Objectives: Fractional Co2 has always been one of the most versatile and must have lasers any aesthetic surgeon should have at their center.Having done more than 2000 cases with the help of a fractional CO2,I would like to highlight few cases of conventional treatment of fractional CO2 for scars and facial rejuvenation along 5 cases of unconventional uses of this laser ,less reported if at all reported before.

Introduction: Offcourse one should never buy a Fractional CO2 laser if the the aim is to treat freckles or pigmentation or keloids ,tattoo’s or any of these cases mentioned below as gold standard results of a fractional CO2 laser is mainly for scars of all kinds namely due to Acne,Trauma,Burns etc and also for facial rejuventation,although when it comes to facial rejuvenation on darker skin it could be a tricky laser to use considering the possibility of post procedure pigmentation.

Materials / method: In this study I present 3 cases of conventional uses and 5 cases of unconventional uses ,treated with a fractional CO2 ,that is of a 74 year old male patient on blood thinning agents treated for Pyogenic Granuloma without stopping the medication,a young male treated for a sinus tract just below a mandibular silicone implant,a young woman with Acrokeratosis Verruciformis, trans epidermal drug delivery for Alopecia Areata and Xanthelasma Palpebrarum.

Results: The results in all the above mentioned cases where very good or satisfactory .

Conclusion: We would like to conclude that Fractional CO2 being a truly versatile laser can be used for various indications once the user is familiar with the laser and the physics behind it.

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Objectives: To recognize the pathogenesis of acne scars.
To be able to analyze the skin barrier function and realize its impairment impact on the skin.
To be able to implement an effective and safe plan to treat acne scars.

Introduction: Acne scars represent a common challenge for Dermatologists. In many cases neither the patient nor the physician are happy with the outcome.

Materials / method: Dealing with this problem requires a deeper consideration for the changes affecting the different lasers of the skin rather than focusing on collagen induction only. Epidermal barrier function must be restored to minimize the trans-epidermal water loss. Procedures with the objective of Collagen induction must be considered.

Results: Skin tightening might be also required if there is a degree of skin laxity.

Conclusion: Designing the ultimate treatment plan to tackle the problem at multiple levels is the only effective way to improve acne scars.

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Objectives: To assess the effectiveness and safety CO2 10600nm laser therapy for wart and begnin tumor on the cilary frange.

Introduction: Warts and benign tumors of the ciliary rim are difficult and laborious to manage by conventional surgery with the surgical scalpel. The ransom scarring is sometimes poorly accepted by the patient and the operator. Electrocoagulation with electrocautery is a therapeutic possibility but may lead to permanent alopecia of the eyelashes. The use of the low energy continuous laser / surgical laser (10600nm) is an excellent alternative for the management of these benign lesions. It is an effective and safe method. It does not produce scar or alopecia eyelashes.

Materials / method: Ten Tunisian patients (6 women and 4 men) with warts or benign tumors of the lower or upper ciliary margin are treated with a 10600 nm continuous / surgical laser. Six patients each presented with a wart, 2 others with keratosis, 1 with seborrhoeic wart and 1 with keratoacanthoma.
After having anesthetized (local anesthesia or locoregional anesthesia) and correctly protected the eyes with metal shells, the lesion is sprayed and then coagulated with a straight handpiece of 100 mm at low power (0.5-3watts).
A healing cream is applied 10 to 15 days postoperatively. Clinical monitoring and outcome

Results: The CO2 laser in continuous mode represents a remarkable therapeutic alternative for warts and benign tumors of the ciliary rim. It allows a simple and fast treatment by taking many precautions to avoid certain complications such as eye accidents. The danger is the diffusion of heat to adjacent tissues, causing post-inflammatory pigmentation, mucocutaneous atrophy and especially permanent eyelash alopecia. In our 10 patients the aesthetic result at 1 month, 6 months and at one year is excellent. We had none of these complications already mentioned above. No recurrence was observed at one year

Conclusion: The 10600nm CO2 laser treatment of warts and benign tumors of the ciliary rim is done under local anesthesia or at best truncular. It is simple and fast. It is a feasible treatment in minutes and in one session. It should be proposed first intention especially that it does not complicate alopecia eyelashes.

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Objectives: The presentation will provide a full overview on a novel FDA-cleared Nd:YAP 1,340-nm laser wavelength for fractional nonablative skin resurfacing in the treatment of mild to moderate inflammatory acne vulgaris in the prevention of acne scars.

Introduction: Acne vulgaris is the most common skin disease in the United States and accounts for 25% of all visits to dermatologists.

Results: Due to its 1,340 nm non-ablative neodymium:yttrium aluminum perovskite (Nd:YAP) laser, which can penetrate up to nine times more deeply than other non-ablative lasers due to both its higher optical conversion efficiency than 1,320 nm Nd:YAG and its water absorption curve specificity, allows the laser wavelength to penetrate in target-tissue, heating and shrinking sebaceous glands, thereby reducing their activity.

Conclusion: 1340 nm (Nd:YAP) laser is effective and safe 1340 nm in the treatment of active acne and acne scars

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请注明名称（个人，公司，学会等等）: Vydance

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Objectives: In this presentation, acne scars will be discussed in two main ways. In the first, we will understand how it is possible to prevent the appearance and / or progression of scars with effective and early treatment. In the second, which are the main treatment options to reduce the scars, and its literature on effectiveness.

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Objectives: 1: Diagnose various type of acne scars
2: Formulate a tailored approach to each individual acne scars
3: Manage acne scars with non-ablative 1550-nm erbium-glass and ablative 10 600-nm carbon dioxide fractional lasers

Introduction: Non-ablative 1550-nm erbium-doped fractional photothermolysis systems (FPS) and 10 600-nm carbon dioxide fractional laser systems (CO2 FS) have been effectively used to treat scars.
We compared the efficacy and safety of single-session treatments of FPS and CO2 FS for acne scars through a randomized, split-face, evaluator-blinded study.

Materials / method: Eight patients with acne scars were enrolled in this study. Half of each subject’s face was treated with FPS and the other half was treated with CO2 FS. We used a quartile grading scale for evaluations

Results: At 3 months after the treatment, the mean grade of improvement based on clinical assessment was 2.0 ± 0.5 for FPS and 2.5 ± 0.8 for CO2 FS. On each side treated by FPS and CO2 FS, the mean duration of posttherapy crusting and scaling was 2.3 and 7.4 days respectively and that of post-therapy erythema was 7.5 and 11.5 days respectively. The mean VAS pain score was 3.9 ± 2.0 with the FPS and 7.0 ± 2.0 with the CO2 FS.

Conclusion: We demonstrated the efficacy and safety of single-session acne scar treatment using FPS and CO2 FS in East Asian patients. We believe that our study could be used as an essential reference when choosing laser modalities for scar treatment.

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