Laser Procedures

Ultrapulse® CO2 (continuous wave) Laser

The continuous wave CO2 laser is used primarily for resurfacing wrinkles and improving scars and to remove seborrheic keratoses(barnacles) and warts. There are two kinds of CO2 laser resurfacing, continuous wave and fractional.  This section deals with the former.

Carbon dioxide (CO2) laser resurfacing is the gold standard of laser resurfacing. This laser procedure can take off as much as 20-25 years in some patients and results are often sustained for 10 years or more. We have patients who have maintained results for more than 20 years.

The UltraPulse® CO2 laser emits a sterile beam of light that not only removes the top layer of skin, but also throws heat into the second layer of skin causing immediate, significant skin tightening (up to 35%), smaller pores, and a smoother skin surface and texture, and marked improvement of pigment irregularity due to sun.  After laser resurfacing, there is a marked increase in collagen deposition in the skin over a period of several months, even up to one year. For many people, this procedure has replaced face lifts as it improves texture, tone and tightens the skin without pull lines or scars, leaving a more youthful appearance.

Laser resurfacing can be performed with topical anesthesia and local nerve blocks. Oral pain medication is optional; however, patients may not drive for the remainder of the day after receiving internal medication. The majority of patients rate discomfort of the procedure at a “4” of “10” with “0” being no pain and “10” being the worst pain they could imagine. Usually there is some stinging after the procedure for 20-30 minutes which is reduced with the Zimmer chiller. Rarely does a patient request pain medication postoperatively as there is almost no significant pain. It is believed that the laser seals nerves.

Postoperatively, there will be a small amount of drainage from the treated areas in the first day or two. Redness, swelling, bronzing, crusting, and peeling are a normal part of the healing process and usually last 4-7 days. Aftercare includes keeping the skin clean, soaking and applying a thin layer of petroleum jelly until the crusts fall off naturally. While healing, it is important to avoid sun exposure and wear a good sunscreen. Total Block® or a sunscreen containing Mexoryl™ or Helioplex™ for UVA protection with a SPF of 30 or above should be worn.

The rate of healing depends on the area being treated, the depth of laser resurfacing, and the patient’s age. The skin may remain pink for 2 months or more, however, makeup can be used. After the procedure, sun exposure should be kept to a minimum and sun protection should be used.

Scarring due to acne, trauma, or surgery and some pigmentation abnormalities can all be treated with the CO2 laser.  We have been treating facial irregularities, including wrinkles and scars, with laser resurfacing since 1988.  We use the UltraPulse® CO2 5000 C™ laser with its computer scanner or the newer UltraPulse® Encore™ for fractional resurfacing (see below). We often do combination procedures.

Skin tags, flat warts, and seborrheic keratoses, also known as ‘barnacles’ or ‘old age warts’ are easily removed with the CO2 (carbon dioxide) laser. The CO2 laser is absorbed by water in the lesions, which vaporizes them, causing the lesions to crust up and fall off. There may be some residual mild pinkness which fades as the area heals. Most keratoses disappear with one treatment. Since seborrheic keratoses are hereditary, new lesions will develop over time. We often remove 300-400 or more keratoses in one office visit. Once cleared, short annual or bi-annual treatments will maintain clearance.

See what our patients are saying....

"Wow! I just can't say enough about how happy I am with my experience with the staff of Dr. Diana Parnell. First let me say that everyone I met was so kind and considerate. For over 20 years I suffered with barnacle moles, some the size of quarters. Then I had laser treatment by Dr. Parnell and my moles [barnacles] are all gone completely. I am thrilled and feel like it is a miracle! Diana Parnell and her assistant took great care of me and made me feel at ease. Her staff is so friendly and help you every step of the way, explaining the process and answering any questions. I highly recommend her for anyone seeking a dermatologist." ~ D.J. Dec. 2009

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