Clinical Roundtable Supplement Cynosure July 2012 : Page 6

clinical roundtable | RevLite “The laser has very stable power output, which the practitioner needs to understand and apply in such a way as to avoid over treatment or under treatment.” Dr. Suwanchinda – It depends on the condition treated and parameter used. With melasma treatment, rebound melasma with hypo-or hyperpigmentation is the most drastic complication after low fluence 1064 nm treatment. Intense pulsed light (IPL), bleaching cream, good sun protection and other types of facial treatments would be the way to treat this, as the skin is very sensitive and melanocytes are vulnerable to any other or further injuries. Dr. Wong – Permanent hypopigmentation is diffi cult to treat, and the only thing we can do is to lighten the surrounding skin to make it less obvious. With 532 nm treatments, PIH is also common in darker skin tones but it is only temporary. Additional complications include acne, herpes activation and other infections; scars and textural changes. Do you combine the RevLite with other treatments or therapies ? If so, please describe. Before Tx Dr. Bekhor – I combine the RevLite with Q-switched ruby lasers in the management of mixed color tattoos (for the green pigment). Dr. Xin – Frequently, I use a combination of ruby lasers, Alexandrite lasers, and other devices depending on the patient’s needs. Combining treatments can be very successful. One must be cautious not to over treat. The laser has very stable power output, which the practitioner needs to understand and apply in such a way as to avoid over treatment or under treatment. The beam quality is the key in terms of consistency and longevity of results. Dr. Rajendran – I have used fractional laser technology combined with the RevLite. I treat acne scars with the fractional laser and follow-up with the RevLite for melasma. The RevLite can deal with pigmentation and skin rejuvenation. After the patient’s skin has become lighter and fi ne lines have been treated, always follow that with topical applications like those containing vitamin C, and medi-cated skin creams. Dr. Suwanchinda – For holistic treatments, combination treatment is the way to go. Most patients come in with more than one problem. One good thing about RevLite is it can be combined with many modalities in the same session. For example, BOTOX and dermal filler injections can be done during the treatment session, and you can use other energy-based devices such as Ultherapy. For skin rejuvenation, I use many types of treatments. For instance, right after treating pigmentation I perform electroporation with growth factors, along with whitening agents such as Arbutin or Tranexamic acid, together with light-emitting diodes (LED), to help reduce dyspigmentation problems. Melasma treatments are usually treated with biopuncture, which is the injection of biomaterials over the acupuncture points. I also use acupuncture to help balance the internal hormone system. After RevLite 532 nm and 1064 nm Tx Photos courtesy of Atchima Suwanchinda, M.D. 6 THE Asian Aesthetic Guide 2012 -Volume 2

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