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Lasers

September 29, 2022

Which Laser Skin Treatment Is Best For Acne Scars?

There are so many entities out there claiming efficacy for treating acne scarring that it can become very confusing. These range from non ablative light based therapies such as Laser Genesis and Pulsed Dye Laser to fully ablative CO2 resurfacing. The Active FX combined with the Deep FX tend to offer the best combination of results, side effects and downtime.   In our experience non-ablative lasers, such as Laser Genesis, will max out at about 30-40 percent improvement with a minimum of five treatments. The best results may require upwards of 8-10 treatments. Most patients favor these procedures for treatment of enlarged pores or fine lines and not necessarily acne scars. On the other end, CO2 laser is the gold standard for results. There are a few downsides to full CO2 resurfacing. These include downtime, which can last several weeks with the possibility of having several months of residual redness. Discomfort and swelling may also last several weeks. Long term side effects such has permanent hypopigmentation (lightening of the skin) and scaring have been significantly reduced but still occur. Due mostly to the significant downtime, full CO2 resurfacing tends to not be the treatment of choice.   For most patients the best options are the fractionated lasers. These include things like Active FX, Deep FX and Fraxel Repair which are all form of ablative CO2 lasers. When treating with a fractionated laser, there are patches of skin that are not affected by the laser. The amount of skin treated vs. untreated can be controlled by your provider. These patches of untreated skin drastically reduce both side effects and downtime. Even though these procedures have mostly eliminated side effects such as skin discoloration and scarring they still produce about 80-90% of the effects that are achieved with full CO2.   I am not as much of a fan of the Fraxel Restore (non-ablative Erbium) because, although it has been proven to improve acne scars, it takes a minimum of 5 treatments and produces less results than 1 -2 treatments of the fractionated CO2 devices (Active FX, Deep FX and Fraxel Repair).   Between the Active FX, Deep FX and Fraxel Repair, I like the combination of Active FX and Deep FX better because the technology is less provider dependent and there are some engineering advantages to the Active and Deep FX. There was a head to head study performed at Johns Hopkins in 2008 where patients had one side of the face treated with the Active FX and the other side was treated with Fraxel Repair. Nine out ten people preferred both the procedure and the results of Active FX side.   No matter what your providers tells you expect 2-3 treatment with a minimum of 30-90 days between treatments for the best results.  

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September 29, 2022

What To Expect After Endovenous Laser Vein Ablation (EVLA)

Varicose veins are caused when the valve directing blood flow back to the heart weakens and malfunctions, allowing blood to pool or flow backward (reflux). They are the most common sign of underlying vascular injury, and they are more than a cosmetic concern. Without treatment, varicose veins can contribute to more vascular complications. Dr. Verebelyi, one of Colorado’s prominent vein surgeons, is one of just a few physicians certified by the American Board of Venous and Lymphatic Medicine, and he can treat your varicose veins and restore your vascular health. *Individual Results May Vary. How Does Vein Ablation Work? Endovenous Radiofrequency Ablation (EVRF) Ablation is simply a way of using heat to close damaged veins. Radiofrequency has become our go to procedure for ablation due to its excellent results and minimal post procedural discomfort. During the procedure a small catheter is placed inside the damaged vein. The damaged portions are heated to the point where the body will remove the vessel over the next several months without any invasive surgery. Endovenous Laser Ablation (EVLA) is another way to add heat to vessels or order to close them. Through the early 2000s this was preferred vein closure treatment. However, as radiofrequency became more effective in the last 10 years, patients have shown a clear preference for the shortened discomfort time associated with RF versus laser. Laser is still used sometimes if a patient has a very short segment of diseased vessel or occasionally for very large vessels.  Why Do I Need To Treat My Vein If I Cannot See Any Major Varicose Veins?  Over time, after the valves within leg veins fail, other medical problems follow if they are not treated. Aside from the obvious superficial vessels, varicose veins and swelling several other serious medical issues eventually develop. Restless Leg Syndrome and night time cramping get worse the longer veins are left untreated. More serious skin problems such as skin thickening, ulcers and blood clots will also develop over time.  Unfortunately there are no prescription medications or supplements that can effectively treat the vein problem. Although compression can help decrease symptoms it does not stop the vessel from refluxing, so closing the damaged vessels in order to re-route the blood into the healthy vessels has become the standard of care for treatment. REQUEST A CONSULTATION Simply fill out the form on this page, and one of our highly trained staff members at Colorado Skin & Vein will reach out to your promptly to schedule your appointment. REQUEST A CONSULTATION Am I a Good Candidate for Vein Ablation? If you suffer with enlarged, twisted veins that are the hallmark of underlying vein disease, you are not only a candidate, but should seek immediate treatment in order to prevent further damage to your vascular system. Any patient with symptoms of heaviness, aching, Restless Leg Syndrome, leg swelling or varicose vein will get significant relief with proper vein treatment. Untreated vein disease can lead to further health concerns like those above which require much more intense medical attention. What is an EVRF Treatment Like? EVRF for vein ablation was originally developed around 1999. As the procedure has matured, it has become extremely effective and the treatment of choice for refluxing leg veins. Dr. Verebelyi has done several thousand of these treatments. He focuses on not only ensuring the procedure is as safe and effective as possible but also making sure all of our patients are incredibly comfortable both during and after procedures. The micro puncture to place the tiny catheter is so small it requires only a tiny bandage to close. The total treatment time is only about thirty minutes to an hour and patients are able to do mild exercise the same day. Patients may experience some mild swelling afterwards but should only expect minimal discomfort that can easily be controlled with Ibuprofen.  Is There Any Downtime with These Vein Treatments? You’ll need to wear a compression bandage for a few days following your treatment, but you will be up and walking the same day. Light activity is encouraged the day of your procedure and may be increased each day following the treatment. What Results Can I Expect? Vein ablation is highly successful, with Dr. Verebelyi’s patients experiencing a success rate of 98% or better, even after four years. The other good news is that many symptoms begin to improve within a few days of the procedure.  Dr. Verebelyi is one of the most highly trained vascular physicians in the country, and he is a fellow of the American Society for Laser Medicine and Surgery (ASLMS). Colorado Skin & Vein is an ASLMS preceptor site, and Dr. Verebelyi has trained many of the field’s top physicians. He has also worked nationally as a legal expert to explain the physiology behind laser energy treatments. There really is no better expert to handle your vascular treatment than Dr. Verebelyi and the Colorado Skin & Vein team. “All of my expectations were met, friendly and informative. I am looking forward to my procedures! Thank you, Renae” RH Take the Next Step To request your vein treatment consultation with us, please call (303) 683-3235 or fill out our online contact form today. Colorado Skin & Vein serves Englewood, Centennial, Parker, Highlands Ranch, Castle Rock and the greater Denver, CO area.

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September 28, 2022

Active FX Vs. Fraxel Vs. Pixel Vs. Profractional: What’s The Difference?

There are quite a few fractionated resurfacing lasers out there. So exactly what is resurfacing and what are fractionated lasers. What makes one fractionated laser different from other? There are quite a few fractionated resurfacing lasers out there. So exactly what is resurfacing and what are fractionated lasers. What makes one fractionated laser different from other? What Exactly is Skin Resurfacing? Resurfacing is a procedure where layers of damaged skin are removed usually by vaporization from a laser. It can be used to get rid of brown pigment caused by sun damage, decrease wrinkles, shrink pores and tighten skin. Vaporization is the process of using heat to instantly evaporate water out of the exposed tissue. Resurfacing not only removes the tissue on top but also heats the tissue below the level of vaporization causing collagen contraction and stimulation. *Individual Results May Vary.   What Exactly is Fractional Resurfacing? If resurfacing is like mowing a lawn where every blade of grass is cut to a somewhat shallow depth then fractional resurfacing is more like aerating a lawn. Fractional resurfacing pokes small but deep holes in the skin but leaves a certain amount of the skin completely untouched. Because these patch of undamaged skin patient heal much faster with minimal side effects. Fractional resurfacing was developed at The Wellman Center of Photomedicine at Harvard around 2001. The original fractional laser did not destroy any tissue (non-ablative), it simply applied heat in order to stimulate new collagen formation. This non-ablative (non-vaporizing) procedure required multiple treatments and has some significant limitations on efficacy. Around 2005 we started testing fractionated ablative (tissue vaporization) CO2 lasers (Active FX, Deep FX, Fraxel Repair and found that in a single treatment we could achieve results that were not attainable after 5 or 6 treatments with the non-ablative fractionated lasers. Is There Any Downtime with Laser Skin Resurfacing? The downtime of about 5-7 day was a huge improvement over traditional CO2 resurfacing (think mowing the law) that can take several months to heal.   How Are These Laser Treatments Different? Now the market is saturated with fractionated products and it is hard for patients to figure out which one is the best for them. The first thing that separates these devices is the actual type of laser. There are two main lasers used for resurfacing CO2 and erbium. The Active FX, Deep FX and Fraxel Re:pair are CO2 lasers. The Pixel and Profractional are erbium lasers. The CO2 lasers heat tissue much better causing more skin contraction and more collagen stimulation. They also cause much less bleeding than erbium lasers. The clinical results speak for themselves as much more skin damage can be removed with by a CO2. Between the CO2 platforms FX (made by Lumenis) and the Fraxel (made by Reliant), the FX is much preferred by patients. In 2007 Dr. Robert Weiss performed a split face study at Johns Hopkins using the Active FX on one side and the Fraxel Re:pair on the other. Nine out of ten patients preferred both the comfort of the procedure and the results of the Active FX. REQUEST A CONSULTATION Simply fill out the form on this page, and one of our highly trained staff members at Colorado Skin & Vein will reach out to your promptly to schedule your appointment. REQUEST A CONSULTATION The Difference Ok so the Lumenis FX gives the best results and the most patient preferred procedure. So then what is the difference between Active FX, Deep FX and Total FX?    The Active and Deep FX are different heads that can be attached to the laser. The Active FX is more shallow (about 1/3 mm) and wide which is better for skin tightening, decreasing pore size and removing pigmented sun damage. The Deep FX is a narrow beam that goes deep (up to about 2mm) into the skin in order to treat wrinkles and scars. The Total FX is more a marketing term that describes using both heads during the same treatment (which is how the procedure is normally done). “The staff at Colorado Skin & Vein is very helpful and always makes sure to answer any questions during visits. I can tell that they truly care about the patient experience. Thank you Dr. Verebelyi and Team!” DC Take the Next Step – Request A Consultation with Dr. Verebelyi   Dr. Verebelyi is always happy to meet with you to review your laser skin resurfacing needs.  Please fill out the form on this page or call 303.683.3235 to schedule an appointment. Colorado Skin & Vein serves Englewood and the greater Denver, CO area.

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