I had the opportunity to attend an invitation only Q&A seminar hosted by the Lumenis corporation featuring Dr. Mitchel Goldman, author of "Cutaneous and cosmetic laser surgery" a few days ago.
Our group of dermatologists and plastic surgeons had the opportunity to ask Dr. Goldman about his expert opinion on common skin conditions and popular laser equipments on the current market.

1. In regard to skin tightening, what works, what doesn't work?
A: No technology on the market currently deliver what they promise. The Cutera Titan does not tighten, the Thermage Thermacool does nothing to lift sagging skin. Only 30% of patients are ever happy about treatment outcome from these RF or infra red skin tightening technology. The Cutera Titan and the Thermage Thermacool is marketing propaganda in his opinion. Both companies are in serious financial trouble at the moment and are sure bound for bankruptcy because these machines are no longer purchased by physicians. The only predictable skin tightening he sees are those performed with fractionated CO2 laser resurfacing in which the effects of collagen contracture are visible every time.
Dr. Goldman is a strong proponent of the IPL technology and strongly urges colleagues to combine IPL treatment with 560nm filter as an adjunct to skin toning with 1064nm ND Yag laser.

2. Does deep resurfacing with fractionated CO2 laser lead to PIH or wosened melasma in Type 4 and Type 5 skin?
A: He has never seen any PIH when doing laser resurfacing with t he fractionated CO2 laser in his asian patient population in San Diego. He discourages pre-treatment with topical hydroquinone cream and encourages use of topical steroid such as triamcinolone after skin resurfacing to minimize risk of PIH.

3. How do you treat acne scar and hypertrophic scar?
A: Acne scar and hypertrophic scar are very difficult to treat period. Laser resurfacing only works for shallow scars. Deep scar require other modalities. He encourages use of intra lesional injection with 5% 5 FU in hypertrophic scars.

4. How do you treat Melasma?
A: He explains to patients that melasma is a genetic disease which cannot be cured. He uses IPL 560nm and topical hydroquinone (TriLuma or Obagi Nuderm) to treat melasma. He mentions that topical hydroquinone can be safely used for periods of longer than 1 year. Use only tri luma or obagi nuderm. Do not use formulated hydroquinone produced by compound pharmacies due to oxidation and decrease in drug potency.

5. How do you treat Rosacea?
A: He uses IPL 560nm filter to treat Rosacea. He did not comment on use of any topical cream such as Metronidazole.

6. What is your opinion on laser hair removal?
A: Current technology in hair removal include IPL, alexandrite, diode, 1064 ND YAG lasers. His favorite, of course, is the Lumenis light sheer diode laser. He uses his own back hair to test each technology.He just bought a Lumenis light sheer duet in February 2009 and uses it solely for hair removal. He claims it to be the fastest and mose effective way to do hair removal procedures.

Overall it was a very informative Q &A session with one of the authority in cosmetic dermatology. I did not know that Dr. Goldman was the inventor of the first IPL machine and that he and Rox Anderson of MGH have such different opinion on recent laser technologies. Of course the set up of the Q & A session was targeted to sell Lumenis laser machines mainly the Active FX, Deep FX, and the Light sheer Duet. I have been a happy sciton user for many years. However I learned a lot from this 5 hour session.

This was very informative, thanks.

Thank you, I still believed in added IPL after laser treatment.

I'm glad you learned so much in such a short amount of time.

That sounds like some good stuff, can anyone explain more?

I had the opportunity to attend an invitation only Q&A seminar hosted by the Lumenis corporation featuring Dr. Mitchel Goldman, author of "Cutaneous and cosmetic laser surgery" a few days ago.
Our group of dermatologists and plastic surgeons had the opportunity to ask Dr. Goldman about his expert opinion on common skin conditions and popular laser equipments on the current market.

1. In regard to skin tightening, what works, what doesn't work?
A: No technology on the market currently deliver what they promise. The Cutera Titan does not tighten, the Thermage Thermacool does nothing to lift sagging skin. Only 30% of patients are ever happy about treatment outcome from these RF or infra red skin tightening technology. The Cutera Titan and the Thermage Thermacool is marketing propaganda in his opinion. Both companies are in serious financial trouble at the moment and are sure bound for bankruptcy because these machines are no longer purchased by physicians. The only predictable skin tightening he sees are those performed with fractionated CO2 laser resurfacing in which the effects of collagen contracture are visible every time.
Dr. Goldman is a strong proponent of the IPL technology and strongly urges colleagues to combine IPL treatment with 560nm filter as an adjunct to skin toning with 1064nm ND Yag laser.

2. Does deep resurfacing with fractionated CO2 laser lead to PIH or wosened melasma in Type 4 and Type 5 skin?
A: He has never seen any PIH when doing laser resurfacing with t he fractionated CO2 laser in his asian patient population in San Diego. He discourages pre-treatment with topical hydroquinone cream and encourages use of topical steroid such as triamcinolone after skin resurfacing to minimize risk of PIH.

3. How do you treat acne scar and hypertrophic scar?
A: Acne scar and hypertrophic scar are very difficult to treat period. Laser resurfacing only works for shallow scars. Deep scar require other modalities. He encourages use of intra lesional injection with 5% 5 FU in hypertrophic scars.

4. How do you treat Melasma?
A: He explains to patients that melasma is a genetic disease which cannot be cured. He uses IPL 560nm and topical hydroquinone (TriLuma or Obagi Nuderm) to treat melasma. He mentions that topical hydroquinone can be safely used for periods of longer than 1 year. Use only tri luma or obagi nuderm. Do not use formulated hydroquinone produced by compound pharmacies due to oxidation and decrease in drug potency.

5. How do you treat Rosacea?
A: He uses IPL 560nm filter to treat Rosacea. He did not comment on use of any topical cream such as Metronidazole.

6. What is your opinion on laser hair removal?
A: Current technology in hair removal include IPL, alexandrite, diode, 1064 ND YAG lasers. His favorite, of course, is the Lumenis light sheer diode laser. He uses his own back hair to test each technology.He just bought a Lumenis light sheer duet in February 2009 and uses it solely for hair removal. He claims it to be the fastest and mose effective way to do hair removal procedures.

Overall it was a very informative Q &A session with one of the authority in cosmetic dermatology. I did not know that Dr. Goldman was the inventor of the first IPL machine and that he and Rox Anderson of MGH have such different opinion on recent laser technologies. Of course the set up of the Q & A session was targeted to sell Lumenis laser machines mainly the Active FX, Deep FX, and the Light sheer Duet. I have been a happy sciton user for many years. However I learned a lot from this 5 hour session.