Guidelines for PicoWay Resolve™ treatment for acne scars and wrinkles: Tips and pearls
The PicoWay Resolve laser provides an outstanding level of treatment for acne scars and wrinkles, and with little to no downtime. Adhering to care recommendations provided by Candela helps ensure that the treatment process works well for both the patient and practitioner.
The right skin preparation
Start by cleaning the treatment area and removing any oil residue, dirt residue, makeup or lotion. Topical anesthesia is not necessary, but keep in mind that some facial areas are more sensitive than others and some patients may prefer to have anesthesia. If so, the provider may consider applying a topical anesthesia roughly 30 minutes before treatment. Be sure to clean it from the skin before beginning the procedure. The patient must wear goggles, and anyone else in the treatment room is required to wear safety eyewear during the treatment.
Per provider discretion, the entire face may be treated, including the forehead, cheeks, nose, chin and jawline. Treatment speed should be adjusted to provide comfort, typically between 5 - 7 hz. Typically, a full-face treatment consists of 3,000 or more pulses but provider must perform test spots and treat to patient tolerance and endpoint.
Other areas of the face require additional focus. Around the eyes, be sure to stay outside of the orbital rim. With eyewear in place, skin may be gently pulled down and treated over the orbital bone to maximize treatment area. When treating near the ear, provider may consider placing gauze in the ear to minimize noise and improve patient experience. Note, the laser should never be pulsed in the ear canal. When treating around the lips, remain outside of the vermillion border.
Treatments are performed utilizing a painting technique. It is important that the handpiece is touching the skin and is held flush and perpendicular to the skin during each pass. Practitioners should break the treatment area up into sections, ensuring each tissue section is treated with multiple passes until the clinical endpoint is reached before moving on to the next section. The clinical endpoint with the Resolve handpiece is a uniform erythema of the treatment area. Test spots should always be performed, and tissue response should be observed throughout the treatment. Alternate passes require a pass in one direction with a subsequent pass in a different direction.
Consider making two passes with the Resolve 1064 nm handpiece and one or two passes with the Resolve 532 nm handpiece depending upon the skin type and indication. You may increase the number of passes in areas with deeper rhytids or acne scars.
Post-treatment expectations and considerations
Most patients experience low to no downtime after PicoWay Resolve treatment. As with any split beam treatment, acneiform eruptions can occur and itching (urticaria) is common and may last up to a few days.
Patients should be reminded to avoid makeup 24 hours following treatments, utilize SPF 30 or greater before going outside and every couple of hours thereafter. They should also wash the treatment area twice daily with a gentle cleanser, apply a non-comedogenic moisturizer, and avoid the use of any acids or irritants to the skin for seven days post treatment.