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    If you are having a tough day, don’t try to read this. I will do my best to explain it to you.

    True lasers are straight beams of light. There are many factors which determine what they will do on, or to, the skin. These include the wavelength of the light and the “target” in the skin. Sometimes the color may be red, or brown, or neither. In the case of acne, red targets would be acne infections or slow healing acne sites. Brown marks are found in people with darker skin types where an increase in pigmentation results from infection. The melanin pigment makes the scar brown in color and is call PIH or Post Inflammatory Hyperpigmentation. This brown color must be removed before the scar is treated. If not, there will still be an unsatisfactory appearance to the skin if the brown color remains. Both the proper medicinal creams and laser are used effectively.  (See below)

    lasers and chemical peels

    Unfortunately, laser manufacturers give their devices sexy soudning names for marketing purposes. Mustang, Corvette, Camero all are the names of sports cars. However, we need more information to understand the difference between them. Similarly, in order to know the difference between different brand named lasers, for one, we need to know their wavelength in order to know what they do. To make matters worse, lasers are named by the material inside the laser tube which generates the light.  The CO2 laser is an invisible laser with an infrared wavelength of 10,600 nm.  This laser explodes the superficial skin cells resulting in a form of “peeling” Nd:YAG laser has a wavelength of 1064 nm and the capability to reach deeper layers of skin tissue by mostly passing through the epidermis. A KTP laser may emit light at a wavelength of 532 nm or 940nm to treat red or brown. Selection of the laser depends on what the goal of the treatment.

    Lasers and Chemical peels

    The basic difference between ablative and nonablative treatments is that ablative lasers (like CO2) remove the top layer of skin, while nonablative lasers( like YAG) often work by heating up the underlying skin tissue (without harming the surface). Again, each use for different purposes. The claim of “building collagen” is greatly exaggerated for marketing purposes.

    To make things worse, there are devices falsely called lasers which are IPL devices. IPL means Intense Pulsed Light. They do not have a single wavelength, rather many wavelengths controlled by a gross filter.  They are less expensive to manufacture than true lasers.

    And Fractional? Fractional refers to the fact that a fraction of the laser output is used on the skin in order to make an easier recovery for the patient. The letter x is added to the word for giving a Brand name to a device. In and of itself treating only part of the skin has no benefit other than a more rapid recovery. Treating the entire surface of the skin is comprehensive and very effective. The drawback is that more time for healing is required. 

    Finally, what about lasers that use 532 and 940nm. The 532nm wavelength reduces chronic active, and delayed healing red acne. The brown color of old acne scar marks are treated with both of these.

     The main point is that box and rolling scars are not appropriate for lasers,  peels, micro needling, cross or otherwise. Destructive reduction of the epidermis is of no value. These scars are deep holes that need to be “released from below” and  “pushed “ up from below. Lasers, etc are not of benefit for deep ice picks and rolling scars. The only scars which benefit from peels and lasers of various types are very superficial. The various Lasers, cross, needles, peels, etc for acne scars are too often, fads which are here today and gone tomorrow.

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