Dr. Paul L. Leong, MD

It's Your Face, Trust it to a Specialist

Laser Skin Rejuvenation (Cortex CO2/Erbium Yag Laser)

derm3We now use one of the most advanced laser systems to achieve improvement in wrinkles, fine lines, acne scars, and sun damage spots. The Cortex CO2/Erbium Yag Laser transmits laser beams deep into the dermis to resurface tired, damaged surface skin while stimulating new healthy growth deep from within. This remarkable treatment is customized for each patient and helps to restore the natural glow and beauty of healthy, smooth skin.

There are many lasers available to patients today. Why is the Cortex laser particularly attractive to patients who want to improve the youth and vitality of their skin?

CortexTo answer this it is useful to review the development of cosmetic skin lasers over the last 20 years. During that time, full CO2 (carbon dioxide) laser treatment has been a common treatment to regenerate new skin and reduce the signs of aging. Full CO2 treatment removes the epidermis (top layer of skin) and part of the dermis (inner layer of skin). Although this ablative laser works effectively to stimulate new skin growth, because of its aggressiveness there is substantial downtime (up to 4 weeks) and a number of possible risks. These risks include, but are not limited to: infection, hyperpigmentation, hypopigmentation, swelling, pain and the formation of scars. The symptoms after treatment often include a painful, weeping, raw face. To combat the issues associated with full CO2 lasers, non-ablative lasers were created to rejuvenate the skin with less intensity and without vaporizing the tissue. Although non-ablative lasers have considerably less downtime, results are gradual and a series of treatments are required. In order to get the best of both worlds, fractionated lasers, such as the Cortex CO2/Erbium Yag Laser, were developed. When a fractionated laser is fired, spaces are left between the beams of energy. This creates areas of vaporized skin along with surrounding healthy tissue, which results in faster recovery and less risk of complications. Fractionated lasers like the Cortex CO2/Erbium Yag laser have revolutionized the world of laser treatments by resurfacing the skin with less downtime and more safety and effectiveness.

How does the Cortex CO2/Erbium Yag Laser work?

The Cortex CO2 &/or Erbium Yag Laser works by delivering focused energy deep into the layers of the dermis to stimulate the growth of collagen and new skin. The body responds to the energy by increasing the skin’s strength and elasticity and promoting the growth of new skin cells. Since the laser is fractionized, tiny spaces of the skin are left untreated which reduces downtime and accelerate healing. The laser settings (energy, pulse, duration, size and density) will be adjusted according to each patient and their customized treatment plan.

What is the difference between the CO2 Laser and the Erbium Yag Laser?

You will have the option to have both CO2 & Erbium Yag laser treatment, CO2 laser treatment, or Erbium Yag Laser treatment. The CO2 Laser penetrates into the dermis (inner layer of the skin) for deep resurfacing. It can decrease the appearance of moderate lines and wrinkles, acne scars, skin texture problems, dyschromias and pigmented lesions. The Erbium Yag laser is for surface treatment of the epidermis (outer layer of skin). It can be used to treat shallow wrinkles and lines, reduce brown spots and improve skin texture. The Erbium Yag Laser could be used as alternative to a chemical peel. I will determine which treatment option is best for you based upon your skin concerns, history and expectations.

What type of patient can be treated with the Cortex?

The Cortex CO2/Erbium Yag Laser is recommended for patients with fair to moderate skin who fall within the Fitzpatrick scale of I-III. The laser could cause hypopigmentation (lightening of the skin) in patients with darker skin. The patient should not be nursing or pregnant, have an immunosuppressive or blood clotting disorder, skin condition or currently be smoking. The patient should be in good general health, with realistic expectations.

How long does treatment take?

This depends on the area being treated. Treatment can take as little as 15 minutes, but as long as 2 hours if there is a large service area to be covered. The Cortex CO2/Erbium Yag Laser procedure is done in our state of the art center located in Pittsburgh.

What should I do to prepare for treatment?

Stay out of the sun and refrain from any laser or chemical peel treatments and Retinoid usage for at least 3-4 weeks prior to treatment. Discuss any current medications that you are taking with the doctor. Certain medications such as Accutane (isotretinoin) can adversely affect treatment results. Blood thinning agents, such as Ibuprofen, Vitamin E, Fish Oil and Alcohol should be avoided. Fill any medication prescribed by the doctor prior to treatment. Antiviral medication is often prescribed to reduce the chance of an outbreak. The CO2/Erbium Yag Laser procedure is done in our state of the art center located in Pittsburgh.

Is treatment painful?

Every patient has a different pain threshold. Many patients describe the pulses of energy as warm and sharp. To reduce discomfort, we apply a numbing cream with lidocaine prior to treatment to numb the area. This is left on approximately one hour prior to treatment.

What is the recovery time?

Patients should expect approximately 8 days of downtime. Outlined below is what you can expect on each day following treatment.

  • Day 1 – you will look sunburned and your skin will feel tight
  • Day 2 – your skin looks bronzed and darker
  • Day 3 – your skin begins to peel and the area feels itchy
  • Day 5 – the peeling should be subsiding. If needed, you can wear make-up (mineral make-up recommended)
  • Day 6/7 – you are usually back to your baseline
  • Day 8/9 – Redness typically resolves

Please note that the recovery time of the neck area is usually longer. It takes approximately 2 -3 weeks to bronze and peel.

What are the post-treatment instructions?

It is vital to continually keep the skin moist after treatment with an ointment or moisturizer. Occlusive products such as Vaseline and Aquaphor work well to retain moisture and should be applied at least 2-3 times daily. Purchase a gentle cleanser and a quality SPF to protect the area from the sun. Cool compresses such as wet paper towels or frozen peas helps to ease the sunburned/tight feeling normally felt on day one. To relieve itching, it is helpful to create a solution of vinegar and water (1 teaspoon of vinegar and 2 cups of water). Avoid the sun, excessive dryness or heat. Eat healthy, refrain from alcohol and drink plenty of water. You may take Ibuprofen or Acetaminophen after treatment to reduce pain or discomfort.

How long do results lasts?

This depends on how well the patient has followed post op instructions and maintains an appropriate skin care regime. Please keep in mind that as you get older, skin continues to age and you may benefit from receiving additional treatments to sustain results.

Dr. Paul Leong is a facial plastic surgeon who focuses exclusively on the face and neck. For more information about Dr. Leong please visit his biography page or contact our practice today.

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