Over 20 years ago, the ablative Co2 laser came along and set the gold standard in resurfacing in terms of results (a standard that it still maintains). Then came the Erbium... then the fractionated Erbium, which offered patients a fraction of the downtime, at a fraction of the cost, but also with only a fraction of the results. Now, with fractionated, partially ablative C02 on the horizon, the clinical downtime has been upped once more in favor of greater results and in many ways it looks as though the technology is heading back to where it began with the traditional, ablative Co2... fractionated Co2 simply being a smaller piece of the same pie (downtime, risks, results).

Sure, it can be argued that the technology is improving and that clients are being offered more options as a result of it, but where does it go from here? The closer we get to Co2-type results... the closer we get back to Co2-type downtime, and risks as well.

Great point: I think that many of the current fractional CO2 machines have the ability to imitate a fully ablative machine - for example, if you turn up the dwell time to 6 or 7 milliseconds, (well beyond the thermal relaxation time) and have a fairly dense MTZ pattern, the lateral heating effect from the long pulse is going to spread well beyond the size of the laser spot - and voila, it's essentially a fully ablative treatment. Same old downtime & risks.

For some patients, this might be clinically appropriate....but not for everyone, eh?

Absolutley correct. It's like we've always been working within Co2's boundaries.