Fraxel at www.newhopelaser.com

	Pearl There is growing demand among patients and practitioners for a more aggressive treatment to address wrinkles and uneven texture while minimizing the recovery time experienced from other ablative technologies. With a 2790 nm wavelength, the Pearl laser provides a technology to meet these market demands; maximizing the ratio of cosmetic benefit to patient downtime.  Request your Pearl Laser DVD or view the video online Mechanism of action These treatment goals can be achieved with the appropriate technology, wavelength, and settings. Ablation: The safe removal of a portion of the epidermis is achieved with a controlled amount of vaporization. 10-30 microns of epidermis are vaporized in this process. Coagulation: Simultaneously, sufficient heat to produce coagulation is generated in the remaining epidermis. Depending upon selected energy, the coagulation region can vary from partial to full epidermal damage. This coagulation region creates a natural protective dressing on the skin that remains intact during the restorative process. Collagen Remodeling: Finally, residual heat in the dermis generates new collagen growth.
Wavelength	2790 nm
Fluence	1.5 - 3.5 J/cm2
Spot Size	6 mm
Scan Size	30 x 30 mm
Pulse Width Range	Sub-millisecond adjustment
Repetition Rates	Single shot to 20 Hz
Working Distance	3.2 inches
Protective Window	Sapphire

www.scarlasers.com - fraxel laser technology for you

ActiveFX with UltraPulse Encore   The latest advancement in minimal downtime, fractional CO2 laser resurfacing for aging skin www.newhopelaser.com Our skin changes over time, losing its youthful look and giving way to brown spots, wrinkles and laxity.  In recent years there has been a growing number of aesthetic procedures available to treat the skin.  ActiveFX - the result of the latest advances in laser technology - is a new procedure that yields remarkable, long lasting results with just one treatment.  A fast, office-based procedure with minimal patient downtime, ActiveFX is your single-treatment solution for beautiful younger-looking skin. Is ActiveFX right for you? ActiveFX is an ideal treatment option if you: have a busy lifestyle or cannot be away from work for a long time want noticeable results with minimal downtime want to treat dyschromia, fine lines, wrinkles and skin laxity What is ActiveFX?  During an ActiveFX fractional resurfacing procedure, a high-energy beam of laser light interacts with the skin's surface, causing the upper layer to peel off and regenerate a layer of new, healthy skin. With ActiveFX, only a  fraction of the skin's surface is treated.  The laser beam is applied in a fractional pattern, leaving small "bridges" of untouched skin.  This technique makes the healing process much faster and enables you to get back to your normal activities sooner. ActiveFX Benefits ActiveFX produces a dramatic effect on the skin: Causes immediate skin tightening Reduces wrinkles and fine lines, and softens deeper frown lines Noticeably improves skin tone and texture Stimulates new collagen formation and plumps the skin Results of treatment are long-term and, with proper sun protection, can last for many years.  Most effects of treatment become visible right away, whereas others - such as new collagen formation - build up gradually and results in continued smoothing over time.  Therefore, most people continue to show improvement up to 6 months after the procedure. What can you expect from ActiveFX? Most physicians perform the procedure in the office with a topical anesthetic cream that is applied before the ActiveFX procedure begins.  This is little to no pain associated with the procedure - most patients say they feel warmth similar to sunburn.  You can drive yourself home after the procedure.  With a gentle washing and moisturizing regimen, your photodamaged skin will begin to flake off within 2 days.  After about 4 -7 days, your doctor will probably let you wear make-up.  Pinkness should be gone in about a week.

Tennessee Laser & Skin Rejuvenation Rocky Top Medical Center 1105 Oak Cluster Dr. Sevierville, TN 37862 Ph:  865.908.3636 Fax: 865.908.3644

	www.newhopelaser.com

ActiveFX

DeepFX

	DeepFX - Fractional Laser Treatment The latest advancement in minimal downtime, fractional laser treatment for aging skin. Benefits of DeepFX Results in a single treatment Minimal downtime Improves scars, wrinkles and texture Deep dermal stimulation Dramatic results To adequately treat these problems, treatments need to reach the deep layers of your skin and renew the collagen foundation. Previous treatments produced great results but were limited in appeal due to lengthy recovery times. With the NEW fractional DeepFX treatments, your physician is able to treat the deep layers of your skin, but keep downtime to a minimum. Now, deep wrinkles, skin texture and scars are dramatically improved after just one treatment." What is DeepFX? DeepFX is a revolutionary fractional laser technology for aged, sun-damaged or scarred skin. The low-downtime procedure uses fractional CO2 laser micro beams to precisely target the deep dermal layers of the skin. This stimulates a cascade of healing responses that leads to tissue regeneration and new collagen formation throughout the entire treatment area. And because only a fraction of the skin is actually touched by the laser, healing time can be limited to just a few days. How does DeepFX work? DeepFX procedures involve treating only a fraction of the skinʼs surface, leaving bridges of untouched skin to aid in the regeneration process. Each laser pulse removes a narrow column of tissue while simultaneously treating surrounding skin. This deep heating causes immediate collagen remodeling. The result is softening and smoothing of wrinkles and scars, and improved skin texture. What is a DeepFX treatment like? office and lasts for about 20 minutes. Your doctor may use an anesthetic cream prior to treatment to aid with comfort. As the micro beams are applied, you will feel a warm sensation at the treatment area. Immediately following the treatment, your skin will feel warm and will be similar in appearance to a deep sunburn. Over the next several days you will follow a gentle washing and moisturizing regimen and avoid direct exposure to sunlight. As your skin heals, it will begin to flake and you will notice improvement in your wrinkles, fine lines and scars. DeepFX results DeepFX produces a dramatic effect on the skin: Improves wrinkles, scars and folds Noticeably improves skin tone and texture Stimulates new collagen formation and plumps the skin You will notice immediate softening of wrinkles, fine lines and scars as the skin heals from the treatment. In addition, the skin responds by stimulating organic growth of new collagen that continues for up to six months. Results of the treatment are long-lasting and with proper skin care can last for many years. Where can DeepFX be used? DeepFX is commonly used on the face, around the lips, for crows feet, the neck, upper chest, hands and arms. Ask your doctor if DeepFX is right for you Who can get a DeepFX treatment? DeepFX is safe for most people; however it shouldn't be used if you have taken Accutane in the past 12 months, have a history of keloid formation, have a history of poor wound healing, or demonstrate excessive or unusually prolonged erythematic, hyperpigmentation or hypo pigmentation upon laser test patching.

ActiveFX is the new way for facelifts

www.newhopelaser.com

There are a number of options for the treatment of fine lines and wrinkles, each with varied expense, recovery time and results. The following are the most common conventional treatments used today:

Nonprescription and Prescription Topicals: The simplest method of skin treatment is the topical application of wrinkle creams. Widely available everywhere from pharmacies to health food stores, these creams are beneficial for the skin, helping to moisturize and nourish it. However, their ability to reduce wrinkles below the skin's surface is, unfortunately, very limited. In addition, any visible improvement may disappear when use of the topical agent is discontinued. Topical application of prescription drugs, most notably synthetic derivatives of Vitamin A (retinoids), can provide better results in improving sun-damaged and aging skin. Clinical studies of topical retinoid formulations find them to be safe and effective in diminishing fine wrinkles. However, most retinoids are skin irritants and often produce skin reactions.

Dermabrasion and Microdermabrasion: Dermabrasion is a traditional skin-clearing procedure that has been widely used in practice since the early 1980s. Sometimes called surgical skin planing, it commonly involves removal or sanding of the skin with a rotary abrasive instrument. The abrasive or planing action evens out the skin, and a new layer of fresh skin replaces the abraded skin. This procedure is usually reserved for extensive acne scarring and deep wrinkles. Due to its mechanical nature, healing and recovery are lengthy, with the treated area remaining red and flushed for an extended period of time.

Microdermabrasion, in contrast, is a more recently introduced treatment. It is particularly popular among individuals with mild skin damage seeking to preserve and maintain a youthful complexion. Essentially, microdermabrasion involves brushing the face with sterile micro-particles to abrade or rub off the very top skin layer, then vacuuming the particles and dermabraded skin away. Experts believe the procedure works best to polish and soften fine lines and dull skin texture. In most cases, a minimum of four to five initial treatments, seven to ten days apart, are necessary to achieve good results.

Chemical Peels: Another major advance in warding off the ravages of age was the advent of the chemical peel. In this treatment, a chemical solution is applied to the skin, causing it to separate and peel off. The new, regenerated skin is usually smoother, tighter and displays a more even color than the old skin. Peels are beneficial for fine lines and minor skin imperfections, and are performed as a single procedure or in a series.

Laser Skin Resurfacing

The goal of laser skin resurfacing is simple: replace damaged skin with new, fresh skin. Techniques for skin resurfacing have made enormous advances, allowing nearly everyone to achieve close to flawless complexions. Many systems allow for light, moderate or deep laser resurfacing. The primary targets of laser skin resurfacing include:

• Fine lines and wrinkles of the face, especially around the upper lip, cheeks and forehead
• Loose eyelid skin
• Crow's feet around the eyes
• Pucker marks (smoker's lines) and frown lines
• Brown spots and splotchy, uneven skin tone
• Scars, especially acne scars
• Loose skin around the neck and jowls

How it Works

The gold standard of laser resurfacing systems, the UltraPulse® CO₂ laser delivers thousands of tiny laser pulses in a pattern over the skin. Each pulse heats a column of tissue eliminating pigment discolorations at the surface and creating a zone of heating deep in the tissue. Unique to the UltraPulse Encore, these zones of heating shrink collagen immediately*. The CO₂laser also offers the benefits of heating deeper layers of skin tissue, thereby stimulating collagen remodeling the skin further. Patients can select from a range of treatments depending on the needs of your skin and lifestyle.

What is ActiveFX “fractional” laser resurfacing?

ActiveFX is a fractional laser procedure performed in a single treatment with minimal patient downtime. During the procedure, a high-energy beam of laser light is used to smooth out lines, wrinkles and scars, remove brown spots and other irregularities. It also stimulates formation of new underlying collagen to continue improvement over time. With fractional laser treatment, only a fraction of the skin’s surface is treated by the laser, leaving small “bridges” of untouched skin. This technique makes the healing process much faster and enables you to get back to normal activities sooner.Download the informational ActiveFX/DeepFX brochure [pdf].

www.newhopelaser.com

What is DeepeFX?

DeepFX is a revolutionary fractional laser technology for aged, sun-damaged or scarred skin. The low-downtime procedure uses fractional CO2 laser microbeams to precisely target the deep dermal layers of the skin. This stimulates a cascade of healing responses that leads to tissue regeneration and new collagen formation throughout the entire treatment area. And because only a fraction of the skin is actually touched by the laser, healing time can be limited to just a few days.Download the informational ActiveFX/DeepFX brochure [pdf].

Is ActiveFX or DeepFX right for you?

ActiveFX or DeepFX is ideal for you if you:

• Have a busy lifestyle or cannot be away from work for a long time
• Want noticeable results with minimal downtime
• Want to treat dyschromia, fine lines, wrinkles and skin laxity*
• Want to reduce the appearance of scars, deep lines, and folds

What you can expect from ActiveFX or DeepFX

Most physicians perform the procedure in the office with a topical anesthetic cream that is applied 30-40 minutes before the ActiveFX or DeepFX procedure begins. There is little to no pain associated with the procedure – most patients say they feel warmth similar to sunburn. You can drive yourself home after the procedure. With a gentle washing and moisturizing regimen, your photodamaged skin will begin to flake off within 2 days. After about 3-5 days, your doctor will probably let you wear make-up. Pinkness should be gone in about a week.

ActiveFX and DeepFX benefits

ActiveFX treatment produces a dramatic effect on the skin:

• Reduces wrinkles and fine lines, and softens deeper frown lines
• Noticeably improves skin tone and texture
• Stimulates new collagen formation and plumps the skin

DeepFX is a revolutionary fractional laser technology for aged, sun-damaged or scarred skin. The low-downtime procedure uses fractional CO2 laser microbeams to precisely target the deep dermal layers of the skin. This stimulates a cascade of healing responses that leads to tissue regeneration and new collagen formation throughout the entire treatment area. And because only a fraction of the skin is actually touched by the laser, healing time can be limited to just a few days.

DeepFX treatment produces a dramatic effect on the skin:

• Improves wrinkles, scars and folds
• Noticeably improves skin tone and texture
• Stimulates new collagen formation and plumps the skin**

The results of ActiveFX of DeepFX laser treatment are long-term and, with proper sun protection, can persist for many years. Most effects of treatment become visible right away, whereas others – such as new collagen formation – build up gradually and become more evident over time. Therefore, most people look even better 3-5 months after the procedure.

View a video of the procedure:

• ActiveFX
• DeepFX™

* D. Railan, Skilmer Ablative treatment of photoaging 2005 Dermatol Therapy 18:227241
** Ross E, McKinlay J, Anderson R. Why Does Carbon Dioxide Laser Resurfacing Work? Archives of Dermatology, 135:444-454, 1999.

www.erasemyscars.com Fraxel - Amazing results

FRAXEL PRODUCTS | FRAXEL RE:PAIR® TREATMENT

THE FIRST OF ITS KIND—ABLATIVE EFFICACY WITH FAST RECOVERY

The Fraxel re:pair laser is the only CO₂ laser on the market that delivers the efficacy of conventional bulk ablative lasers—without the prolonged downtime, risks or complications.

Though it’s the newest product in the Fraxel family, the Fraxel re:pair laser has already started revolutionizing the industry. It delivers dramatic results in a single treatment—without weeks of downtime. It’s also a compelling option for patients who want remarkable results without surgery.

Advanced technology—
CO₂ resurfacing meets fractional photothermolysis
Unlike traditional CO₂ lasers, which perform a thin, general ablation of the entire skin surface, the Fraxel re:pair laser uses microscopic treatment zones (MTZs) to ablate tissue deep within the dermis. Even though the laser does not protect the stratum corneum, the unique Fraxel technology spares much of the surrounding healthy tissue in the demis. This results in immediate coagulation, tissue shrinkage and skin tightening.

The Fraxel re:pair is a CO₂ laser which combines the efficacy of ablative skin resurfacing with safety of fractional delivery. See how the Fraxel re:pair laser compares to the conventional CO₂ laser:

	Fraxel re:pair Laser	Conventional CO2 Laser
Wavelength	10,600 nm	10,600 nm
Power	40-watt CO2 source from Coherent Inc.	60 watts
Modality	Fractional, ablative, deep dermal volumetric removal	100% coverage with ablative or pseudo-fractional ablative removal
Indications treated	Rhytides Pigmented lesions Moderate to severe wrinkles and furrows in lax skin Fine lines Textural irregularities Vascular dyschromia	Rhytides Pigmentation Moderate to severe wrinkles Photodamaged skin
Wound Care	Up to 2 days	4-7 days
Downtime	1 week	2 1/2 - 4 weeks
Dermal ablation?	Yes	No

Video about the revolutionary Fraxel re:pair

Powerful and versatile—Treat many indications with a single system
Thanks to the unique fractional technology, the Fraxel re:pair system can be used for both superficial skin conditions and deeper damage. And since you select the energy level, treatment level and number of passes, you can tailor each treatment to your patient’s needs. Key features of the Fraxel re:pair system:

• Treats up to 4 times faster than any other ablative fractional device. Our exclusive Intelligent Optical Tracking^® system adjusts to hand speed and ensures treatment is uniform and fast. A typical full-face treatment takes just 30-40 minutes, which enables you to treat more patients and maximize ROI. The continuous-motion system, meanwhile, delivers higher coverage and better, longer-lasting results.

• Delivers the broadest range of fractional ablative treatment parameters. The intuitive, touch-screen interface guides you through the parameter selection—superficial to deep (5-70 mJ) and mild to aggressive (5-70% coverage). The system optimizes the microscopic spot size for each energy level, maximizing penetration while minimizing bulk heating in surrounding tissue.

• The only fractional ablative device with FDA clearance for vascular dyschromia. In addition, Fraxel re:pair treatment is cleared for ablation and resurfacing of soft tissue, rhytides, pigmented lesions, wrinkles, fine lines, furrows and textural irregularities.

• Ease of use. Fraxel re:pair is a single-handed, single-operator treatment. Plus, it is the only fractional ablative device with built-in smoke evacuation, minimizing plume and smell—and eliminating the need for staff support.

• Safe choice. The unique Fraxel scanning technology, combined with the precision and effectiveness of a CO₂ laser source, reduces the degree of risk for lines of demarcation or long-term side effects compared with traditional CO₂ lasers.

• Clinically proven technology. The Fraxel re:pair laser is backed by extensive research with more than three years of clinical follow-up with over 2,500 patients and 5,000 histologies.

Fraxel photos of scars and sun damaged skin at www.erasemyscars.com

please check out the new photos on www.erasemyscars.com

the pictures are actual fraxel patients who underwent fraxel therapy for their scar and sun damaged skin.

truly amazing results from the newest laser technology.

enjoy!!!!!

Fraxel repairs sun damaged skin. Fraxel also repairs scars

Click on www.erasemyscars.com for a great photo set of a patient with Moh's surgery scar that was successfully lasered with Fraxel technology

www.erasemyscars.com for the best in Fraxel and Scar treatment

What it is

Fraxel is a revolutionary therapy which can eliminate the old skin cells, making it fresh, shiny and healthy! Fraxel can offer the newest and most advanced microlaser therapeutic rehabilitation, which activates the deepest skin cells naturally, so as the skin will revert to its previous appearance. You will look and feel younger, as chaps, wrinkles, birthmarks, acne scars, melasmas and maculas are immediately disappearing from face, hands and neck, without side-effects and a long recovering time.

How it works

Contrary to the common lasers that are applied only on the face, Fraxel laser is applied as well as on the neck, the neckline, the hands and the scars wherever on body.

 

This is achieved, as Fraxel laser can heal accurately thousands of microscopic skin areas using laser beams, which penetrate under the skin surface to eradicate the affected cells. It is the only laser which can safely reach the deepest skin levels without destroying the protective skin layers. What is achieved is the natural activation of the collagen, without any fear of implications and the burning annoyances. The fractional laser treatment stimulates the natural healing procedure of the organism itself, which recreates the destroyed skin, making it healthy and young.
The fractional laser, has the ability to aim 5 to 50% of the skin surface, leaving the rest 50 to 95% of the skin surface available to heal the area treated quickly. The exact precise of the Fraxel treatment makes the therapy safe, not only on the face, but also on sensitive areas as the neck, chest and the hands.

        

Each person's skin has different needs, depending on his daily habits, the medical history and other parameters. For these reasons, doctor savas Konstantoglou develops a plan therapy adapted to your individual skin needs.

The results

You can expect two levels of results: the immediate and the progressive. After the completion of the first therapy, your skin will be shinier and with a better complexion. The enhancement of your skin will continue and will have stunning results, as the desired results will be visible during the next 3-6 months, as the deeper skin layers continue healing.

Depending on the type and the problem of your skin and having in mind your social and professional obligations, you can decide how you would like to achieve the stunning results of the Fraxel Laser therapy, always according to the doctor Konstantoglou's suggestions. An aggressive treatment demands less sessions but could need a few-day «retirement» from your daily obligations. A less aggressive treatment has the same results without stopping your daily activities. It needs, however, more sessions. For some skin types and some dermal cases there is an indication for milder or fewer sessions. Fraxel therapy is specially designed to enable your doctor having full control, based on your personal needs.

        

See more enhancement cases in our brochure.

Amazing hand rejuvenation using ActiveFX Fraxel at www.scarlasers.com

65 year old patient treated with Fraxel.  Four week after treatment photo.

WWW.NEWHOPELASER.COM

scars erased at www.newhopelaser.com

This is a 75 year old lady who had Moh's surgery.  Her scar was resurfaced 2 months after the procedure.  The "after" photo was taken one month after the resurfacing with fractal laser.

Laser Scars Away at www.dermcard.com

Fraxel Review.   www.erasemyscar.com

Summary:

Fraxel is a skin laser treatment for men and women that is found at many spas and clinics all over the United States. The draw to this procedure is that it is supposed to be non-invasive, so there should be no downtime. This treatment is made for anyone who has aggressive facial wrinkles, intense sun damage, obvious dark spots, hyperpigmentation, acne scarring, crow’s feet, or other scarring. This is supposed to revitalize your skin and bring back your youthful radiance. There are four different choices in these treatments, which are a refine treatment, a restore treatment, a repair treatment, and the Skin Ecology System. The refine treatment is used to prevent skin damage, the restore treatment is for medium to more serious sun damage, and the repair treatment is for intense skin conditions and excessive sun damage. The Skin Ecology System is designed for care post-treatment. There are pictures found on the website, and they offer customer reviews and stories on the website as well. The website does provide further information about what your skin looks like and how it can potentially be damaged in your 20s, 30s, 40s, and 50s.

Product Details:

This is an advanced anti aging skin care treatment, which does need to be administered by a professional. There is no downtime needed, and you do have to find a doctor in your area who can administer the treatment to you. There is a doctor locator tool on the website. The use of these treatments is for aggressive wrinkles, sun damage, scarring, or hyperpigmentation. There is no information about a money back guarantee since it is something that is administered in a spa or clinical environment.

Fraxel Pros:

• This is a professional procedure, and it will be administered by a physician.
• There are patient reviews and stories, as well as pictures of results from the treatment.

Fraxel Cons:

• These are professional treatments, so you cannot do them at home.
• They also do not offer any type of refund if you are dissatisfied with your procedure.
• There is little information about potential side effects from undergoing the treatment.
• There is also no price for the treatment listed on the website because you do have to go through your own doctor.

Overall Impression

Some individuals may find that this is a great laser skin treatment for them because it offers quick results for excessive wrinkling, sun damage, or sagging skin. However, it is going to be much more expensive than any at-home treatment. If you are looking for an affordable and advanced skin care product to take home with you, that it would be best to keep looking for a quality anti aging product that meets your needs. For instance, look for ingredients like Argireline and Collagen to apply topically to your skin at home, which will provide a much more affordable option as opposed to undergoing a professional spa treatment to resurface your skin. This treatment does not have any downtime, but it still will be pretty costly and involve time in going to a clinic or spa to have it administered.

Laser Scars Away at www.scarlasers.com

Laser Resurfacing In dermatology, lasers adds another dimension for the treatment of skin diseases. Laser resurfacing can improve cosmetic flaws, such as wrinkles, scars, and sun damage, and is the latest scientific breakthrough in skin rejuvenation. Lasers (short for Light Amplification by Stimulated Emission of Radiation) work by producing an intense beam of light that travels in one direction. This beam can gently ablate skin tissue to improve wrinkles, scars or blemishes. In addition, lasers can also be used to destroy visible blood vessels or to cut skin tissue. Using a laser hand piece, undesired skin cells and wrinkles disappear and are replaced by fresh skin cells. One of the laser's most significant advantages over traditional techniques for skin resurfacing is that treatment is relatively bloodless. This procedure also offers increased degree of precision and safety in treating delicate areas. It is important to understand the limitations of skin resurfacing using lasers. The laser is not a substitute for a facelift, nor can the procedure eliminate excessive skin. However, by tightening loose skin, laser resurfacing can improve certain folds and creases. More importantly, laser resurfacing offers an alternative to traditional resurfacing (dermabrasion) and can also work well in conjunction with other cosmetic skin procedures such as chemical peels. Laser Types There are two types of lasers used for laser resurfacing, the erbium:YAG and the CO2 (carbon dioxide) lasers. The procedure is performed on an outpatient basis, using local anesthesia in combination with orally- or intravenously-administered sedative medications. Laser resurfacing is often used to treat facial wrinkles. Wrinkles around the eyes, mouth or forehead may be treated individually, or full-face laser ablation may be performed. In general a partial-face laser ablation takes 30-45 minutes and the full-face treatment takes 1-1/2 to 2 hours. Following laser resurfacing, a sterile dressing is applied to the treatment sites for 24 hours. The patient then cleans the areas three times a day with saline solution. An ointment such as Vaseline or Aquaphor is then applied. Strict wound care is intended to prevent scab formation and facilitate healthy wound healing. Typically, the areas heal in 10-21 days. Once the areas have healed, makeup may be worn to camouflage the pink to red color that is generally seen after laser skin resurfacing. Most dermatologist recommend oil-free make-ups as well as green-based foundation since they neutralize the red color. The redness in the laser-treated sites generally fades in two to three months but may take as long as six months to completely disappear. People with blonde or red hair may have a prolonged period of recovery. Conversely, patients with darker skin tones have a greater risk of healing with darker pigmentation (referred to as post-inflammatory hyperpigmentation). This may be minimized by use of a bleaching agent before laser skin resurfacing as well as continued use of this agent after healing. Laser resurfacing is a relatively safe procedure. However, as with any other medical procedure, one should be aware of complications that may arise. Milia, or small white bumps, may appear in the laser-treated areas during healing. These lesions may be removed by gentle cleansing with a washcloth and do not scar. As mentioned above, increased pigmentation, and rarely decreased skin pigmentation, may result in the laser-treated areas. Lastly, reappearance of a cold sore may occur, especially after laser skin resurfacing around the mouth. This can be prevented by pre treatment with antiviral medication a day prior to the procedure. The final result of laser resurfacing can take up to six months to fully appear. These results are long-lasting, but not permanent. Some people will require re-treatments over the years. Protection from the sun and the institution of a good skin-care regime can help in maintaining a rejuvenated look. Laser Resurfacing Cost The cost of laser resurfacing is in the $2500 range.

Scarring - treated with new laser from Fraxel

How scarring occurs (www.erasemyscar.com)

Hypertrophic scarring one year after Road rashon the left, and the original wound on the right.

A scar is a natural part of the healing process. Skin scars occur when the deep, thick layer of skin (the dermis) is damaged. The worse the damage is, the worse the scar will be. Most skin scars are flat, pale and leave a trace of the original injury that caused them. The redness that often follows an injury to the skin is not a scar, and is generally not permanent. The time it takes for it to go away may, however, range from a few days to, in some serious and rare cases, a few years. Various treatments can speed up the process in serious cases. Scars form differently based on the location of the injury on the body and the age of the person who was injured. To mend the damage, the body has to lay down new collagen fibers (a naturally occurring protein that is produced by the body by fibroblasts). In wounded tissue these fibers are over expressed with collagen, but not so in non wounded tissue. Stable forms of topical vitamin C have been shown to improve collagen formation^[2]. Recent research has also implicated the gene product osteopontin in scarring and University of Bristol have developed a gel that inhibits the process^[3][4].

An injury does not become a scar until the wound has completely healed. And because the wounded body tissue over expresses collagen on the fibers and cannot re-build, the new tissue will have a different texture and quality than the surrounding normal tissue. This collagen producing process results in a fortuna scar.

Transforming Growth Factors (TGF) play a critical role in scar development and current research is investigating the manipulation of these TGFs for drug development to prevent scarring from the emergency adult wound healing process. As well, a recent American study implicated the protein Ribosomal s6 kinase (RSK) in the formation of scar tissue and found that the introduction of a chemical to counteract RSK could halt the formation of Cirrhosis. This treatment also has the potential to reduce or even prevent altogether other types of scarring.^[5]

[edit]Abnormal scars

Two types of scars are the result of the body overproducing collagen, which causes the scar to be raised above the surrounding skin. Hypertrophic scars take the form of a red raised lump on the skin, but do not grow beyond the boundaries of the original wound, and they often improve in appearance after a few years. Keloid scars are a more serious form of scarring, because they can carry on growing indefinitely into a large, tumorous (although benign) growth. Keloid scars can occur on anyone, but they are most common in dark-skinned people.^[6] Keloid scars can be caused by surgery, an accident, by acne or, sometimes, from body piercings. In some people, keloid scars form spontaneously.

Although they can be a cosmetic problem, keloid scars are only inert masses of collagen and therefore completely harmless and non-cancerous. However, they can be itchy or painful in some individuals. They tend to be most common on theshoulders and chest.

Alternately, a scar can take the form of a sunken recess in the skin, which has a pitted appearance. These are caused when underlying structures supporting the skin, such as fat or muscle, are lost. This type of scarring is commonly associated with acne, but can be caused by chickenpox, surgery or an accident.

Scars can also take the form of stretched skin. These are called striae and are caused when the skin is stretched rapidly (for instance during pregnancy, significant weight gain or adolescent growth spurts), or when skin is put under tension during the healing process, (usually near joints). This type of scar usually improves in appearance after a few years.

[edit]Treatments for skin scars

Currently no scar can be completely removed,^[7] although healing in embryos and some animals even after extended injuries can occur without scarring.^[8] Therefore all treatments will leave a trace, but a number of approaches have been tried with silicon gel sheeting and steroid injections having the most widely accepted role in general scar treatment.^[9]

In historical sequence, corticosteroid therapy by injection into the scars was introduced in the 1960s, from the early 1970s pressure garment therapy was introduced for widespread burn scars, and silicone gel sheets from the 1980s.^[10]

[edit]Needling

Needling is an inexpensive process where the scarred area is continuously needled to promote collagen formation. Once needled the area is allowed to fully heal, and needled again if required depending on the intensity of the scar. Scarring needles and needling rollers are available for home use; however, needling should not be done on parts of the face or areas where major nerves are located without professional medical supervision. Needling at home must also be done in line with hygienic and sterilization requirements.

[edit]Pressure garments

Pressure garments should be used only under supervision by a medical professional. They are most often used for burn scars that cover a large area, this treatment is only effective on recent scars.

Pressure garments are usually custom-made from elastic materials, and fit tightly around the scarring. They work best when they are worn 24 hours a day for six to twelve months.

It is believed that they work by applying constant pressure to surface blood vessels and eventually causing scars to flatten and become softer.

[edit]Steroids

A long term course of steroid injections under medical supervision, into the scar may help flatten and soften the appearance of keloid or hypertrophic scars.

The steroid is injected into the scar itself; since very little is absorbed into the blood stream, side effects of this treatment are minor. However, it does cause thinning of the scar tissue so it does carry risks when injected into scars caused by operations into ruptured tendons. This treatment is repeated at 4-6 week intervals.

Topical steroids are ineffective.^[11]

[edit]Silicone sheeting and gel

Silicone scar treatments improve scar appearance and are often used to prevent and treat hypertrophic scarring. The exact mechanism of action is unknown though some studies suggest a manipulation of local ionic charges or a decrease in production of “pro-inflammatory” substances like TGFβ2.^[12]

Dimethicone silicone gel appears to be as effective as silicone sheeting in improving scar appearance.^[13]

[edit]Dermabrasion

Dermabrasion involves the removal of the surface of the skin with specialist equipment and usually involves a general anaesthetic. It is useful with raised scars, but is less effective when the scar is sunken below the surrounding skin.

[edit]Collagen injections

Collagen injections can be used to raise sunken scars to the level of surrounding skin. Its effects are however temporary, and it needs to be regularly repeated. There is also a risk in some people of an allergic reaction.

[edit]Laser surgery & resurfacing

The use of lasers on scars is a new form of treatment. Several cosmetic lasers have been FDA approved for the treatment of acne scars by using laser resurfacing techniques. Vascular lasers have been proven to greatly reduce the redness of most scars 6–10 weeks after the initial treatment. It has been theorized that removing layers of skin with a carbon dioxide or Erbium:YAG laser may help flatten scars.^{[citation needed]}

Scarring caused by acne (left), and photo 1 day after scar revision surgery. Area around sutures is still swollen from surgery

[edit]Surgery

Surgical excision of hypertrophic or keloid scars is often associated to other methods such as pressotherapy or silicone gel sheeting. Lone excision of keloid scars however shows a high recurrence rate close to 45%. A clinical study is currently ongoing to assess the benefits of a treatment combining surgery and laser-assisted healing in hypertrophic or keloid scars.

[edit]Radiotherapy

Low-dose, superficial radiotherapy, is used to prevent re-occurrence of severe keloid and hypertrophic scarring. It is usually effective, but only used in extreme cases due to the risk of long-term side effects.

[edit]Natural remedies

Research shows the use of vitamin E and onion extract as a treatment for scars is ineffective. Vitamin E causes contact dermatitis in up to 33% of users and in some cases it may worsen scar appearance.^[11][14] Vitamin C normalizes collagen production and encourages the production of an organized, healthy collagen framework ^[15] which improves scar appearance. Vitamin C and some of its esters also fade the dark pigment associated with some scars.^[2]

[edit]Intentional scarring

The permanence of scarring has led to its intentional use as a form of body art within some cultures and subcultures (see scarification). These forms of ritual and non-ritual scarring practices can be found in many groups and cultures around the world.