There is no one device that does everything well. That really is my Commandments 1, 2 and 3. When adding laser surgery to your practice, instead of trying to do it all and being a jack-of-all-trades and a master of none (which I think is a recipe for disaster), find the one thing that you really want to treat and find the one laser that treats that thing most effectively and safely, and buy it.

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You should never take treatment advice from sales reps, not EVER. If you do, you get what you deserve.

As a doctor you should know what/how to treat, and understand the physics of the device and the biology of what you are treating. It is extremely important to know some of the physics behind what you’re doing. Long wavelengths

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I use it for treating photo-damage, every type of vascular lesion including spider veins on the face and the legs, port wine stain birthmarks, scars, rosacea and I also use it for photo-aging sun damage. I believe that the pulsed dye laser is effective for reducing pore size and tightening skin, to a limited degree, and most of my patients agree.

See Commandment #1. I do not use intense pulsed light sources in my practice because I believe:

1. It is harder to predict results with IPL
2. IPLs are not safe to use around the eye
   
3. The
   
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   Posted 2nd January 2009 at 10:43 am in IPL, Laser's 10 Commandments Comments (0)   |   Add Comments

There are many different fractionated devices and there are differences. It is key to know the type and extent of the tissue injury to help to distinguish the potential clinical effects.

When treating tattoos its almost always necessary to use more than one laser. When they become resistant to one laser I believe turning it up by decreasing the spot size is more likely to cause a scar. Shrinking the spot size to increase the energy once a tattoo stops responding is in a way analogous to a bacterial infection that becomes resistant to a given antibiotic, one needs to switch the antibiotic (or in this

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To treat all skin types optimally, I believe, it takes more than one device and/or more than one wavelength. I use the Nd:YAG laser almost exclusively on skin types 5 and 6 and vary the pulse duration of the energy to account for the diameter of the hair and color of the skin. These parameters will change throughout a patient’s treatment history as the hair shrinks in size or the patient’s skin changes in color.

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Leg veins, especially larger ones are indeed better treated with sclerotherapy than any other treatment. However, the literature supports a 15% incidence rate for matting (small clusters of bruise-resembling veins that occur as a result of sclerotherpy), and i personally think the incidence is closer to 30% (lots of folks who get matts are lost to follow-up. For these folks and those with only smaller veins (less than 0.75 mm)

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