One of the most frequently asked questions we receive at Atlantic Coast Aesthetics revolves around various options for laser treatments on the skin. An example of this is our ACA Question of the Week, which came in from one of our Twitter followers. The patient says, “I have moles all over my face and [my] dermatologist suggested me to go through a fractional CO2 laser treatment. I am concerned as it is a matter of face. So help me with this.” Dr. Thomas A. Pane, our founder and Chief Medical Officer, wanted to address this question because there are a couple of misconceptions associated with laser treatments and their benefits limitations, largely because of the newness of the technology, that come into play with questions like this one.

Dr. Pane notes that it’s important to set a clear definition for what is being discussed. Naevii, or moles, are raised areas with heavy pigment on the skin. Moles are generally not responsive to laser therapies. However, if the problem is age spots or a pigment condition like melasma, also known as chloasma, laser therapy can be very effective for these kinds of problems. Because laser treatments are not appropriate for moles, Dr. Pane feels one of these is the more likely problem and the rest of his observations stem from this point.

With regards to the actual treatment, a carbon dioxide laser uses highly focused light energy to remove the top layer of skin down to the dermis in a very precise and predictable way. Fractional laser treatments are almost never done individually. Instead, they are done over a series of treatments about a month apart. The purpose of fractional laser treatment is to reduce the amount of energy being poured into the patient’s skin, downtime and potential side effects of the treatments by breaking up the face into individual treatments unit over time.

As with any other procedure, fractional CO2 laser treatment has its pros and cons. One of the pros of fractional laser treatments is that generally the peeling and scaling of the skin associated with a full laser treatment doesn’t occur because of the reduced laser energy and limited area in which the laser is being used. Another benefit is that fractional laser treatments take less downtime for each treatment. However, this can also be one of the biggest drawbacks because over time, fractional CO2 treatments require less downtime individually but that smaller downtime can ultimately add up to more than if the fully powered single treatment option had been exercised. Also, laser treatment is not appropriate for moles, which if this is in fact the case with this patient would make laser treatment a far less likely option.

Any form of dermal laser treatment is a medical procedure which can be performed on an outpatient basis. As with any other procedure, there are some risks and the potential for side effects. In experienced hands, this is typically not an issue. Dr. Pane says most patients run into problems when someone who does not know what they are doing pushes too much energy through the laser, but a skilled cosmetic surgeon will not have this problem and the risk of side effects from the procedure is greatly reduced as well.

In closing, Dr. Pane notes that single-pass laser treatments as opposed to fractionals are coming back into favor in the cosmetic surgical community, but this may not be a good option for everyone or every condition. Dr. Pane prefers to evaluate each case individually and propose a range of solutions that best fit the patient’s needs, desired results and lifestyle. By presenting the patient with options and working through the pros and cons of each together, the patient becomes an advocate and ally in their own care and treatment and has more control and ownership in the results the procedure can deliver.

If you have a question for Dr. Pane or the staff of Atlantic Coast Aesthetics, we invite you to reach out to us by phone at (561) 442-4116, by email at https://acplasticsurg.com or follow us on Twitter and Facebook! We are always pleased to help you evaluate your options and determine the best course of treatment for your needs, and your question may be ACA’s next Question of the Week, which Dr. Pane will answer live in an upcoming Google Hangout. Remember, at ACA we believe there’s only one bad question, and that’s the one you don’t ask!