The methods currently used under the name "treatment of acne scars, pores, and wrinkles" are inadequate or unsafe! For years, different methods have been used to treat skin aging, wrinkles, and acne scars:
• Chemical Peeling: This involves renewing the skin using various chemical substances. The effectiveness of even the deepest peels is low.
• Microdermabrasion: This involves applying aluminum salt to the skin in a spray form to exfoliate it. Its effectiveness is around 10-20%.
• Mechanical Dermabrasion (sanding): This involves sanding the skin. Due to the serious damage it causes to the skin, it is no longer preferred today.
• Botox and Fillers: Fillers plump the skin, effectively reducing wrinkles and blemishes for a limited time. Botox, on the other hand, paralyzes the facial muscles responsible for expressions, causing a temporary reduction in wrinkles.
• Light Therapy (Intense Pulsed Light: IPL): Concentrated light pulses stimulate collagen fibers beneath the skin, increasing skin elasticity. It is up to 25% effective in skin rejuvenation and renewal.
• Non-invasive Radiofrequency: Radiofrequency waves stimulate fibroblast cells in the skin, leading to collagen production. This method is safe and risk-free, but its effectiveness is insufficient on its own.
• Laser Treatment:
• 1. Nd:YAG laser: Due to its very mild and superficial effect, it is no longer preferred for wrinkle and scar treatment.
• II. Er:Glass and Er:YAG lasers: These systems are frequently preferred for wrinkle and scar treatment, but because they are not deep enough, both the patient and the doctor are often not satisfied even after several treatment sessions.
• III. CO2 laser: This is the world's most effective method for treating scars and wrinkles with deep penetration. While it has a very deep effect, its side effects can also be serious. Therefore, in the last 5 years, the "Fractional CO2 laser," which has revolutionized the world of "Laser Dermatology" and reduced the side effects of this system to almost zero, has been developed. The success rates of the methods mentioned above, other than laser treatments, in treating scars, pores, and wrinkles are partial, ranging from 5% to 25%, and sometimes they are not effective at all. In addition, since the application depth cannot be measured with these methods, serious unwanted side effects may occur.
Why Laser?
The most effective treatment method for scars and wrinkles. Over the last 15 years, laser technology has made significant strides in treating acne scars, pores, wound scars, burn scars, and facial and neck wrinkles, and continues to produce surprising results with new developments every day. Three types of laser systems have been designed in recent years for effective skin rejuvenation and scar treatment. Today, these three systems are preferred as the most successful methods for treating various scars and wrinkles:
1. Erbium:Glass laser (Er:Glass): 1,540 nanometer wavelength
2. Erbium:YAG laser (Er:YAG): 2,940 nanometer wavelength
3. Carbon dioxide laser (CO2): 10,650 nanometer wavelength
One of the most important factors determining the effectiveness of a laser is its wavelength. Wavelength indicates the depth at which the laser penetrates the skin, and therefore how effective it is. Er.Glass and Er:Yag systems have lower wavelengths, so their effectiveness is limited, and they are only partially effective in treating scars and wrinkles even after a few sessions.
CO2 lasers, with a wavelength of 10,650 nm, penetrate the deepest layers of the dermis, the middle layer of the skin, producing unparalleled results and are currently the gold standard method for skin tightening, renewal, rejuvenation, and the treatment of all types of scars. CO2 lasers have been used since 1996 for skin peeling and the treatment of mass lesions. Initially, CO2 lasers, followed by Er:YAG lasers, received FDA approval for skin rejuvenation. While the first CO2 lasers were quite effective, they had some side effects due to the long pulse duration, the deep peeling and heat effects they generated, and prolonged redness. Er:YAG lasers, on the other hand, have a much more superficial peeling and heat effect, resulting in fewer side effects but also weaker skin rejuvenation effects.
Fractional Laser: Prevents damage to the skin that powerful and deep lasers can cause!
Why Fractional CO2 Laser?
Fractional CO2 Laser: The latest advancement worldwide in the treatment of acne scars, pores, and wrinkles. It is the most advanced, deepest, and safest laser system.
CO2 lasers, used to treat wrinkles, lines, sagging, acne scars, and pores on the face and neck, can cause excessive tissue damage and consequently lead to blemishes and new scars if their rays are delivered directly to the skin. Therefore, fractional laser systems have been designed. In this laser system, a filter-like mechanism is applied in the treatment area, preventing the rays from passing through certain points and ensuring the laser beam is not directed to the entire skin area. Consequently, this system is microablative, not ablative (damaging), and does not cause significant scarring or permanent damage to the skin.
The first fractional laser system produced was the Er:Glass system (Fraxel). Following this device, fractional Er:YAG lasers were developed and put into use. These two systems, used in Turkey and worldwide, treat wrinkles, marks, pits, and various scars; however, their effectiveness is limited due to the short laser wavelengths, and sometimes achieving the desired results is not possible even with numerous applications. To overcome this limitation, the latest development worldwide is the fractional version of CO2 laser systems.
Currently, Deka SmartXide devices are the most advanced fractional carbon dioxide laser (fractional CO2 laser) systems worldwide. During fractional laser applications, the thickness of the treated skin is not determined by visual estimation or experience, as in chemical peels or dermabrasion; the depth to be penetrated is precisely known. Despite its power, thanks to its fractional nature, the healing rate after application is very high, and the recovery time is short. Its effect is also much higher than similar systems. While dermabrasion is performed under local or general anesthesia, and chemical peels, which have a significant effect, are performed under general anesthesia, no anesthesia is required for fractional laser application.
What are the advantages of fractional CO2 lasers over Er:YAG and Er:Glass lasers?
CO2 laser treatment causes an immediate 30% shortening of subcutaneous collagen fibers and skin tightening, while this rate is incomparably lower with Er:YAG and Er:Glass systems. Depending on the patient's needs, the skin is treated at a depth of 10-250 microns (this depth is between 2-50 microns in Er:YAG lasers and even more superficial in Er:Glass lasers). Thanks to these advantages, the CO2 laser system maintains its position as the gold standard in skin rejuvenation applications. Among fractional laser systems, only fractional carbon dioxide (CO2) laser is effective in treating deep scars and wrinkles.
In which fields are the “Mixto SX and SmartXide DOT” Fractional CO2 Lasers used?
Fractional CO2 laser skin rejuvenation is undoubtedly the most effective method for facial rejuvenation and the removal of wrinkles and lines on the face, eyelids, neck, and décolleté areas.
1- Removal of fine wrinkles,
2- Removal of deep wrinkles and facial rejuvenation,
3- Scar Treatment; This is the most powerful and effective treatment method for acne scars (pimple scars) on the face, back, and chest, pores and pits, wound and burn scars, and stretch marks!
Treatment of acne scars; acne scars are classified into two main groups: superficial and deep.
a. Superficial acne scars and pores:
These are scars that affect the upper layer of the skin. These scars appear especially after acne treatment and are seen as slight pits and depressions on a background of redness. Superficial acne scars can usually be partially reduced with superficial skin peeling methods such as chemical peels, but acne scars that do not heal can be easily treated with fractional laser.
b. Deep acne scars:
Ice pick, acne scars, and deep pores:
Ice pick scars are pinpoint pits on the skin, usually less than 2 mm in diameter, that appear as if they were punctured with an ice pick. Although relatively small, these scars can be extremely deep, sometimes penetrating even the subcutaneous fat layer. Therefore, laser treatment is the best option for "ice pick" acne scars. Among laser systems, the most effective and with the fewest side effects is the fractional CO2 laser system.
Box car (freight wagon) acne scar (pimple mark):
These are acne scars that form in a round or oval shape.
Rolling scar (wavy) acne scar:
• These acne scars, which are usually deep, result from the upper layer of skin being pushed inward by the underlying layers. Fractional CO2 laser treatment shows up to 80% improvement in these types of acne scars, which are among the most difficult to treat.
• Elimination of large pores and rough appearance of the skin. III. Elimination of sun spots, age spots, postpartum spots and superficial pigment disorders on the skin.
• Reduction of excessive connective tissue (hypertrophic scarring) and keloids. 3. Thanks to its special laser application head, it is used in "aesthetic eyelid surgeries, minor facial surgical procedures, and injury correction":
• Treatment of precancerous skin lesions (Bowen's disease, Paget's disease, Queyrat's disease, leukoplakia)
• Treatment of skin cancers (BCC, SCC)
• Treatment of mass skin lesions (dermal nevus, senile keratosis, HPV-skin tags, nevus sebaceous, milium, syringoma, dermatofibroma, chondrodermatitis, epidermal nevus, cyst, neurofibroma, trichoepithelioma, etc.)
• Treatment of mass lesions in the hair, eyebrow, and beard area
• Treatment of pyogenic granuloma
• Treatment of rhinophyma and otophyma
• Treatment of congenital or acquired moles
• Treatment of cholesterol plaques (xanthelasma) that form on the eyelids. 9. Treatment of masses (verruca-warts, condyloma) that have formed in places such as the hands, feet, and genital area.
What are the advantages of Mixto SX and SmartXide DOT Fractional CO2 Lasers?
• Its fractional feature means that, unlike fractional Er:YAG lasers which are lens-related, all laser pulses are not delivered simultaneously; each laser pulse (dot) is delivered individually within microseconds. This reduces the potential damage the laser can cause to the skin to almost zero.
• Smart Pulse feature: When this option is used, each laser pulse actually consists of two separate pulses: an effective and powerful pulse in the first 20-30 microseconds, and a lower power pulse for the remaining time (150 or more microseconds) to reduce heat damage to surrounding tissue.
• The Hi-Scan feature is another factor that reduces heat damage to the surrounding tissue. Thanks to this feature, each shot can be delivered separately and to distant points, preventing heat damage that could occur due to shots fired side-by-side on the skin.
• Thanks to its Hi-Scan feature, the number, shape, and frequency of laser pulses can be adjusted according to the needs of the skin being treated, and the pinpoint laser pulses are not fixed in number, frequency, or shape. This increases maneuverability in the treatment and therefore the success rate.
• The SmartXide DOT CO2 laser has pulse points with a diameter of 120 microns, approximately half the size of a human hair. Therefore, these laser pulses are called "microscopic treatment zones".
What are the changes that occur on the skin as a result of Fractional Co-op laser treatment?
CO2 laser treatment causes an immediate shortening of 30% in subcutaneous collagen fibers. Over the next 1-3 months, new collagen formation and restructuring of the subcutaneous connective tissue occur. As a result of all this, skin rejuvenation occurs, characterized by skin tightening, a significant reduction in blemishes, spots, and scars. Pores shrink, and the skin's structure returns to its condition 10-15 years prior.
Is Fractional CO2 Laser Treatment Painful?
During the procedure, there will be a stinging sensation, similar to laser hair removal. This sensation can be reduced by using anesthetic creams or cold air.
How many times is fractional CO2 laser treatment performed?
In fractional CO2 laser systems, the number of sessions varies depending on the severity of the problem and the power and depth settings of the application. An average improvement of approximately 40% is observed after each application. While 1-2 sessions are sufficient for mild to moderate wrinkles and scars, treatment for very deep acne scars and wrinkles requires several (3-5) sessions. The frequency of sessions varies according to the depth of application: treatment is repeated every 1-1.5 months for superficial applications and every 2-3 months for deep applications.
What are the characteristics of the recovery process?
Fractional CO2 laser treatment does not require dressing changes. There are no complaints other than skin peeling lasting 3-7 days, followed by a few days of redness. Patients can apply makeup starting from the second or third day. This advantage of fractional laser allows patients to resume their daily lives.
What should be considered before the procedure?
The patient should avoid sun exposure and tanning beds for one month prior to the procedure. Medications that prevent blood clotting (aspirin, heparin, etc.) and retinoid-containing medications (isotretinoin) should not be taken. Skin-abrasive treatments such as dermabrasion and peeling, or skin tightening surgery, should not be performed before the procedure. If the patient has a history of frequent herpes outbreaks, they must inform the doctor and take any necessary medication before the procedure.
What precautions should be taken after the procedure?
The skin should be kept dry for 1-2 days after the procedure; showering is possible after the third day. Cold compresses can be applied to reduce swelling and inflammation. To prevent crusting after the procedure, the skin should be kept moist and clean. Makeup can be applied from the second or third day onwards. Depending on the patient's skin type and environmental conditions, sunscreens should be used after healing, and exfoliating creams should not be used for at least one month.
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