Laser Treatments

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Dr. Cockerham offers several options for face rejuvenation which improves the appearance of your skin, removes age spots, sun induced freckles and most benign pigmentation. Please take some time to review some of the following laser treatments that we offer through our MedSpa.

We are happy to answer any of your questions, please feel free to call directly.

Los Altos Office Phone: 650-559-9150
Santa Cruz Office Phone: (831) 476-8934
Campbell Office Phone: (408) 866-2087

Laser Options for Facial Rejuvenation
	Laser or radiofrequency removal of lumps, bumps or cancers
	Laser treatment of hyperpigmentation & redness (Luminus IPL)
	Fraxel for fine wrinkles, hyperpigmentation dur to sun exposure
	Active FX and Max FX laser therapy for the eyelids, face and neck
	Laser or surgical eyelid skin removal, resurfacing and fat sculpting
	Laser hair removal
	Spider vein treatment
	Skin regimen for post - laser care

Laser or radiofrequency removal of lumps, bumps or cancers

Information Coming Soon...

For more information on radiofrequency products, visit Ellman.com

Fraxel

Face, neck and chest cost = $1000

If you are purchasing other treatments at the same time, e.g. fillers, surgery, Botox, you will receive 20% of all services.

Upper eyelid skin removal and fat sculpting (blepharoplasty) plus Fraxel of lower eyelids = $ 2500

Indication for Fraxel: fine wrinkles, ruddy texture, hyperpigmentation due to sun exposure, hormonal fluctuations such as pregnancy. Not good for Rosacea or broken capillaries. Fraxel is also effective at smoothing post-traumatic or acne scarring.

Typical Areas to treat: around eyes, full face and, neck/chest but arms, legs and backs can also be treated. Each additional region treated adds $1000.

Typical Social Downtime

• Redness like a bad sunburn for 24 hours or less
• Mild sun and aging skin changes will respond to two treatments approximately 4 weeks apart. It is best to exfoliate with a peel or microdermabrasion the day before the treatment and 10-14 days after the treatment.
• More severe changes may require 6 or more treatments spaced approximately 3-4 weeks apart. This is different than the active FX which is typically a single or at most two treatments spaced six months apart.

Pre-op instructions

If you have ever had a cold sore, fever blister or Herpetic outbreak of any kind, lasers can stimulate a breakout on your lips, face or elsewhere. Valtrex is recommended starting two days before, the day of treatment and for two days after the treatment. (Valtrex 500 mg is taken twice daily)

On the day of treatment

• Please don’t wear make up, or remove it upon arriving at the office. Your face will be cleansed and then numbed with a topical Betacaine-Lidocaine-Tetracaine product for 30 -45 minutes. This will be removed and the face cleansed again.
• The treatment will take approximately 30-45 minutes per region treated.
• Sunblock will be placed in a thick coating and cold packs will then be applied for 10-15 minutes prior to your departure. You should use ice for at least 30 minutes of every hour while awake during the first 24 hours for comfort.

Post-op instructions

• You will be red everywhere that was treated. This redness feels very warm, but does not hurt. This redness will persist for at least 4 –6 hours.
• You will be seen post-op day one, day 3 –5 depending on the depth of your treatment and at two weeks post-treatment.
• During this time it is ok to shower, but avoid glycolic products and Retin A. You should avoid direct sunlight as much as possible in the days following your treatment. UV block should be used on a daily basis to protect the treatment
  

Active FX and Max FX laser therapy for the eyelids, face and neck

Facial resurfacing (does not include eyelids see below) = $3000

Chest and Neck resurfacing = $1500

Eyelid resurfacing (note this requires injection of local anesthetic and placement of metal laser protective shells) = $1000

Eyelid surgical or laser skin removal and fat sculpting (blepharoplasty) $ 2000 – 4000 depending on whether upper, lower or both eyelids are operated on.

Laser Post-Operative Kit = $250 (essential for appropriate healing)

Active FX Protocol and Online Purchase request (current patients only)

Contents: White vinegar, distilled water, acquaphor, Cetaphil, Jan Marini transformation serum, Skin Ceuticals Epidermal Cream and physical block, Color Science micro block, Benedryl and a Vicodin for before the procedure.

If you are purchasing other treatments at the same time, e.g. fillers or Botox, you will receive 20% of all services. These should be done at least two weeks after the laser.

Indication for Active Fx

• Fine line and wrinkles
• Ruddy texture due to large pores
• Brown spots or white spots due to sun exposure, hormonal fluctuations such as pregnancy.
• Note: Active FX is not good for Rosacea or broken capillaries, See IPL laser discussion.

For significant brown spots that are noted at many layers in your Visia Skin Analysis; pre-treatment with IPL is indicated to improve the effectiveness of the active FX.

Typical Areas to treat: around eyes, full face and, neck/chest but arms, legs and backs can also be treated. Each additional region treated adds $1000.

Typical Social Downtime

Redness like a bad sunburn for at least 3 days followed by spotty brown appearance for at least 3 days. The higher the thermal settings, the more long-term effect but also the longer the social downtime.

Unlike the IPL and Fraxel one treatment usually achieves the desired effect. If it is repeated, the duration between treatments should be six months as the effect continues for that duration as the elasticity (collagen) under the skin continues to improve.

Pre-Treatment Instructions

You should be on an effective skin regimen that includes Hydroquinone (a prescription strength topical medication to suppress pigmentation) and Retin A ( a prescription strength topical medication that increases skin surface turn over time).

If you have ever had a cold sore, fever blister or Herpetic outbreak of any kind, lasers can stimulate a breakout on your lips, face or elsewhere. Valtrex is recommended starting two days before, the day of treatment and for two days after the treatment. (Valtrex 500 mg is taken twice daily)

If you are having your eyelids treated with the laser, you will need to avoid aspirin, motrin and all pain relievers except Tylenol. You should also avoid all herbal remedies except your Arnica in your laser kit. You will be very swollen and also bruised for up to 5 -14 days depending on the effect desired. Remember – more downtime = more effect.

On the Day of Treatment

You will need to have someone drive you to and from the treatment – let them know that you will be at least 3 hours (we are near Ranch Shopping Center, The Los Altos Village Shops and not far from Stanford Shopping Center).

Please bring a small cooler with frozen peas or corn (2- 16 oz sized bags), we will show you how to construct your post-op ice packs.

Please don’t wear make up, or remove it upon arriving at the office. Bring sunglasses and a hat to protect your skin. Tape a paper bag to the window on your side of the car or sit in the middle of the back seat. You can not put UV block on your face for at least one week so will need to be very careful as sun exposure will damage skin and delay healing process.

When you arrive, you will be photographed and then asked to read the consent, ask any questions you might have and sign the consent.

A surgical hat will be placed to keep the numbing cream out of your hair. Your face and other sites to be treated) will be cleansed and then numbed with a topical Betacaine-Lidocaine-Tetracaine product for at least 60 minutes. If you are having your neck, chest or back treated you will be asked to change into to spa robe. Please bring appropriate loose clothing that you do not care about as the topical anesthetic can stain clothing.

The topical anesthetic will be removed and laser protection goggles will be placed on you. If you are having the eyelid surface treated then you will have drops placed in your eyes and then metal protectors placed in your eyes. You will then be given local anesthesia injections just under the eyelid skin.

The treatment will take approximately 20 – 90 minutes depending on number of areas treated.

Post-Treatment Instructions

Aquaphor will be placed in a thick coating and cold packs will then be applied for 10-15 minutes prior to your departure. You should use ice for at least 30 minutes of every hour while awake during the first 24 hours.

You will be red everywhere that was treated. This redness feels very warm, but does not typically hurt. This redness will persist for at least 48 hours and then will evolve into a dark brown irregular appearance that will persist for at least 48 hours. If you have had a very deep treatment around your eyes (MAX FX) a redness that can be covered with make-up may persist for weeks.

You will be seen post-op day one and the aquaphor will be removed and your face patted with distilled water/vinegar mix. We will go over all of the contents of your laser kit bag and insure that you understand how to proceed.

Day of Treatment – Do not wash your face or take a shower

Day 1

• We will wash your face and reapply the acquaphor
  
• Do not wash your face or take a shower

Day 2

You can shower but don’t have the water spray directly onto the areas treated
You will use the distilled water (8 oz) with one tablespoon vinegar combination twice today - just pat – do not rub. After “washing” your face apply a thin coating of acquaphor.

Day 3

You can shower same as above
Red areas – continue to treat as above. Hives sometimes form at the edge of the treated area that can be uncomfortable. Take 25 mg of Benedryl and apply cold compresses. Stop acquaphor in that region.

If you are now brown with little red you can move to cleansing with the Cetaphil cleanser twice daily. Do not rub the face. Start epidermal lotion in am and transformation serum in pm on brown areas. If you feel dry or too tight you can use a small amount of acquaphor.

Take Benedryl 50 mg at bedtime to treat itching sensation. You will be seen on post-op day 3 and then day 5 – 7 depending on the depth of your treatment and then over the first post-operative month as needed.

During the first month you should avoid glycolic products and Retin A. You should avoid direct sunlight as much as possible in the days following your treatment, as UV block needs to be avoided until the skin is healed adequately. Once you are predominately brown you can resume your daily UV block. Once the brown is completely resolved, you should add the color science powder whenever going outdoors for at least the first six months to maximize your outcome.

Please call Dr. Cockerham directly at 650-804-9270 if you have any questions or concerns.

Serious Problems that warrant immediate evaluation:

1. Crusting
2. Scabbing
3. Vesicle formation
4. Odd smell to face
5. Fever, chills, malaise

An untreated infection can result in permanent scarring of the treated area.

Before & After Images

Light and Heat....to smooth, improve color, and tighten

Learn more about Active FX
Active FX Protocol and Online Purchase request (current patients only)

	What it does	How long it lasts	Pain-o-meter	Downtime	Average Cost (may differ)
For Color Corrections
Q switched Yag Laser	Emits beam of light and absorbed by colored pigments in the skin, including melanin and tattoo pigments (such as tattooed makeup).	After a series of three to six treatments, yearly maintenance is often required.	(2) "rubberband snap" discomfort	Skin can be pink for 1 to 2 days.  Minimal bruising can occur for 5 to 7 days.	$100 to $600 per treatment, depending on size of area treated
For a Little Bit of Everything
Intensed Pulse Light	Broad-spectrum light wavelength targets redness, mild discoloration, and mild wrinkling.  Great for minor to moderate sun damage.	Results can be long lasting with proper sun protection.  Maintenance treatments are usually required once or twice a year.	(1 to 2) very minimal discomfort to"rubberband snap"	Skin may be pink for a few hours, a day at the most	$400 to $600 per treatment, depending on the size of the area being treated

Please call us if you have any questions (650) 559-9150

Laser or surgical eyelid skin removal, resurfacing and fat sculpting

Coming Soon...

 

Intense Pulsed Light (IPL) Photofacial

IPL technology improves the appearance of photo aged skin, removes age spots (sun-induced freckles), most benign brown pigments, and redness caused by broken capillaries through a process called photorejuvenation for face and body. The process is ideal for patients with active lifestyles because the procedure requires no downtime and has a low risk of side effects.

Photorejuvenation IPL Therapy Image provided by www.Lumenis.com web site

Learn more about photorejuvenation How it works? Frequently asked questions?

Face Cost $500 per treatment or $1250 for 3 treatments
(If you buy one and then want to buy the package, you will still get the discount)

If you are purchasing other treatments at the same time, e.g. fillers, surgery, Botox, you will receive 20% of all services.

Indication for IPL: hyperpigmentation due to sun exposure, hormonal fluctuations such as pregnancy, mild textural issues.

Typical Areas to treat: face, neck/chest, and hands but arms, legs and backs can also be treated. Each additional region treated adds $250.

Typical Social Downtime

NONE (mild redness for a few hours, darkening of existing sun spots that persists for 7 – 14 days before flaking off).

Mild sun and aging skin changes will respond to two treatments approximately 4 weeks apart. It is best to exfoliate with a peel or microdermabrasion the day before the treatment and 10-14 days after the treatment. More severe changes may require as many as 5 treatments spaced approximately 3-4 weeks apart.

Pre-Treatment Instructions

You should be on an effective skin regimen that includes Hydroquinone (a prescription strength topical medication to suppress pigmentation).

If you have ever had a cold sore, fever blister or Herpetic outbreak of any kind, lasers can stimulate a breakout on your lips, face or elsewhere. Valtrex is recommended starting two days before, the day of treatment and for two days after the treatment.

On the Day of Treatment

1. Please don’t wear make up, or remove it upon arriving at the office. Bring sunglasses and a hat if it is a sunny day to protect your skin.
2. You will be photographed and then asked to read the consent, ask any questions you might have and sign the consent.
3. A surgical hat will be placed to keep the numbing cream out of your hair. Your face and other sites to be treated) will be cleansed and then numbed with a topical Betacaine-Lidocaine-Tetracaine product for 30 minutes. If you are having your neck, chest or back treated you will be asked to change into to spa robe.
4. This will be removed and then a clear ultrasound gel will be placed on the region to be treated. The treatment will take approximately 20 minutes per region treated.

The gel will be removed and UV block placed. Cold packs will then be applied for 10-15 minutes depending on your skins response to the treatment.

Post-Treatment Instructions

You may be slightly red everywhere that was treated, or in blotches where you were most hyperpigmented. This redness feels slightly warm, but does not hurt and typically resolves within hours of the treatment. Occasionally small scabs will form along the hairline or where there is a lot of pigment.

It is ok to shower, but avoid glycolic products and Retin A for 24 hours. You should avoid direct sunlight as much as possible in the days following your treatment and should use UV block on a daily basis to maintain your treatment effect.

Post-Treatment Follow-up Schedule

1. Please call or email Dr. Cockerham directly
   cell 650-804-9270 or dr@cockerhammd.com
   
2. Post-laser check at one week
   
3. Peel or microdermabrasion at week two
   
4. Second treatment at 4weeks
   
5. Repeat as needed

Download IPL consent form

Skin Regimens For Post - Laser Care

If Hyperpigmentation is your problem:

A.M.

1. Glycolic wash
2. Cesta serum or CE Feurulic
3. Bioclear
4. At least 30 UV block with zinc oxide or other physical block
5. Colorscience micronized zinc brush for freshen up when out in sun

P.M.

1. Glycolic wash
2. Retin A under eyes and in problem areas (contraindicated if Rosacea is present)
3. Hydroquinone in hyperpigmentation problem spots
4. Age Intervention or transformation serum depending on degree of sundamage and skin type

if Fine Lines and Poor Texture is your problem:

A.M.

1. Glycolic wash
2. CE Feurulic or Cesta Serum depending on skin type
3. Bioclear
4. At least 30 UV block with zinc oxide or other physical block
5. Colorscience micronized zinc brush for freshen up when out in sun

P.M.

1. Glycolic wash
2. Age intervention cream on face and neck
3. Retin A sparingly on entire face at least once a week

Once weekly: use papaya wash and mask to improve texture and prevent flaking. Once monthly glycolic peel and/or microdermabrasion will optimize your outcome.