Case 10- Fraxel Laser for enlarged pores

Diagnosis: Enlarged and prominent facial pores on a background of sun damage.
Treatment: High density Fraxel Laser resurfacing by Dr Davin Lim and Emily Hyde RN. Multiple small sized acne pores do well with Fraxel, larger and deeper pores do best with TCA CROSS chemical peels.

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Case 9- Fractional CO2 Laser for acne scars

Diagnosis: Atrophic and tethered acne scars
Treatment: CO2 Fractional Laser Resurfacing. This is where Fractional Lasers excel in their role- for the treatment of atrophic scars. Each session takes 15 minutes to perform, with a recovery period of only 4 days. This patient had 3 treatments. Scarring will continue to improve with mores sessions planned.

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Case 8 - CO2 CORE Fractional 3 treatments

Diagnosis: This patient has a mixture of atrophic and box car scars, skin type 3.
Treatment: Given the busy lifestyle of this patient, fractional laser was chosen. My choice? The CO2 CORE by Syneron Candella. 3 passes, maximal power, 3 treatments one month apart. Great results with at least 80% improvement.

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Case 7 - Rolling and atrophic acne scars on background skin type 4

Diagnosis: Rolling and atrophic acne scars on background skin type 4
Treatment: Fraxel laser, 5 treatments. Last photo shows results 1 month post laser. Once again in darker skin patients with acne scarring the treatment parameters MUST be conservative or post laser skin changes can occur. Acne scar revision in darker skin patients is best carried out with FRACTIONAL laser resurfacing - Fraxel or Erbium. In some cases I do use CO2 laser, but do not overlap. Dark skin patients can be treated with laser, but treatment is always conservative.

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Case 6 - Atrophic, box-car, mixed acne scars in Asian skin type

Diagnosis: Atrophic, box-car, mixed acne scars in Asian skin type
Treatment: Fraxel 1550, 5 treatments. In darker skin types, more laser treatments are needed on the side of safety. Darker skin patients have higher chances of post laser skin colour changes, and hence lower settings are needed. The flip side is that an extra one or two Fraxel treatments are needed- all on the side of safety.

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Case 5 - Long standing acne scars in Caucasian Skin type

Diagnosis: Long standing acne scars in Caucasian Skin type. Rolling scars, atrophic scarring on the background of mild sundamage.
Treatment: Erbium micropeel, followed by Fractional Erbium Laser. 2 treatments, 8 weeks apart. This was done in 2008. Now I would use newer generation CO2 CORE laser + Erbium followed by Fraxel 1550. This combination will result in more superior scar reduction. Ideally followed by focal fillers.

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Case 4 - Long standing acne scars in Asian skin patient

Diagnosis: Long standing acne scars in Asian skin patient. Primarily rolling and atrophic acne scars on the back ground of sundamage skin.
Treatment: Fractional laser resurfacing using Scition Erbium Fractional laser. Downtime of 4 days. Last picture shows what the skin looks like at day 5 after laser.

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Case 3 - Rolling and atrophic scarring on darker skin type

Diagnosis: Rolling and atrophic scarring on darker skin type. This form of acne scarring is very difficult to treat, given skin type
Treatment: CO2 CORE Fractional laser in conservative settings, 4 treatments needed to achieve result given darker skin type. Darker skin patients WILL need more laser treatments as a safety margin is needed.

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