Another great article. You can find it in Vogue April 2009. Silk Touch offers treatments using the Smartxide DOT Therapy and we also offer Affirm skin tightening treatments.
Easy Does It
In the past, laser resurfacing has been epically harsh or barely noticeable.
Catherine Piercy reports on the breakthrough that’s finally getting it right.
It’s a bright winter morning when I arrive at dermatologist Deborah Sarnoff, M.D.’s
So imagine my surprise when Sarnoff swings open the door to a pristine white treatment room and reveals…an eggplant, perched in a reclining chair atop its own paper surgical gown.
“I know, I know, “she says with a laugh. “But you’ve got to see this.”
And then, like the Jetsons—esque hostess of some far-out futuristic culinary show, she aims a nearby laser head at that dark, ripe flesh, and fires, searing a square grid of tiny, tightly packed pink dots onto its surface (and filling the air with the scent of cooked eggplant).
What Sarnoff has just demonstrated is fractional carbon dioxide resurfacing, and it may be the biggest breakthrough in laser skin care in nearly a decade. The spot eradicating, line-smoothing results, swears Sarnoff, are good enough “to turn a prune-face” back into a taut, juicy plum, and they has the most conservative dermatologists feeling giddy with excitement.
If the new class of fractional carbon dioxide lasers sounds vaguely familiar, that’s because their name, like the technology behind them, merges the best of two well-established lasers—the mighty CO2 and its gentler cousin, fractionalized therapy—into a single power tool.
Searing through the uppermost layers of the skin in a single uniform sheet—delivering in effect, a second-degree burn to the face—the original CO2 lasers, with their 10,600-nanometer beams, seemed a godsend when they debuted in the early nineties. Dermatologists hailed their ability to diminish severe sun damage and dramatically tighten skin in just one treatment, but they now acknowledge that their reputation is a “blowtorches” was no coincidence. “Do you have three weeks to hide from your friends, family, co-workers?” asks David Goldberg, M.D., a clinical professor of dermatology at
The kinder fractional procedures of recent years—lasers like Fraxel and Affirm—delivered their weaker 1,550 nm of erbium energy in a series of micropixels (rather than a single beam), projected on the skin as a checkerboard grid. By poking selective holes in the skin’s surface, they left what Sarnoff calls “a tiny island of healthy skin behind” for every dot they vaporized. The result: pinkish skin that healed in up to two days and a noticeable improvement in fine lines and sun spots (after three to five $1500 treatments). The concentration of Fraxel was genius, that it redefined the way doctors ______about deliver____ laser light, “says
But for women with deeper wrinkles, severe sun damage, and limited reserves of time and patience, “the results were mediocre at best.”
Combine the principles of each—a friendlier, fractionalized delivery system with all the strength, depth, and reach of the original CO2—and you’ve got the new fractional CO2. While the chief function of any laser is to temporarily wound the skin, triggering the production of fresh new collagen fibers as it vaporizes old, damaged tissue, none of these new hired guns which go by the brand names of Fractioanl Re:pair (from Reliant Technologies, UltraPulse ActiveFX (Lumenis) and SmartXide DOT Therapy (Deka)—inflict anything close to the harrowing collateral damage of their prehistoric predecessors. “In most cases, we’re talking about four to seven days of what looks like a very bad sunburn,” says Goldberg. “And don’t forget, it’s usually a one-shot deal.”
The NEW FRONTIER
The innovations don’t stop there. Like the keypad on your gym’s elliptical machine, the fractional CO2 allows derms to tailor the intensity of its pitch pattern—the distance between each little dot as well as its depth—with the push of a button. Sarnoff might set the device “closer together for a more aggressive treatment around the mouth or crow’s fee,” farther part “on sensitive areas like the jawline.”
When I drop by dermatologist Frederric Brandt, M.D.’s
To combat the first signs of aging, dermatologists like Manhattan’s Patricia Wexler, M.D., are sticking with gentler resurfacers, like the original Fraxel (now called Fraxel Re:store). However, there are instances where Wexler feels the potency of fractional carbon dioxide is appropriate for younger skin—for example, to treat acne scars in patients as young as their 20s.
Roy Geronemus, M.D., a dermatologist in
In some cases—lip and forehead lines, cracks at the corner of the mouth—Wexler is using fractional CO2 in place of fillers like Cosmoderm. As she points out, “you don’t have to come back every eight weeks to have it touched up.” The new CO2’s effects last, by most estimates, between five and eight years.
Like ay emerging technology, the first generation of fractional CO2s are works in progress. Lasers, says Goldberg, “are like laptops—your new model is constantly being updated.” If the old CO2 was the truck-size monitor on your first Macintosh, the fractional CO2 is your new MacBook Air: fabulous but soon to be tweaked in exciting new ways.
Though they remain unsuitable for darker skins, which may be prone to heat-related scarring, the new CO2s have slightly more range than their predecessors, extending from fair to light-olive and, in some cases, light Hispanic and Asian skin tones. As for hypopigmentation (small, permanently colorless patches of skin that appeared in patients up to a year after the old CO2 procedures were performed), “fractional technology seems to have virtually eliminated the risk,” says Alexiades, who is currently conducting the FDA trials for Deka’s DOT Therapy device. “But it’s still early, and there may be limits to how close together each little dot can be placed without causing a similar effect.”
Not unlike the feeling one might experience while looking at Sunday Afternoon on the