LASER RESURFACING: FRACTIONAL ERBIUM YAG LASER RESURFACING IN BIRMINGHAM

MULTI AWARD WINNING LUXURY AESTHETIC CLINIC

PROCEDURE TIME

30-90 minutes

LASTS FOR

Permanent with yearly maintenance

COMMON SIDE EFFECTS

Swelling, redness, peeling

PRICE

From £750

DONE BY

Advanced Skin Therapist or Advanced GMC Registered Medical Doctor

CONCERNS

Pigmentation, redness, rosacea, broken capillaries,freckles,sun damage

NUMBER OF SESSIONS

1-2

BONUS

Free Complimentary Mailbox Parking
Additional privacy facility available upon request
24/7 access to Royal College of Emergency Medicine doctor for all post care emergencies

Add Ons

BBL/IPL

About:

The world’s only hybrid fractional laser that allows for intense collagen stimulation with skin tightening as well as resurfacing of the skin texture, pores, scars and/or pigmentation in a single treatment modality. Powerful enough that 1-2 treatments is what is usually required. It is safe for all skin types, all year round. The parameters can be tweaked completely bespoke to your personal needs ie) more skin tightening or more resurfacing or both! Physicians have used lasers for many years. Based upon the principles of selective fractionated photothermolysis, Halo’s use of 1470 nm laser wavelength selectively targets dermal tissue containing water and haemoglobin. It does not cause the water in the tissue to vaporize (ablate) but rather the laser energy heats the tissue in a controlled manner. This creates microscopic columns ofwounded tissue that stimulate neocollagenesis, a process in which new collagen is produced by the body. The sequential use of 2940 nm wavelength selectively targets epidermis containing water and haemoglobin to precisely vaporize (ablate) tissue in a controlled manner. This hybrid use addresses both non-ablative and ablative delivery modalities.

The Halo fractional treatment creates outcomes based on the aggressiveness of the treatment taking into account your skin concerns, the health of your skin and your individual healing ability. Due to this, patient response can vary after a Halo fractional treatment. Erythema (redness) and possibly oedema (swelling) are the desired responses within a few minutes after the completion of the procedure. The degree of redness and length of healing time will increase with the depth and coverage of the procedure.

In a 2018 study, of 29 women receiving 2 Halo treatments 6 weeks apart (Waibel et al 2019), independent photographic assessment showed a significant skin improvement in 80% of cases. A survey showed 100% of the study participants were satisfied with the treatment.

Procedure:

All skin requires preparation for any form of ablative laser therapy as the treatment is essentially vaporizing parts of the skin. The length of pre-treatment skin prep will be determined by your doctor or therapist at your initial consultation. It is imperative that you follow the prescribed skincare routine given to you by the doctor for your individual treatment indication and face/body location and stay out of the sun with no active tan for at least 2 weeks prior.

Before the procedure, you will need to arrive at least 45 minutes in advance so we can apply a 30% topical local anaesthetic (the strongest form of topical anaesthetic available). This is a special formulation compounded in a private laboratory just for our clinic.

The skin is cleansed before this application and will be cleansed, sterilised and degreased once again to take the numbing cream off prior to the treatment commencing.

Baseline photos and/or videos will be taken before and after the procedure for medical records.

Light from a laser can be harmful to eyes and wearing special safety eyewear is necessary at all times during the procedure.

The 2940 nm Erbium YAG laser wavelength of Halo Pro is delivered through a focused scanning device that precisely removes channels of tissue by vaporizing (heating to high temperature) the water within tissue. The device has the ability to create micro channels while leaving the area around the channels intact.

The 1470 nm laser wavelength of Halo is delivered through a scanning device that creates microscopic columns of wounded tissue that stimulates new collagen. The Halo Pro fractional laser treatment may produce pinpoint bleeding in the area of the channels. This event usually subsides in a few minutes to a few hours. More uncommon, it can persist up to 24 hours.

The sensation, while being treated, may feel like pin pricks, bursts of heat or similar to a sunburn.

After the procedure, laser treatment may produce scanning patterns visible on the skin. This event usually fades while in the healing phase.

The eye shields will be removed and post-procedure skin treatment will commence.

The procedure necessitates a strict post treatment skincare regime that must be followed.

Immediately after treatment, your clinician may apply an occlusive barrier cream and/or a face mask. The cream should be reapplied as needed to keep the skin moist.

 

Results:

The resurfacing results usually start to become visible around day 7-10. The skin tightening and plumping from the collagen stimulation is usually first noticeable around day 14 and continues to improve over the coming months.

If it is scarring and texture that you are trying to improve, the result achieved in the existing scar tissue is considered a permanent improvement.

All results are best maintained with a good skincare regime, adequate sun protection and health lifestyle practices.

How Many Treatments Do I Need?

We usually recommend 1-2 deeper field treatments followed by yearly maintenance for the collagen stimulation and glow. For scarring you may need more treatments initially but the results are considered permanent improvements.

All results are best maintained with a good skincare regime, adequate sun protection and health lifestyle practices.

If you choose gentler settings for less downtime, then more treatments may be required initially.

What’s the difference between Fraxel, Clear and Brilliant and Halo?

The HALO laser is more powerful than the Fraxel and Clear and Brilliant. Fraxel and Clear and Brilliant are both older technologies. Most dermatologists who have had both, have replaced their FRAXEL device with HALO.

HALO utilises two powerful wavelengths in one treatment for more dramatic results in fewer sessions. The downtime, discomfort and patient satisfaction has all been rated better than Fraxel as well.

Clear and Brilliant although has less downtime, it is non-ablative alone (HALO is ablative and non ablative) and does not have the texture-improving or resurfacing element of the HALO.

Multiple sessions would be required of Clear and Brilliant to achieve the results of 1 HALO. The beauty of HALO is the parameters can be tweaked depending on the amount of downtime you can afford, your skin type etc giving full tuneability for a bespoke procedure.

Pre-Care:

  • No alcohol, ibuprofen or aspirin at least 48hrs prior. These thin the blood, increasing the risk of bruising and prolonged swelling
  • You must come at least 45 minutes earlier for deep numbing cream to be applied. Paracetamol can be taken 500mg x2 at this time (optional). If BBL is being done at the same time, numbing will be applied after the BBL treatment so is included in the treatment time.
  • You must not have tanned for at least 2 weeks before or have any active tan on the day of the treatment in the area being treated
  • Stop all topical steroids, actives, acids, retinoids, AHAS, BHAS 5 days before
  • If you have previously suffered from facial cold sores, there is a risk that this treatment could contribute to a recurrence.
  • If you are acne-prone, you will require 5 days of doxycycline post-procedure to reduce the risk of a temporary breakout
  • If a more intense treatment is being conducted, antivirals and antibiotics may be prescribed
  • Skin care or treatment programs may be used before and after laser skin treatments in order to enhance the results or minimise the risk of side effects – if required, the clinician will discuss this with you at your initial consultation.
  • It is your responsibility to ensure you disclose all medications, prescription and over the counter, herbal or recreational drugs in advance in our pre-treatment medical questionnaire.

Contraindications

  • Pregnant or breastfeeding
  • Skin cancer in area being treated
  • Open wounds
  • Active acne
  • Patients who are intolerant or allergic to anaesthetic based agents
  • Patients with active excoriations, open wounds or active inflammatory skin conditions in the area being treated
  • Patients with connective tissue disease
  • Patients who are immunocompromised or compromised healing
  • Patients who have used isotretinoin (e.g. Accutane, Sotret, Claravis, Amnesteem) within the past year

Cautions:

  • Photosensitizers
  • Herpes simplex virus or cold sores
  • Patients with propensity for keloid formations
  • Patients who are on long-standing systemic steroids (e.g. Prednisone, Dexamethasone)
  • Patients with a medical condition that may affect wound healing
  • Patients on anti-coagulants
  • Patients who smoke may experience delayed healing and decreased benefit.

POSSIBLE SIDE EFFECTS & RISKS

Although the majority of patients do not experience complications, you should be aware of all of them in order to make an informed decision. Some are more expected side effects as part of the natural healing and recovery process such as swelling, redness, feeling of heat, bruising and peeling skin. It is imperative you follow the strict aftercare routine prescribed to you – this is the key determinant of your recovery.

  • Swelling & Heat Sensation – This is to be expected and is variable from significant to mild but usually settles in 48 hrs to 5 days.
  • Oedema (swelling) of the skin may occur and can be minimized by keeping the area upright.
  • Urticaria (itching) often times occurs as the old skin is shed and the new skin is being formed.
  • Bruising – Bruises and rarely large bruises called haematomas may form in and around areas that have been injected for anaesthetic purposes. This can also rarely occur over areas of deeper resurfacing.
  • Infection ‑ Although infection following laser skin treatment is unusual, bacterial, fungal, viral and parasitic infections can occur. Herpes simplex virus infections around the mouth or other areas of the face can occur following a laser treatment. This applies to both individuals with a past history of Herpes simplex virus infections and individuals with no known history of Herpes simplex virus infections in the mouth area. Specific medications may be prescribed and taken both prior to and following the laser treatment procedure in order to suppress an infection from this virus. Should any type of skin infection occur, additional treatment may be necessary.
  • Scarring ‑ Although normal healing after the procedure is expected, abnormal scars may occur both in the skin and deeper tissues. In rare cases, keloid scars may result. Scars may be unattractive and of different color than the surrounding skin. Additional treatments may be needed to treat scarring.
  • Burns & Blisters ‑ Laser energy can produce burns. Burns are rare yet represent the effect of heat produced within the tissues by laser energy. Additional treatment may be necessary to treat laser burns.
  • Colour Change ‑ Laser treatments may potentially change the natural color of your skin. Skin redness can last 2 weeks, but can last weeks to months. There is the possibility of irregular color variations within the skin including areas that are both lighter and darker (hypopigmentation and hyperpigmentation). A line of demarcation between normal skin and skin treated with lasers can rarely occur. Rarely, colour changes can develop much later after treatment as a delayed side-effect. PIH or post inflammatory hyperpigmentation (browning) and hypopigmentation (lightening) have been noted with laser procedures. These conditions usually resolve within 2-6 months. Permanent colour change is a rare risk. Vigilant care must be taken to avoid sun exposure (tanning beds included) before and after the treatment to reduce the risk of colour change. After the skin has gone through its healing phase and is intact, sunscreen and / or sun block should be applied when sun exposure is necessary.

 

  • Flare of underlying skin conditions, cysts, milia and/or acne eruption – Rarely underlying skin conditions such as melasma or eczema can flare after any laser treatment. Additionally, due to the need of using heavier, skin protecting products constantly for the initial recovery period, it is not uncommon to develop temporary clogged pores which can develop in to cysts or milia or sometimes an acne-like eruption due to the heaviness of the product ingredients. This will be reviewed and will eventually subside.The HALO laser itself can trigger a breakout. Additional antibiotics may be prescribed as part of the treatment if need be.
  • Dry, tight, irritated and/or itchy skin – As the new skin heals, it is normal to feel dry, tight or develop sensitive, sensitized or itchy skin and is greatly reduced by following the aftercare instructions and ensuring the skin is kept moist and covered with the given creams, sprays and/or balms during the recovery period
  • Loss of Hair In Treated Area – Although this laser does not target hair, in certain instances of deeper resurfacing, the hair follicles may be damaged and the hair may not grow back in these areas
  • Roaccutane (Isotretinoin) or its generic forms ‑ Roaccutane is a prescription medication used to treat certain skin diseases. This medication may impair the ability of skin to heal following treatments or surgery for a variable amount of time, even after the patient has ceased taking it. Individuals who have taken the medication must inform their doctor in advance and allow at least 12 months post usage before considering this treatment.
  • Skin Tissue Pathology ‑ Laser energy directed at skin lesions may potentially vaporize the lesion. Laboratory examination of the tissue specimen may not be possible.
  • Visible Skin Patterns ‑ Laser treatment procedures may produce visible patterns within the skin. The occurrence of this is not predictable.
  • Damaged Skin ‑ Skin that has been previously treated with chemical peels or dermabrasion, or damaged by bums, electrolysis (hair removal treatments), or radiation therapy may heal abnormally or more slowly following treatment by lasers or other surgical techniques. The occurrence of this is not predictable. Additional treatments may be necessary.
  • Unsatisfactory Result ‑ As with any medical treatment, individuals will respond differently and a guarantee of any particular outcome is not provided.
  • Pain – During the healing period, you may experience some discomfort, especially initially once the anaesthetic wears off.
  • Vision Damage or Blindness – This is extremely rare and can only occur if the laser beam hits the eye however we use intraocular shields and/or fully shielded eye protection to minimize the chance of this happening.
  • Damage to Teeth – This is exceedingly rare and can only occur if the laser beam hits the tooth.
  • Allergic Reactions ‑ In rare cases, local allergies to tape, preservatives used in cosmetics or topical preparations have been reported. Systemic reactions which are more serious may result from drugs used during medical procedures and prescription medicines. Allergic reactions may require additional treatment.
  • Pigment removal – If you have any tattoos including microblading, tattooed eyebrows or lip blush, the laser may remove this as it vaporizes the skin. If this is directly in an area that is being treated, that is unavoidable however even if it isn’t, all necessary steps are taken to minimize the risk of effecting these areas but no guarantee can be made.
  • Unknown Risks ‑ There is the possibility that additional risk factors of laser skin treatments may be discovered.
  • Local Anaesthesia – All anaesthetics involve risk. There is the possibility of allergies, anaphylaxis, complications, injury, and even death from all forms of anaesthesia. There is also the possibility of skin reactions such as contact dermatitis to the anaesthetic agent

Aftercare

  • No sun exposure or tanning beds or heat for next 48hrs including no hot showers/steam rooms/jacuzzi/saunas
  • Avoid strenuous exercise and sweating until after skin has healed.
  • Any laser/lights/electrolysis/surgical procedures or injectables should be discussed with the treating practitioner in advance and only booked after their advice on minimum interval
  • No ibuprofen or aspirin or any blood thinning medication for 48hrs – please ensure you disclose all medications prescription and over the counter, herbal or recreational drugs in advance
  • Stop all topical steroids, actives, acids, retinoids, AHAS, BHAS for at least 5 days post procedure or until the skin has fully healed.
  • Only use the recommended and approved skincare discussed with your practitioner for the following 2 weeks which would include a gentle cleanser, gentle moisturiser and SPF every 2hrs during daylight hours
  • If any irritation or side effects is present after day 5 please notify your practitioner and hold off commencing any actives/acids on your skin until advised by the practitioner
  • Direct and intentional sun exposure should be avoided for 2 weeks post treatment. Daily use of sun block immediately after treatment, and for at least the next 30 days, is recommended to avoid pigment related complications.
  • Patients should avoid the use of exfoliating skin care brushes/scrubs and any other form of manual exfoliation of skin for at least 2 weeks after the treatment.
  • Cleanse the skin two times a day with plain, lukewarm water and a gentle cleanser; e.g. Cetaphil, beginning the morning after the treatment. Use your hands to gently apply the cleanser and water and finish by patting dry with a soft cloth.  DO NOT rub, scrub, use an exfoliant or a skin care brush e.g. Clarisonic in the treated area. Doing so could result in scarring and pigmentation complicate
  • Moisturizer should be applied generously over treated area and reapplied whenever your skin feels dry. For severe dryness, add Aquaphor or vaseline on top of your moisturizer or mix it in with it.
  • Peeling and flaking generally occur within 24 hours post treatment and should be allowed to come off naturally. DO NOT PICK, RUB, OR FORCE OFF ANY SKIN DURING THE HEALING PROCESS, THIS COULD RESULT IN SCARRING, PIGMENTATION COMPLICATIONS AND INFECTION!  Gently washing the skin more frequently will help to promote the peeling process.
  • Sunscreen is a MUST and should be used daily beginning the day of treatment and used vigilantly for up to 3 months post procedure. Use recommended sunscreen with broadband protection (UVA and UVB) and a sun protection factor (SPF) of 30. Apply sunscreen 20 minutes before sun exposure. Reapply sunscreen every 2 hours. If direct sun exposure is necessary, wear a hat and clothing that covers the treated area. If treated area is exposed to sun (direct or indirect) blistering, scarring, hyperpigmentation or hypo-pigmentation can / will occur. Sun exposure should be avoided for 2 months post treatment.
  • Typically after the peeling process is complete, make up can be worn.
  • When showering in the next few days, be sure to avoid getting shampoo directly on the treated area. You may consider taking your shower with the back of your head to the water to avoid directly hitting your face with the full force stream of the water.

What to expect:

  • Redness is normal and expected. Redness generally increases in intensity the first few days after treatment with day 3 being most intense. Redness can persist for up to 7 days depending on the aggressiveness of the treatment.
  • Pinpoint bleeding may occur. This can last for a few hours – 12 hours depending on the treatment depth and may be isolated to certain treated areas.
  • Immediately after treatment, swelling is common and expected. Use of a cold compress or ice packs will help to relieve the swelling.  To avoid further swelling, you may choose to sleep in an upright position the first night after the treatment.  The first morning post treatment is when swelling is more prevalent, especially under the eyes. Swelling may last 2-4 days depending on the aggressiveness of the treatment.
  • The treated area may be extremely warm for 12-24 hours after the treatment. Cold compresses or ice packs may provide comfort during this time.
  • On the 2nd or 3rd day after treatment, you will increasingly notice tiny dark spots and bronzed appearance to the treated skin. This is called the MENDS (microscopic epidermal necrotic debris). In individuals with heavily pigmented skin, or in areas where sun damage has produced pigmented lesions, the microscopic wounds, known as MENDS, contain large amounts of melanin. Because there are so many MENDS, they can make the skin look bronzed and small areas appear crusted (do not try to scratch them off). This is part of the healing process where treated tissue is working its way out of your body as new fresh skin is regenerated. During this time, your skin will be very dry and have a sandpaper texture and will begin to flake and peel. If the face is treated, it could take 5-7 days for the peeling process to be completed. If the neck, chest or anywhere on the body was treated, this process could take up to 2 weeks.
  • After the peeling process is complete, your skin will have a rosy, pink glow that will gradually resolve. Your clinician will inform you and advise you of when make-up can be used and which kind.
  • If an antiviral and/or antibiotic was prescribed for you, continue to take as directed.
  • Post treatment discomfort may be relieved by over the counter oral pain relievers; i.e. Extra Strength Tylenol or prescribed pain medication if ordered by the doctor.
  • Itching may be experienced during the healing phase and is completely normal. Oral antihistamines such as piriton may help itching but can cause drowsiness. DO NOT scratch the treated area as scarring and pigmentation complications can occur.

Visit our Acne Clinic in Birmingham:

  • Free Complimentary Mailbox Parking
  • A 5-minute walk from Birmingham New Street Train Station
  • Additional privacy facility available upon request

Our luxury skin clinic provides professional Acne Treatment in Birmingham, West Midlands as well as surrounding areas such as Solihull, Edgbaston, Wolverhampton, Walsall, Coventry, Dudley, Sutton Coldfield, Stourbridge, Bromsgrove, Redditch, Tamworth, Cannock and Lichfield. 

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