Aspen – Dermatologist Paul M. Friedman, M.D., outlined many uses for the dual fractional 1550 nm/1927 nm laser at this summer’s Cosmetic Bootcamp (CBC). He is director of Dermatology & Laser Surgery Center in Houston.
For periorbital wrinkles, “The 1550 nm wavelength is our workhorse, given the range of skin types that I’m seeing. We utilize higher fluences for deeper rhytids and scars, and lower density for darker skin types and patients who are experiencing discomfort. Total energy with this device is usually 2 to 4 kJ for a full-face treatment, in combination with forced-air cooling.”
The biggest advance with the 1550 nm laser is its ability to treat the neck, chest and décolletage – “areas we wouldn’t resurface in the past because of concerns for scarring. We found out when doing this treatment that not only was it improving the dyschromias, but some of the vascular component as well. It’s something we see when treating acne scars or surgical scars with erythema, and even red stretch marks, so much so that I no longer do pulsed-dye laser on the red stretch marks. I go right to the 1550 wavelength.”
The 1550 nm laser is safe for all skin types, he added. “Practicing in Houston, which is the most ethnically diverse city in the United States, it’s been an incredible new device to help us treat a variety of indications.”
Because the 1927 nm laser provides greater water absorption than 1550 nm, “There will be less penetration.” This makes the 1927 nm wavelength well-suited for addressing skin tone, texture and pigmentation, said Dr. Friedman. Treatment typically requires 1.6 to 2 kJ total. “Unlike the 1550 wavelength, I don’t use this wavelength for patients with skin types above 3” to avoid postinflammatory hyperpigmentation.
“Typically you’re looking at about a one-week healing process. Instruct patients to expect flaking and erythema lasting 3 to 7 days. Our patients use cooling gels and masks to reduce erythema and edema, and moisturizing twice daily for 3 to 5 days.”
Commonly, he combines the 1550 nm and 1927 nm wavelengths to provide deeper penetration and address superficial indications on the same day. “We’ll do the 1550 nm laser first (average: 2 to 3 kJ), followed by the 1927 (1 to 2 kJ). You get a nice resurfacing effect in skin types 1 through 3. We commonly treat the hands, forearms, chest and legs – the latter in combination with Q-switched laser.”
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