*Dot Therapy Laser Skin Resurfacing FAQ

While no one has found the “fountain of youth”, SmartXide DOT is a significant step forward in the search to stay looking young. Since first being reported in 1991, the carbon dioxide (CO2) laser has been the “gold standard” for non-surgical skin resurfacing. Unfortunately, the CO2 laser removes (ablates) the entire skin surface. This results in a prolonged and somewhat difficult recovery. Instead of removing the entire surface, SmartXide DOT treats hundreds of DOTs within a treatment area, leaving the majority of the skin’s surface intact. Since most of the skin’s surface is left intact, SmartXide DOT approaches the “gold standard” result of the CO2 laser with greatly diminished recovery time and much less discomfort. Over the next few years, SmartXide DOT will set a new standard for skin resurfacing and become the treatment of choice for reversing the effects of aging on the skin.

What is SmartXide DOT?

The great promise of SmartXide DOT is a 30 watt, carbon dioxide based laser with a 10,600 nm wavelength. A scanning head delivers the laser impulse in one of several available patterns. This allows Dr. Kerr to individualize the treatment area for each patient. Within each pattern, 150-700 tiny DOTs are created, each about 300 microns (0.003 millimeters) in size. Dr.Kerr can also vary the space between each DOT, the depth of each DOT, and the length of time the laser stays on each DOT (dwell time). Thorough knowledge of the laser’s tissue effects and the ability to customize for each patient, allows the best results for each individual. Silk Touch MedSpa introduced the first laser to Boise, Idaho.  He has a thorough understanding of how to achieve the best results for you,

What Does SmartXide DOT do?

The SmartXide DOT penetrates into the upper layer of the dermis. The dermis is the supporting layer of our skin and contains most of its collagen. SmartXide DOT targets water in the tissues resulting in tissue ablation inside the DOT. In addition, each DOT is surrounded by a zone of thermal tissue damage formed by the laser.

Actual Skin  Laser DOTs

This thermal damage is responsible for the most of the superior results seen with the old CO2 laser. SmartXide DOT is able to achieve a wide zone of thermal damage without removing the entire skin surface. This zone is thermal damage is responsible for most of the skin tightening and skin thickening that occurs following SmartXide DOT treatment. Collagen shrinkage as a result of thermal damage results in some immediate skin tightening. More importantly, further improvements in skin tightness and collagen density occur as a result of collagen remodeling and begin about 30 days after the treatment. These improvements continue for up to one year.

Figure 2 (insert diagram of treatment timeline)

Where can SmartXide DOT be used?

Another important feature of SmartXide DOT therapy is its ability to be used on body areas other than the face. Previous CO2 laser treatments were restricted to the face. The greater density of sebaceous glands and other deep skin structures allowed healing from below to occur on the face. This allowed complete ablative treatments that could not be done on other parts of the body. SmartXide DOT allows healing to occur from the intact skin to the side of the DOTs. This allows SmartXide DOT to be performed on almost any body area. The ability to treat any area of the body allows the treatment of problems such as loose skin, scars and stretch marks. This makes SmartXide DOT much more useful to patients.

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What is a SmartXide DOT treatment like?

Treatment begins with understanding the patient’s desires and needs. The laser settings Dr. Kerr chooses are determined by the problem the patient wishes to emphasize. While most treatments will improve both skin color and provide skin tightening or scar improvement, Dr. Kerr has the ability to emphasize one area over another. Superficial problems like pigment disorders or mild wrinkles are treated with close DOTs. Deeper problems such as scars or deep skin creases are treated with more distance between DOTs and fewer overall DOTs, greater depth and longer times with dwell times. Patients whose primary concern is overall skin laxity and general wrinkling are treated between the two extremes. Treatments off the face generally use similar distance between the DOTs and depth settings as the face, but dwell times approximately one half the settings of facial treatments. Upper eyelids can be done with laser eye shields in place. The area is first covered with a topical anesthetic. The topical anesthetic is allowed to stay in place for about an hour. Using the topical anesthetic allows the SmartXide DOT treatment to be done with little discomfort. Immediately having the procedure, the area we treated will feel hot. Therefore, we cool the area down with ice and a special cooler for about 30 minutes. Altogether, you should plan on about 2 hours for your SmartXide DOT treatment.

(insert photo of face before and after)

So how well does SmartXide DOT actually work?

The results from SmartXide DOT treatments are impressive and approach those of full CO2 ablative treatments. Skin crease improvements are substantial. Pigment improvements are also excellent, and generally better than other treatments such as intense pulsed light. Scar revision results are substantial (figure 13). However, one of the more exciting features of scar revision is the ease with which multiple treatments can be performed in an area. Overall, clinical results confirm the promise of SmartXide DOT therapy and position it to dominate the skin resurfacing market for the next decade.

So what does all of this mean?

SmartXide DOT laser therapy represents the marriage of two important skin resurfacing technologies, CO2 laser ablation and fractional skin resurfacing. While the CO2 laser has represented the “gold standard” for results, the prolonged and difficult recovery time and inability to use the CO2 laser off of the face have greatly reduced its popularity and utility. Fractional resurfacing has become one of the most popular types of skin resurfacing treatments in the last 2-3 years. However, fractional treatment with mid infra-red lasers has been plagued by less than satisfactory results in many cases. SmartXide DOT laser therapy promises to remedy both of these problems. Recovery time is decreased to 7-10 days on average, with redness lasting around 14-21 days. Results challenge those of conventional CO2 ablation and significantly exceed those of current fractional treatments. The ability to work off the face adds many additional applications and benefits. Finally, the ability to perform multiple treatments on difficult areas promises to yield results not previously available with any cosmetic treatments. SmartXide DOT laser treatment should replace conventional CO2 resurfacing as the “gold standard” of treatment and dominate a large part of the cosmetic market for many years to come.