In 1986, after completing my dermatology residency, I joined Dr. Richard Fitzpatrick at Dermatology Associates of San Diego. Together, we embarked on a journey that would significantly transform cosmetic dermatology through groundbreaking advancements in laser resurfacing.
Early Challenges: Seeking Better Solutions
During the 1980s, treatments for wrinkles, sun damage, and skin lesions often involved harsh, invasive procedures with lengthy recovery times and inconsistent results. Traditional continuous-wave CO2 lasers could effectively remove lesions but frequently resulted in severe scarring and prolonged redness due to deep thermal damage. Dr. Fitzpatrick and I knew there had to be a safer, more effective approach.
We experimented extensively, initially focusing on actinic cheilitis—a common precancerous lip condition. The treatments available at the time were often painful, leaving patients with weeks of discomfort. Early experiments with CO2 lasers were promising but still posed significant challenges, motivating us to refine our techniques further.
Discovering a Revolutionary Approach
Our breakthrough came with the UltraPulse CO2 laser (Fractional CO2 Laser), originally developed for precise gynecological surgery. Unlike traditional CO2 lasers, the UltraPulse delivered controlled, short bursts of energy, enabling highly targeted vaporization of damaged skin with minimal collateral damage. This approach significantly reduced recovery times and dramatically improved cosmetic outcomes.
Initially, we tested the UltraPulse laser on challenging cases, including congenital lesions of the skin, squamous cell skin cancer in elderly patients where excisional surgery was not recommended and pre-cancerous skin lesions. The results were astonishing—patients healed faster and experienced fewer side effects. Recognizing the enormous potential of this technology, we began exploring its use for cosmetic rejuvenation.
Revolutionizing Skin Resurfacing
The adoption of the UltraPulse CO2 laser marked a pivotal shift in dermatological practice. By precisely vaporizing damaged skin layers, we significantly reduced side effects such as scarring, redness, and prolonged discomfort. Patients could now achieve youthful, rejuvenated skin in days rather than weeks, dramatically increasing their satisfaction and willingness to undergo the procedure.
Our continued research led us to introduce fractional laser resurfacing technology (Fraxel Laser). Fractional treatments targeted only fractions of the skin surface at a time, dramatically enhancing healing and minimizing downtime. This innovative approach expanded the potential for laser resurfacing, making it accessible to a broader range of patients, including those with sensitive skin types.
Combining Technologies for Optimal Results
Always striving for improvement, we identified further refinements by combining different laser modalities. Recognizing the limitations of CO2 lasers alone, we integrated Erbium:YAG lasers (Erbium Laser Resurfacing) into our practice. This combined laser approach significantly enhanced patient outcomes by further reducing residual thermal damage, accelerating healing, and improving overall results.
Our pioneering combination treatments quickly became the gold standard for comprehensive skin rejuvenation, setting new industry benchmarks for effectiveness, safety, and patient satisfaction.
Comprehensive Patient Care
Innovation extended beyond the lasers themselves. We prioritized comprehensive patient care, developing advanced post-care regimens, including skincare products and wound-healing protocols, ensuring optimal recovery and enhanced outcomes. These holistic approaches have significantly improved patient comfort, satisfaction, and long-term results, further establishing our leadership in cosmetic dermatology.
A Lasting Legacy
Reflecting on our journey, I am profoundly grateful for the collaborative spirit, curiosity, and dedication that have driven these transformative advancements. My work with Dr. Fitzpatrick and many skilled colleagues shows the great power of innovation, teamwork, and patient care. It has been profoundly rewarding to witness the positive impact of our work on countless patients’ lives worldwide.
About the Author
Dr. Mitchel P. Goldman is a highly respected dermatologist, internationally recognized for pioneering contributions to laser treatments and dermatological surgery. As Medical Director of Cosmetic Laser Dermatology in San Diego, Dr. Goldman continues to drive innovation, ensuring outstanding patient care and results.
Schedule your consultation today and experience firsthand how advanced laser resurfacing can restore your skin’s youthful glow and confidence.
