Hi,

Im interested to buy a laser mainly to treat Acne scars also for rejuvenation.My patient population is Indians ( Type IV and V ). My main requisites are that PIH should be minimum or non existent (if possible) . Also, down time should be minimal perferably patients should be able to go back to work in 2 days ( with makeup if reqd ). The clients would be all rite with 3-5 treatments overall.

I have had a trial with the Palomar Lux 300 - 1540.I tried it on around 20 patients the first time around and Im again doing another demonstration of the same next week, but I was very happy with the results of the Palomar the first time around. Only concern, the other representatives have mentioned to me that the Palomar system has a limitation of 1,00,000 pulses on the system and the machine will not work after that, so you gotta buy additional pulses in batches of 50,000. ( I gotta confirm this, perhaps someone can comment ).

Now the Sciton representative claims that the Sciton Profractional XC would give a better and more uniform results than the Palomar 1540 and also comes with a scanner and no consumable costs.Also, he claimed that there would be no downtime practically and also the 2940 erbium would be "safer" to the erbium of the 1540. Also it would offer me an option for more aggressive treatments if I choose to. The price of add ons would be cheaper (i.e.) Long pulse ND Yag / IPL at a future date compared to the Palomar. Unfortunately, they don't have a system I can do a demonstration on.

Another option for me to consider would be the Sellas 1550, the cost is much more favourable to the above systems, almost 40% cheaper and again claims to have no consumables. The wavelength is the same as Fraxel 1550 and seems to be an interesting system if it can deliver visible results at every sitting.I would really like user feedback for this laser on the indication of acne scars. Again, the demonstration system is not available as yet.

I have read various reviews of the Fractional CO2 on this site and have used the Alma Pixel CO2 with no problems of PIH so far. If there is another CO2 also I can consider I would be open to it. I would love feedback on the fractional CO2 specially the Smartxide and other options.

My one requisite is that I don't want a system with consumables, so am ruling out the fraxel system.My main indication definitely acne scars, and surgical scars as well. I currently own a Medlite C6, Cutera Xeo with Pearl, Titan and Vantage, Lumenis ET and a Accent RF.

Thanks for your help and suggestions.

My derm says that she has seen a case where Deep FX has gone so deep to the fat that it caused pock marks in the skin in and that I should stick with her Erbium YAG resurfacing for better and more predictible results. Is this a fair thing to say?

You are asking a difficult task - treat acne scars in type IV & V's with no PIH.
I don't know of any method or machine that can do this reliably.
It will be interesting to see what the other experienced users here say.

Check out Goldman's Complications of Laser and you'll see some interesting pix. It seems that non-ablative lasers produce too much heat for the darker skin-type, which will generally cause scarring, necrosis and other problems. The Sciton Erbium profractional does not make too much heat, but there is still a risk. Heat is the enemy of the darker skin type as it destroys melanin in the DEJ. I think this post is too late for you, but hope to help anyone else checking this.

We can recommend the Palomar StarLux. We are getting great results not only on scars but also on striae.
There are no consumables and the machine is veryreliable.

Palomar offers a warranty that you can renew after it expires.. We have a starlux and we do not buy extra pulses... we buy a warranty.. call palomar for correct information.. your sale's rep should know..

Palomar will gaurantee the Lux 1540 up to 100,000 pulses. After that there is no additional pulse you can purchase or buy an additional warranty. I have had a some experience with the Paloamr on Fitz 5 & 6. Must pre treat with Bleaching agents and continue during and up to several weeks after last treatment. This hand peiece works very well on scars on all skin types. But you have to use caution

Texas Laser: The Palomar policy on continued service for their 1540 nm laser seems very strange to me. With lasers it is usually very easy to use up a million shots. With all the lasers I am familiar with you can simply replace the flash lamp at this point (maybe 500,000, maybe at 1 million pulses, etc.) and continue using the laser for several more years. Sometimes - due to a multitude of different reasons -- the laser rod or pump chamber may require replacement also. This is generally an expensive proposition and makes it a good idea to have a service agreement after the initial warranty expires. IPL systems are a different story. Many systems require new flashlamps at 10,000 pulses, and other systems go as high as 300,000 pulses before replacing the lamp(s). I have heard before that Palomar's IPLs are only "guaranteed" for 100,000 pulses. It would surprise me if their lasers had similar limitations.

I looked at the Smartxide and the Lutonic CO2, bought the latter. Easier to operate and use. No consumables, but may need tips if you wear them out. I would do the "bleaching" creams x 2-6 weeks on darker patients prior to doing laser ablation. No experience from me because most all patients are Type II.

The sales rep telling you that a 2940 ablative Er: YAG is safer than a non ablative Er:Glass laser is really just another ridiculous sales pitch, trying to play around the fact that they don’t have a non ablative fractional device that works for anything. While the non ablative treatment represents the possibility of post inflammatory hyper-pigmentation (which is easily treated), an ablative Er:YAG can represent the possibility of hypo pigmentation, hyper pigmentation, scarring, etc. And being that I am assuming that you are attempting to treat some deeper scars, the amount of resurfacing necessary would definitely bring with it an increased risk of the above mentioned complications, espescially in darker skintypes. I would definitely recommend the more non ablative option for acne scarring. Either the Reliant Fraxel system, or the Palomar 1540. While the Sellas does use a good wavelength (and a nice price), there is no contact to the skin, so penetration as well as cooling is an issue for them. If you are trying to tackle muscle based peri orbital or peri oral wrinkles, ablation is really the proper method of treatment (along with Botox) If you are in the market for an Er:YAG, the Palomar Lux 2940 fractional is the only system on the market with the ability to fire in a dual pulsed mode, and is able to lengthen its pulse duration to simulate more of a CO2 type of thermal coagulation. This thermal coagulation and stimulation is the key to wrinkle treatments, however, if acne scars and other scar tissue is your focus, the non ablative approach is a safer method.

Cartman,

You may have made some wrong statements above. Many would argue that the fractional CO2's and erbiums are going to give you better results than the non-ablative devices and in fewer treatments for acne scarring but with more downtime. I own the original fraxel and have done over a thousand treatments with it. I am now looking into a more aggressive means to treat acne scars and rhytides. I also own the Sciton Erbium for full ablation.

I would agree with the statement that the non-ablative devices are safer than the ablative devices. That is why it is important to know who is using the laser.

To my knowledge there has not been hypo-pigmentation from the fractional ablative lasers. There are a number of studies out there with the use of fractionated erbiums being safe on darker skin. Pozner did a study and did not have problems with pigmentation on darker skin types. The problem occurs when too much heat is applied to the skin and it destroys the melanocytes. If not used in long pulse mode the erbium is safer than the CO2 on darker skin types.

You also stated that the Palomar is the only erbium that has dual pulse erbium. You are wrong the Sciton was the first with dual pulsed mode for full ablation but the second for fractionated dual pulsed mode.

I treat a lot of Type IV patients with Sciton 2940 Erbium laser using the single spot, Scanner (Micro Laser Peel, Resurfacing,...). The key to not getting PIH after treatment is to educate patients about sun protection. When doing deeper resurfacing > 80 micron at 30% overlap, I require the patients to cover up the treated area with duoderm tape to prevent any sun exposure. It is very difficult to educate the amount of sufficient sun screen to use because the amount used is relative to personal and subjective opinion. Wearing a surgical mask and frequent use of Duoderm tape to cover up the freshly treated area seems to be the most effective means of preventing PIH in my practice.

Med Spa guy,

It is true that you get a standard 100K gaurantee on all of the handpieces. Regardless if it is IPL or 1540, 1064, 2940. I have had some of my IPL hand pieces go up to 300K pulses with no problems, but sometimes you may only get 101K before they stop working as effectively. Kinda like a box of chocolates. You never know what cha gonna get. I am not sure why Paloamr wont warranty past the 100K mark on the "laser" peices. If anyone know why....let me know. I guess part of the reason for Palomar stopping at the 100K mark for the Lux 1540 would be that it is an external hand peice and would be more prone to breakage?

Hi, Thanks a lot for your replies. I bought the Palomar 1540 last october, and am very happy with my decision. Sometime , though I feel the results on deeper scars leave a bit to be desired. Considering a fractional CO2 for the same, perhaps the Smartxide in conjunction with the Palomar 1540. Haven't really had too much problems with PIH with the Palomar, apart from a few patients who I treated more aggressively or stacked pulses as suggested as per one of their protocols. so have stopped doing that. Also, I think more than acne scars, for surgical scars the fractional Palomar works beautifully.

Just about completing the 1,00,000 shot tomorrow, so now the warranty issues start, lets see hopefully they are better than Cutera. Had a terrible experience with the Xeo recently and the exorbitant price of their spares. Have to buy another hair removal laser, and though really liked the Cutera Vantage, don't want to buy it for lack of support and poor after sales. Am considering buying the Soprano XL, especially for their SHR mode, like the concept and have done couple of demonstrations, seemed nice and also the Laser Blanching and Skin Tightening handpiece on the same seems very interesting.

Also, for my Palomar Starlux 300 with the 1540 handpiece, want to buy the IPL handpieces, but am very confused whether the same requires a software upgrade for any of the IPL handpieces to work. The distributer says that but he himself is not sure. Of course the company should be able to answer that question, but the distributer was saying a prohibitive cost for enabling the IPL handpieces, so am considering rather to just buy a separate IPL machine.If anyone has an experience on the same, pls let me know. Regards

For the IPL handpieces for the Starlux 300. You can purchase any of the IPL handpieces and they should work with the Starlux without any need for software upgrades. You have to purchase a Starlux 300 compatible IPL hand piece. The are Starlux 500 compatible IPL handpieces, but these will not work on the 300 platform. I use a Starlux 500 in my clinic and it would be fairly inexpensive to purchase a new or used green, red or yellow hand peices to work on your platform. The only issue would be that you buy a "300" compatible IPL hand piece

Thanks a lot.... The Palomar Distributer specifically disagrees with me or says is unsure himself and is in fact quoting me a large figure to upgrade the software first and then get the handpieces. I guess I will write to the company directly. The problem is i'm based in India and no one else is really using these handpieces, so the distributer also doesn't have experience on the same.

No problem. Typically the software update is as easy as plugging in the 512 Mb card in the front of the system. I am not sure what the latest on the Starlux 300 series software is, but it is likely 3.0. I am using a 6.1 on my Starlux 500, but I know there have been some upgrades for this system (probably around 7.1). I would call the company direct, ask for the service dept. They should be able to shed some light for you. There should be nothing interanl that should have to be done. to use any of the IPL hand pieces.

Yeah..... but for plugging in the 512mb card, the distributer is quoting me $30000 , just for the software, handpieces apart :) So am thinking would just rather buy a separate IPL machine as compared to doing that, though I would love to try the IPL handpieces on the Palomar. What is your feedback on the Palomar IPL hand pieces in case you are using them ? Thanks

If I was a betting man I would guess that the flash card would cost him $100 US or maybe nothing. So if he is trying to have you pay something crazy like that for opening the oval on front of your box......tell him to stick where the sun doesn't shine. In regard to the IPL hand pieces: if you are in India, your patient population is likely skin type 5 & 6 for the most part. The R (red) hand large would be great for hair removal with this population. But I am not sure if you would want to purchase the G (green) for photo facials or the Y (yellow). Those are both for skin tyes 1-4.

I have the G, R, Rs, Y and V IPL hand pieces. As well as the 1540 fractional. They all work well for my business.I use a Cutera Xeo platform and I love the 1064 on the system, but the Palomar IPL's work much better for speed and safety.

haha... yeah my thoughts completely. We have skin types IV and V , normally dont have VI. I have used the 1540 handpiece quite a lot and am very happy with the same. I use the Cutera Xeo with Vantage, Titan and Pearl as well. Im extremely happy with the ND 1064, I also have a lightsheer but hardly use it since I got the 1064 couple of years back. The problem with the Cutera is that it has failed a couple of times and the repair costs are very high. I don't think Cutera chooses to repair anything, but rather takes back the non working part and makes you buy a new one, probably they just refurbish the part and sell it to the next customer. My Distributer and his technician told me that the repair is a few capacitors which should cost around $150, but Cutera wont give the same to him, so I need to spend and spend $10000. So I thought the R handpiece would serve as a good back up and also get a second system.

I wish you well. From my personal experience, Palomar and Cutera have great equipment. But they are both probably the worst as far as warranty high costs and getting parts and 2nd partys to be able to service.

I wish you well. From my personal experience, Palomar and Cutera have great equipment. But they are both probably the worst as far as warranty high costs and getting parts and 2nd partys to be able to service.

I wish you well. From my personal experience, Palomar and Cutera have great equipment. But they are both probably the worst as far as warranty high costs and getting parts and 2nd partys to be able to service.

I wish you well. From my personal experience, Palomar and Cutera have great equipment. But they are both probably the worst as far as warranty high costs and getting parts and 2nd partys to be able to service.

Hi, If you already own Cutera...I dont understand why you are not using Laser Genesis. Call Cutera's clinical department or your rep for additional training if required...but Laser Genesis will safely treat your darker skin types with NO PIH. There was an article recently published in the Journal of Dermatology on treating skin type VI with Laser Genesis. Good luck

Hi, If you already own Cutera...I dont understand why you are not using Laser Genesis. Call Cutera's clinical department or your rep for additional training if required...but Laser Genesis will safely treat your darker skin types with NO PIH. There was an article recently published in the Journal of Dermatology on treating skin type VI with Laser Genesis. Good luck