New photos of great results for LARGE cyst and scars

I am sorry that I am not on the board as much as I would like to be. I am extremely busy and have a hard time keeping up with my day to day responsibilities.

I did want to post some great results of a patient who has struggled with acne for about 5 years. She did Accutane and it failed to work on her. She had had this cyst on her cheek for a couple of years.

This photo was taken 2 months after her SECOND Photodynamic Therapy treatment with VBeam. We did her THIRD treatment the day this was taken. The scars are almost gone, and I credit the Neocutis Gel with that. Go to www.neocutis.com to read about that. We give most of our severe acne patients the Gel while they are undergoing treatments in order to decrease their chances of scarring and it has worked wonders in cases like this.

Hello... I love this board

Hi everyone,

My name is Susan. 40 years young, married, 2 kids, 3 dogs.

Although I have been a member for some time of this board, I hardly ever post. I have lurked a lot, and have referred many patients to this board for non-biased opinions. I love how everyone shares information here and gives feedback (good or bad) of different products, treatments, etc.

I hope I will be allowed to post here occasionally. I don't have a ton of time, so forgive me please if you email me and I don't get back immediately! I am a Registered Nurse and Esthetician and own a cosmetic laser center along with my husband and best friend, a physician. No, he isn't a Dermatologist, although in the 4 years that we have been open we HAVE finally (believe it or not) gained the respect of local Derms and even Derms from bigger cities around us and get referrals from them. (List of referrences available on request.)

I started my business BECAUSE I also struggled with acne for many years. Mine didn't start until I was 30 and got pregnant with our first child. I did the whole Derm visit- no improvement- changing antibiotics- etc etc thing for YEARS without any real improvement. I was lucky to never have really scarred other than severe hyperpigmentation, which cleared up with Obagi Nu Derm.

Now I have the joy and great satisfaction of helping many others with their own acne issues. (We treat lots of other conditions too, but acne IS my favorite thing to treat, as it is the most rewarding for me.)

People look at my skin now and don't believe I ever actually HAD acne, but I have pictures to prove it! I will email them to anyone who asks. I used to have them on my website but I didn't want anyone to google my name from my home town and find them!

Enough about me... I love this site and I am glad Dan has made such an informative site for acne sufferers!

Photos of Levulan with VBeam

Hi everyone,

I have been a member of this forum but don't have much time to post due to the fact that I am really busy at work, home, etc.

We use Photodynamic Therapy and utilize the Vbeam laser to activate the ALA. We have been using this method for 3 years with about a 90% success rate. We do pretty agressive treatments, with Acetone prep, microdermabrasion then 60-90 minutes incubation of Levulan and do an average of 800 pulses per treatment. We schedule treatments 2-4 weeks apart and recommend 4 treatments, then one treatment per year.

This photo is of a 17 year old who came to us after being treated by a Dermatologist for 2 years. We did 4 PDTs, then several Vbeam and Gentleyag treatments. The last photo was about 14 months after he first started coming to us. I also started him on Neocutis Gel for the scars to decrease scar tissue buildup and speed the healing time.

There IS hope for even very severe cases of acne, but unfortunately insurance doesn't cover them.

What is the average cost of Dermaroller needling?

Can anyone tell me if they have had Dermaroller needling done by an M.D. what they paid for this procedure? How much improvement did you have?

Blistering during Smoothbeam... How to prevent

Hi everyone... I have been reading alot of posts about blistering during Smoothbeam and I just have to comment here. I own a Laser Center and use the Smoothbeam, as well as the VBeam and Gentlelase. There are many factors that go into finding the right setting for the Smoothbeam. First of all, the tech should be performing test spots with every treatment and look for the correct tissue response. If they don't know what they are looking for and don't understand the skin and how it functions then they will be clueless in what the response is. Be aware that a doctor in many states can train even the janitor or secretary to do laser treatments. You don't need any special qualifications to run these machines in some states. Every state has their own rules for who can do this.

The settings that you are all mentioning are the joules that we use "12,13,14". What is even MORE important when discussing the problem of blistering is the cooling spray setting. It has to be adjusted when the joules are adjusted. It is pretty simple... For 12 you use 30, for 13 you use 35, and for 14 it is 40. This is of course an average. BUT.. if a tech has the joules to 13 and the spray on say 25 or 30, you can blister. If you go up on the joules you go up on the spray. If there is too much spray then you will likely hyperpigment. If the laser guide isn't TOUCHING your face you are really risking pigmentation as the cryogen can go under the guide and cause harm.

I just spent all day this past Monday with a Derm in his office doing Smoothbeam and VBeam treatments. He is one of the doctors whose name is on the paper that was submitted to the FDA for acne. So he knows what he is doing. He pretty much always uses these settings::

Skin Type I and II: 14 and 40 (joules and spray)
III: 13 and 35
IV: 12 and 30
V and VI: 10 or 11 and 20/25

He doesn't have problems with blistering and bad outcomes because he looks for the right response before blindly proceeding.

I also use these higher settings when at all possible to improve outcomes. I have never (knock on wood) had a bad outcome, except in a 17 year old boy who didn't wear sunscreen and went in the sun for 8 hours one day despite warnings NOT to do this. He is hyperpigmented and we are treating it with a steroid cream and hydroquinone. But nobody has EVER blistered.

With acne scarring and the pictures that are posted on the Smoothbeam website and other doctor's sites I want you to realize that those settings were at 14 and 40 for ALL of them. I realize that this is a HIGH and PAINFUL setting. We don't use Emla or Elamax (now called LMX). It is only 4 or 5% lidocaine and in my experience NOT strong enough. We get ours formulated for us by a pharmacy and it is 10% Lidocaine, 10% Tetracaine and 4% Prilocaine. MUCH stronger and alot more effective. There is no reason a doctor can't get this for his office. All he needs to do is get a formulating pharmacy to do it. We use Hollis Pharmacy in Nashville TN. The pharmacist's name is John Hollis. He will ship anywhere in the US. All your doc needs to do is fax a Rx for this laser cream!

I really hope this helps give you some knowledge about who to go to and questions to ask. I got this info from Candela and the doctor who did the research on this laser. It WILL work when used properly. Hugs to all!