Hi,

I've spent a lot of time reading the physicians thread concerning Active/Deep Fx and found it helpful. It seems to me that the main benefit of fractionated CO2 is repeat patient visits. I have shallow, atrophic acne scarring in one area only but it bothers me very much. It becomes practically invisible when I pull my skin, I've read this type is very amenable to laser treatment. To be totally honest, with the variety of parameters available the first thing I think of as a patient is: How did my doctor decide the parameters for my concern? Did he choose the right one? More cynically, how do I know the treatments aren't being drawn out or that repeat procedures will be necessary as a result of the parameters chosen?
I would like to treat my acne scarring, but with the least amount of treatment sessions possible. In my area, fractionated laser treatments are just too expensive for such subtle results. I'm concerned that some doctors don't want to (or don't know how to) operate outside of certain parameters. I'm exhausted with doctors (but mostly assistants) who use buzzwords. I mean no offense, but I'm not a housewife who can afford $4,500 or more for a slightly more even skintone and the feeling of pampering one expects to get from plastic surgeons with art deco style offices. That's great and all, but my problem requires downtime, removal of skin, etc. Doesn't it? I want to do the most I can for my problem so I can put it behind me.

My Question: For patients that desire 1 treatment for their scarring, what parameter provides the closest results to CW CO2? Is it possible to achieve similar results with Active/Deep Fx or should I look harder/travel to find someone with a CW laser? (Nearly impossible, fractionated lasers have really caught on.) Downtime is not a concern, I have spent many years disliking my skin, what's 2 or 3 months? Even 6 while the last bit of redness lingers? Not a concern for me.

Thanks so much!

PS; My unsolicited opinion: I think fractionated lasers are a bubble that's primed to burst. From a patients perspective it seems like these lasers make nearly everyone a candidate for treatment, increasing the money a doctor makes not just from the amount of people that are suitable to receive treatment but also because the sophisticated scanning systems and device settings allow delegation to other medical personnel. So many clinics seem to forget that some people present problems needing correction that typically only comes with an invasive procedure. Brightening, increased radiance or an improvement in skin texture don't count as problems or anything to be impressed about if those are the result. Because seeking treatment means the patient cares, its easy to see why some might not appreciate subtle results. Especially considering the high costs. I'm all for doctors making money, make as much money as possible! The high cost/subtle result fractionated lasers provide has been embraced in a big way, but so many doctors seemingly think of these devices as the only option. There are few other areas where this combination of cost to results would be tolerated. Doctors answer every question with "better tolerated, less downtime" as justification but its the price that makes it about as tolerable as getting shot. My advice to doctors (not that any asked or need it, strictly speaking from a patients perspective) is most importantly, to not be the first one to buy a particular laser! Then, invest wisely in a laser that has more than one application, little/no consumables (less to pass on to the patient could mean a price more patients are willing to pay), comprehensive maintenance and limiting to 3 or 4 lasers. Some practices have 7 or 8 making some redundant. The only reason I could see for having them was to collect dust until 1 person asked about it so they wouldn't have to send them to clinic B. Lastly is the likelihood of someone following through with treatment. Some are ok with subtle results because their problems are subtle or nonexistent. I think they are less likely to follow through on a procedure after a consult though. If they do, certainly not a second one. Most of my friends have little to no skin problems and their tiny bit of concern would disappear after hearing most prices. On the other hand, people willing to spend are usually willing to put up with a little downtime. It doesn't really make sense to pay so much for something just to shrug your shoulders in indifference at the outcome. Usually people are handing that money over for a reason. That's not everything of course and its just my opinion! I know things are never as simple as they appear from anyone's perspective!

Thanks so much for reading! (Didn't intend on the novel length!)