are on blood thinners.  Bruises are temporary and resolve within 1-2 weeks.

Uncommonly, a skin wound such as superficial blisters and scabs can occur, which heal within 2 days to 14 days.  Use of antibiotic ointment on a regular basis usually results in uneventful healing.  There is a <0.5% possibility of a skin wound leaving behind a permanent scar.  It is also rare for an infection to occur since the skin is usually not broken.

What happens after Photorejuvenation?

After the treatment, gel is wiped from the area, the eye shields or goggles are removed and you are free to go about your daily business.  The area may be pink for a few hours after the treatments.  Makeup and/or sunscreen may be applied immediately and you may return to work or any social engagements.  You may also continue your skin care regimen.

Is there another way to get the same effect?

There are may other laser and light systems which can be used for rejuvenation.  One way to enhance the effect is to use a photosensitizing drug prior to the Photorejuvenation treatments which helps improve acne blemishes and precancerous cells (this treatment is also known as photodynamic therapy).  Other alternative treatments include erbium or carbon dioxide laser resurfacing, fractional resurfacing (Fraxel^® Laser Treatment), chemical peels, and microdermabrasion.  However if the alternative is a mild treatment, they would not typically produce the same degree of effect and the effect might be more temporary. 

How is this different than other procedures?

The advantage of the Photorejuvenation procedures is that they remove sun damage very effectively with no downtime.  With laser resurfacing, although very effective, there is usually 5-10 days of being unable to appear in public.  Fractional resurfacing is a good alternative which may help a bit more with fine wrinkles and scars, although there is typically a bit more discomfort, a day or tow of downtime with each procedure, and it is a bit more expensive.  This is often used for people who have melasma, scarring, marked textural abnormalities of the skin, and body areas such as the chest, neck, back, and arms.  Medium potency chemical peels have more downtime and low potency peels and microdermabrasion would not be expected to achieve the same degree of improvement.

Can this be combined with other treatments?

We can combine this treatment with BOTOX^® Cosmetic, Injectable Fillers such as Restylane™, Sculptra^®, and Radiesse™, tissue tightening procedures such as Thermage^®, ReFirme ST™, Polaris WR™, and Titan^®, the PanG™ Lift, chemical peels, and medical-grade facials.  All of these procedures complement and enhance each other.

What is the cost of Photorejuvenation?

The fees for Photorejuvenation are based on the areas being treated.  Please call Advanced Dermatology for a consultation and the Cosmetic Coordinator will develop a personalized treatment protocol with you.