Juan Camilo Ramirez R.
Intern dermatologist at Uniláser Médica in 2021
Expression lines, wrinkles, warts, spots, loose skin, sagging skin and neck are common causes of concern as they relentlessly advance throughout the body.
As time goes by, skin exposed to solar radiation shows signs of aging such as wrinkles and, above all, spots. Senescence, on the other hand, causes all kinds of warts and thinning of the skin.
Among the treatment modalities that seek to contain skin aging, creams and lasers are the ones with the most scientific evidence.
All creams provide moisture and others with retinoids induce cell replacement with some limitations in terms of the irritation they could cause.
Lasers have replaced less manageable procedures such as peels, electro and cryosurgery.
They have also managed to achieve fractional forms that are increasingly close to the results of deep dermabrasions/peelings, avoiding scars and irreversible pigmentation disorders. Finally, fractional alternatives from various sources have become popular, such as radiofrequency and ultrasound, which we do not understand how they can generate collagen by destroying spaces where there are no fibroblasts.
The place where these cells, which are the ones that regenerate the skin, are most concentrated is the dermo-epidermal junction and when uncontrolled surgical instruments are placed in this area, pigmentary disorders are more easily caused.
For large areas, retinoid creams are not practical. The remaining alternative is fractional laser procedures. Low-power CO2 lasers may not achieve the best results, and higher power lasers will cause inflammation, pain, and prolonged redness, which are discouraging. The Fraxel ® laser has been the most recognized laser for aging because it allows better control of inflammation, although when applied to the entire body, it is not very popular due to increased costs and pain.
Is there then a laser that allows me to treat large areas with less pain, less redness and at a lower cost?
Alma® fractional CO2 laser equipment fully meets these criteria. At Unilaser Médica we have been developing protocols for the CO2 laser and Fraxel ® for this purpose.
What happens to my skin when a CO2 laser is fired ?
The only way to mitigate aging is to cause the skin’s surface to renew itself.
The laser forces the body to replace the skin.
The CO2 laser has shown its greatest utility by making homogeneous superficial “sweeps” of the skin better than Fraxel®, which is used more to stimulate the skin because it acts at a deeper level without altering the surface further, but, to achieve the effects of the CO2 laser with Fraxel®, many more sessions must be accumulated.
It has been proven that nothing is achieved by exposing the skin to the risks of a “miracle” session, since after this, aging continues and wrinkles reappear in a few years.
The skin is left sensitive and depigmented, without taking into account the risk of prolonged redness and scarring.
Since then, the strategy of maintaining the effect of the laser by performing frequent sessions with more controlled thermal effects, results in less inflammation, less pain, and short-term redness.
Of course, in cases with prominent grooves on the lips and chin, a greater thermal effect will have to be used to vaporize the irregular parts of the skin, since complete dermabrasions of these areas frequently result in loss of skin pigment.
What’s new in CO2 laser ?
The new Alma® Pixel shows advantages in this application due to its design in scanner systems, not present in other fractional CO2 lasers .
Fractional CO2 lasers are very difficult to control when looking for faster results.
Cannot be used with high density and power.
With the Alma® system we have observed a tolerance similar to that of Fraxel® in high concentrations, adding the benefits of faster micro-exfoliation and greater availability to perform scanner framing to treat at the same time areas that have deeper lesions and that require different exposures.
The equipment has a random mode of manual scanning which facilitates the exposure of large body areas without using anesthesia.
What can I expect from Alma® Pixel on my skin?
The shots are finer and more efficient, which allows a larger area of skin to be treated without causing prolonged redness and allowing for improved skin results. It causes tiny scabs in very fine and small circles that fall off in the first week without causing any major redness of the skin and therefore, a lower risk of pigmentation.
Patients have rated the pain intensity of the interventions as 4/10 on the analogue pain scale; additionally, they have reported improvement in a shorter time than with other laser equipment.
References :
Soul Pixel CO2. Advanced Technology With Maximum Versatility
Rios A. Skin aging at UNILASER medical [Available online: https://unilasermedica.com/tratamientos/rejuvenecimiento/ ]
Esmat SM, Abdel-Halim MRE, Gawdat HI, Kamel M, ElRamly A, Helmy K, Esmat SM. Persistent Pixel Stamping Marks: a novel complication of fractional CO2 laser in scar treatment. Lasers Med Sci. 2019 Aug;34(6):1125-1135. doi:10.1007/s10103-018-02700-5. Epub 2019 Jan 4. PMID: 30610402.
Reilly MJ, Cohen M, Hokugo A, Keller GS. Molecular effects of fractional carbon dioxide laser resurfacing on photodamaged human skin. Arch Facial Plast Surg. 2010 Sep-Oct;12(5):321-5. doi: 10.1001/archfacial.2010.38. PMID: 20855774.
Omi T, Numano K. The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology. Laser Ther. 2014 Mar 27;23(1):49-60. doi: 10.5978/islsm.14-RE-01. PMID: 24771971; PMCID: PMC3999431.
