Blistering during Smoothbeam... How to preventsteroid
Posted 31 January 2004 - 08:41 AM
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!
Posted 31 January 2004 - 09:19 AM
Posted 31 January 2004 - 12:42 PM
Thanks so much for posting! I am sure you have saved a lot of people's skin with the information you provided. I wish I lived closer! I would feel extremely comfortable in your hands.
Again, thank you and please stop in again!
Posted 31 January 2004 - 03:22 PM
Posted 31 January 2004 - 04:45 PM
I do have very similar scars like the guy on Candela's pic (my temples look like that on both sides). I have a pretty big 1/2 inch in diameter rolling scars on my right cheek also that I'd like to get rid off. My skin tone also similar to the (Asian) guy on the website
Here's what I have done so far:
First Treatment: about 720 zaps at setting 12 (no hyperpigmentation).
Second Treatment: about 650 zaps at setting 13/14 combined (lots of hyperpigmentation but they're now back to normal already).
Third treatment (couple weeks ago). setting 13 for 350 zaps. Reason why the zap count is low because the practitioner said she didn't want to zap the same area twice (like she did on my first two treatments).
Am I going to see any improvements at all with what I'm doing? I was planning on doing 4-5 treatments, and after finishing my 3rd I don't see much improvements on my face, except for the compliments from the people at the treatment center. Not that i don't trust them, but I just want to get an unbiased opinion.
I hope I'm not spending my money without any good cause.
I also post this hear instead of PMing you because I hope your answers can also help out others in the similar situation.
Thanks for your time.
Posted 31 January 2004 - 08:12 PM
Gold Rex.. I charge $1900 for a series of 6.
Anna.. thank you. I am in SC, where are you?
Posted 31 January 2004 - 08:47 PM
You confirmed what I had suspected. It makes me mad untrained, inexperienced people allow people to think they're in capable hands.
I would trust you to perform it as well. Wish you were closer
Posted 31 January 2004 - 09:10 PM
I'm in very green but rainy Seattle! I hear South Carolina is beautiful though. I have a friend whose mom was a former Miss North Carolina!
Have a great day!
Posted 31 January 2004 - 10:41 PM
Thanks for all this detailed info. I now have a better understanding of how Smoothbeam works. Now I feel a little bit better about the whole thing.
Posted 31 January 2004 - 10:56 PM
Posted 01 February 2004 - 07:36 AM
I am surpised you got blisters at 11 and 12. I am guessing the cooling spray was too low for you and that caused it... not the joules amount.
emmanuel ... This is upsetting to me as well, believe me. In general these lasers are very safe. However it isn't fair to charge someone for a full charge and then give substandard service because the tech isn't intelligent or experienced enough to go to a high enough setting.
Here is a link to our website if anyone is interested. I can't take credit for it other than the text and colors... I just had a really good designer. I own this along with my MD spouse and I LOVE what I am doing now. I am also a licensed ethetician and do many of these treatments myself! Beats hospital work any day! It is a joy and privledge to help people attain the skin they have always wanted!
Posted 01 February 2004 - 12:23 PM
Don't you find that you be way too expensive? Especially for south carolina?
I mean, I thought if you get get all 6, there should be a deal.
320/treatment isnt exactly a deal.
Posted 01 February 2004 - 02:24 PM
Posted 01 February 2004 - 04:43 PM
Posted 01 February 2004 - 06:25 PM
I had this area on both of my cheeks that was "thickened". It never would really come up to a head, but it was always there.... bugged me too! About 3 days after my first Smoothbeam they all came up and out. They were little hard pieces of sebum that would've still been there without Smoothbeam. Now my cheeks are totally smoootthh. After a few treatments this normally stops.
Posted 01 February 2004 - 07:01 PM
Posted 01 February 2004 - 07:08 PM
I struggled with acne myself for years after my kids were born 6 years ago. It all started then... severe cystic acne that really really got me down. I have always tired to look my best and I felt so very frustrated! A year ago exactly, the local Derm wanted to put me on Accutane. But for personal reasons I felt it wasn't a good choice for me. [-( That was when I started seeking alternative treatments. :-k When I finally got my own skin cleared up it gave me the confidence I needed to open my own Medical day Spa. I had always been interested in going back to Esthetics school, but my own skin problems always prevented me from following that dream. I felt that nobody would really listen to an esthetician who had terrible skin herself! Now I don't even wear makeup except for a little eyeliner and mascara and lip gloss! / I never thought that would be possible. I always take out my own before and after pictures to show my clients that I REALLY DO understand how they feel! So now I am on a mission to give others that confidence to follow their dreams and become the people that God intended them to be! Best wishes in your journey!
Posted 01 February 2004 - 07:13 PM
Posted 01 February 2004 - 07:16 PM
Posted 02 February 2004 - 01:20 AM
Also, I'm on tazorac .1% gel right now, which has made a marked difference in the texture of my healthy skin, and now, closing in on two months since I first started, it is killing my acne completely. I'm immeasurably pleased by this, and plan on staying with tazorac for as long as possible.
However, if I stay on tazorac while I have my treatments with you, how long would you say I should refrain from using it before the treatment? Perhaps a week? I'd like to contact you off the forum with questions, and actually set up a date, and I'd like to do this stoon...
I'd probably fly into Dulles, because of family in the area, and then drive down to Florence. I live in Chicago.
Thanks in advance.