Dear dr. Charry,

In your acne regime,

do you use aquaphor/ patroleum jelly for the night care since your using MLP?

DocRokky

420 nm immediately after MLP (MLP at 10μm).

rad2011

Yes i use aquaphor only for ONE day!!

Charry,
can't it cause a pigmentation, because 420 nm is still an UV spectrum?

DocRokky

With a light MLP (8-10 μm) you can't cause a pigmentation especially in up to III type patients.In darker skin types try a superficial MLP (e.g. 6 μm) or none and you will never get a problem.

Have any of you noticed hair turning from black to blonde after hair reduction?

I have a patient with acne scars. We've done 4 treatments (PF (850micr, 15%) + Resurfacing (nearly 100 mic). But result is not impressive. Here is her before http://io.ua/18194563 and after http://io.ua/18194564 photo. Could you comment this and give some advice. Her skin after last treatmen became very sensitive.
Thanks.

DcRokky

Maybe you could use higher coverage on your PF treatments.I would use a higher coverage in PF and a more superficial Contour TRL (e.g.30-40mic).

Charry

Higher coverage 20% or more? With the same deepness?

DocRokky

Yes higher at least 20-22% with the same deepness.

Is it reasonable if there is no Metvix, ALA (any other sensitizers) to treat acne ST, then MLP 10 microns, then 420 nm?

DocRokky

Yes it is reasonable but the result would be less efective as it is with the sensitizer.

DocRokky:
I would stop the costly PF for the time being. Why not try punch excising the largest of the ice pick scars (those greater than 1mm) and then doing a 100% TCA CROSS protocol (4-6 treatments at 2-4 wk intervals). Following this you could finish with a superficial Contour peel 50-100um. SHe has thick sebaceous skin in these areas and would readily tolerate it.

Hi Everyone.
I am looking for some guidance on treatment parameters to treat deep melasma in a Fitz 3 with the BBL. I did one session using both the 515 and 560 and while other things improved in her skin the melasma didn't respond at all.

I do 515 nm 14-16J 10 ms 10C (2-3 sessions). If you are not confident in her skin type reaction, use 560nm 16-18J 10ms 10C first and 515 at the second session. If there is still no good responce, I do PF 200-400 microns 11% no coag and add hydroquinone to their everyday care.
What parameters did you use?

Mark,
I did 2 Cross TCA, but you know, every patient tells that scars become wider after TCA. I don't see any difference after 2 Cross TCA, but I started to do it only a couple of monthes ago (nobody do it here). What result do I REALLY have to see after Cross?
Thank you.

Kate

What parameters did you use?I usually use 515 nm with 11-13 J ,10-15 msec and 22 C for type III.These are my starting settings.At the next sessions I usually decrease the pulse width down to 10 msec and increase the Fluence at 1J increments.At the end maybe i use my MLP for lightening a melasma.

Dear colleagues,

What settings do you use ifor skin types 5 for Melasma,
Dr. Charry you mentioned you get exellent results with BBL, would you mind elaborating on that.
what percentage of your patients respond and how many relapse.
Thanks

D R
sorry, i only noticed your question today. I think selection of icepick scars is important - any larger than 0.8 - 1mm should be punch excised. placing the tca only in the scar is the trick (I use 2.3x loops). I have had good results but it takes more than 2 treatments (usually 4-6) and unfortunately there is 4-6 d social downtime with each procedure.

Dr.Chalasani

I haven't used the BBL in treating of melasma in type V patients.My patients are mostly II-IV Ftz.About all of my patients II-IV have very good results in 2-4 sessions, but there is a relapse in 25% of them after the next summer.As you know there are many reasons that create a melasma.

Once again
The dot pattern after Profractional.

Every time I do PF XC resurfacing I see the dot pattern for months after the procedure. Truly saying I am not sure that it is going to be resolve at all.
I did PF alone and MLP after it, every time the same picture.
Does anyone have this problem?

I think this problem is related with the size of dots (250μm on PF-430μm on PF-XC).I think Sciton would reduce the size of the dots in ErYAG (PF and PF-XC).

So, my patients are going to have this pattern all their lives?

DocRokky,

Please give me a call or email about your problem. I'd like to see if I can help. My phone number is 913-707-0128 and my email is doug.carrow@sciton.com.

Director of Product Development
Doug Carrow

Dear Dr. Charry,
Thank you for your insight into Melasma with the BBL.