New in My Practice: Devices

Lumenis’ ULTRApulse Alpha

With Jane Yoo, MD

In each issue, Practical Dermatology® asks top dermatologists about the newest products or devices they are offering to patients. Here, Jane Yoo, MD, a dermatologist and Mohs surgeon in New York, discusses Lumenis’ ULTRApulse Alpha CO2 laser.

What is the ULTRApulse Alpha CO2 by Lumenis, and how are you using it in practice?

Jane Yoo, MD: The ULTRApulse Alpha is Lumenis’ newest CO2 laser. The original UltraPulse is the gold standard of CO2 devices and a workhorse in many practices and hospitals. There are so many options with this device! First, it facilitates ablative skin resurfacing, significantly improving aging signs from deep periorbital/perioral rhytides to skin texture, laxity, and tone. It can also help improve the appearance of pitted acne scars and treat benign lesions such as rhinophyma and syringomas without scarring. Furthermore, the laser offers a complete blepharoplasty solution because there is an incisional handpiece, and you can also provide complementary eyelid resurfacing. With laser-assisted incisions, bleeding during the procedure as well as post-surgery bruising are reduced. Finally, the device provides advanced treatment for traumatic scars, which can have some pretty life-changing consequences in some patients.

What sets this device apart from other ablative skin resurfacing devices?

Dr. Yoo: The ULTRApulse Alpha technology enables the deepest penetration with the lowest amount of energy. It enables ultra-short pulses per energy level such that there are optimal clinical outcomes with minimal excess heating.

Lumenis has developed CoolScan technology for enhanced patient comfort as well as a BrushFX scanning mode to help blend different anatomical subunits. In the Scaar FX mode, there is up to 4 mm penetration depth in a single pulse, which makes it ideal for treating deep, thick lesions. With this new device, there is a user-friendly, intuitive graphical interface that enables the physician to create presets.

Who makes the ideal patient?

Dr. Yoo: The ideal patient is realistic about the time needed for recovery to achieve the optimal cosmetic results. Compared to other non-ablative laser devices, there is a longer downtime period. The length of the recovery time is contingent on the type of treatment that one receives. The DeepFx may require up to a full 2-week recovery period. Patients often experience remarkable results with just one treatment, but the full benefits may take up to 6 months to manifest.

How many treatments for optimal cosmetic results?

Dr. Yoo: It depends on what is being treated. Scars may require more than one treatment.

Is there a learning curve for providers?

Dr. Yoo: Like all devices, there is definitely a learning curve. One must also be careful and knowledgeable about the risks of using this device in patients with darker skin types.

Please share your treatment protocol(s) and any pearls.

Dr. Yoo: It’s important to pick the right patient and to set realistic expectations from the very beginning. This includes explaining the necessary steps for preparation before treatment, detailing the actual procedure, and outlining the post-procedure instructions. Another key is to make the patient feel as comfortable as possible, so this may include using topical anesthesia as well as nerve blocks and anxiolytic medications.