I am getting lots of redness which is lasting 6 weeks and longer.
Checkerboard where I did Deepfx. Any suggestions about how to avoid or help
it fade faster. It fades to the point where it can be covered up within 2 weeks,
but still would like to know any tricks you have come up with.

Also for men, they don't use coverup makeup! - so this is more of a problem.

Finally, any tips for better visualization of where you have treated with
DeepFx?  Hard to see pulse patterns and with blood and serum oozing, hard to tell exactly where you have been. Any tips???  Are you all having the same problems?

I do Deepfx at 17.5 j with Density 3
I do ActiveFx over deepfx at density 1 energy 70 (to blend color).
I try to place pulse patterns right next to each other without leaving
spaces. I do Activefx around the eyes (not deep)

JEE

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I think your settings are pretty reasonable for what you are doing. The
question for me then would be what product or treatment can you do to
accelerate the healing? Or is it simply the patient profile that would be
more likely to stay red. I have had a few stay red up to 3 months, and
several go about 4-6 weeks, but fading gradually over that time. The
patients that do this tend to have more fair skin to start with, but I also had an
FST4 that stayed red for 6 weeks, so go figure. Sun exposure is obvious but it
seems like people don't want to follow that one and it can keep them red much
longer if they dont comply. If it comes down to product, we have done well
with SkinMedica Ceramide Treatment Cream. Not a definitive answer but hope it starts some conversation.

Brian

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This is an indication that you’ve done a deep treatment. Think back to your experience with totally ablative co2 – deeper treatments are pinker for longer. You may want to adjust your parameters to decrease your fluence.

 

Tom

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Agree with all, but we also use a series of high intensity red and yellow led treatments afterwards which definetly helps. Some redness post Co2 is expected though and this happens even with the lowest treatment settings.

 

Mtich

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Thats a great point - who is using LED and what is your opinion? I have heard
both sides but only a small survey. Any downside to LED?

 

Brian

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Any long term pigment issues (hypo/hyper) with ST 4? Have you done darker ST
with the fractional CO2?

You are right on with the sun issue. People will use every crappy cream in the
book or stand on their head for the first 24hrs, but sun avoidance is the
uncompliant patients specialty.

Greg

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I have done acne scar revision on a few FST4 and 5 with ONLY DeepFX and have
had no pigmentation issues past the 5-7 day healing time. If they are prone
to PIH based on history or my gut feeling, I will pre-treat with Tri-luma for
a few weeks prior to the procedure, but it seems like the trick is to heal
them as fast as posible to avoid the lingering inflammation that wakes up the
melanocytes. I should also add that I have done test spots on those FST 4 and
5 patients before treating also and all of them so far have passed the test.

We have gone so far as to make a 'contract' out of the bullet points on pre
and post care (like sun exposure) and they have to sign it that they fully
agree and understand before we treat. This is in addition to the actual
consent. Minimal liability protection to be sure, but it puts it in writing
in front of them one more time.

Brian