Cortex Fractionated CO2 /Erbium Yag Laser

We 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. To answer this it’s useful to review the development of cosmetic skin lasers over the last 20 years.

The History of Aesthetic Laser Development over the 20 Years

The widespread use of lasers to improve the quality and appearance of the skin became popular in the 1990s. During that decade, the most popular lasers were whole beam or non-fratcionated ablative CO2 lasers. These lasers could obtain pretty good results; however, there was a very substantial recovery period (6 weeks or more) and complications such as changes in the pigment of the skin were not uncommon. Most patients and physicians felt these treatments were too onerous. The pendulum then swung from a good bit of downtime to very little downtime with the advent of fractionate non-ablative lasers. These lasers needed to be used in a series of treatments – generally 4-6 treatments about a month apart. The advantage of these fractionated non-ablative lasers was that downtime and complications were a lot less than with the fully ablative lasers used in the 1990s, the disadvantage was the results could be less than the patient hoped for.

The Newest generation of Cosmetic Skin Lasers Strikes the Best Balance between Reasonable Downtime and High Quality Results
The Cortex Laser combines the use of a fractionated ablative CO2 laser and a more superficial Erbium Yag laser. The downtime after a full treatment with this laser is around one week. While this is still an imposition on a patient’s schedule, my experience is that patients are willing to work with a week of downtime in order to get good results they can appreciate. Fundamentally, these lasers are resurfacing the skin and some degree of downtime is necessary to make a substantial improvement.

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 skins strength and elasticity and promoting the growth of new skin cells. Since the laser is fractionated, 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 superficial 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. Anti-viral 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. Toreduce 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 appear 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. In general, patients can expect improvement in their skin for 4-6 years into the future. Please keep in mind that as you get older, skin continues to age and you may benefit from receiving additional treatments to sustain results.

What is fractional resurfacing?

Instead of affecting the entire surface of the skin, a fraction pattern of micro laser spots is applied, resulting in a unique wound healing process. Each laser spot is surrounded by untreated tissue for faster healing time. Fractional wound healing results in rapid replacement of the surface of the skin for textural improvements as well as collagen remodeling in the deeper dermis for wrinkle reduction.

How is Cortex different than similar devices and treatments?

Cortex is designed to allow for greater treatment flexibility, allowing your provider or clinician to precisely tailor your treatment.  CO2 laser energy is used for deeper wrinkles and areas that may need a stronger treatment while the Ebrium laser energy is lighter and can be used to treat more superficial issues such as fine lines and sun-damage.  After treatment, the epidermis peels away as it heals and reveals new, healthy firm skin with less sun damage and wrinkles.

What should I expect?

You should expect the emergence of young, healthy, radiant skin within a week or so after treatment as well as a reduction in the appearance of wrinkles and skin texture irregularities.*  Treatments usually take less than 30 minutes for a full face fractional skin resurfacing.

* results may vary.