A Physician's Perspective
By J. Kevin Duplechain, MD, FACS

Patient Perspective
Laura - PIH Patient

Clinicians overseas have been using Spectra VRM II, a dual pulsed Nd:YAG laser, for several years with great success for a variety of applications. My own experience is that the VRM II is an incredibly versatile laser that it is very kind to the skin.

Utilizing a unique top hat wave form and featuring a proprietary pulse width, it has the ability to penetrate deeply without causing significant epidermal injury, making it one of the most useful lasers ever manufactured for dermal and epidermal lesions. Throughout Asia it is considered the “gold standard” for treating melasma. Seborrheic keratosis, ephelides, and deep or resistant port wine lesions all also respond well to it. And, it’s extremely effective for skin rejuvenation.

With two pulse modes (Q-switched Mode and Spectra Mode) and 4 wavelengths, the hallmark of this laser is its flexibility. This flexibility makes it possible to safely treat all skin types. I have treated several Fitzpatrick V and VI tattoos and epidermal lesions with no difficulty or skin color change because of the adjustable fluence. Patients with active skin conditions may need to have treatment parameters altered, but beyond this, I can’t think of anyone who couldn’t be treated with this laser.

The laser’s versatility allows treatments to be tailored for little or no downtime. For instance, SpectraPeel, a deep dermal stimulation peel coupled with an epidermal exfoliation peel, can cause slight swelling and some erythema but typically requires only a day or two of healing. SoftPeel demonstrates immediate results, creating a healthy glow and vibrant appearance with no downtime at all. The removal of epidermal and dermal lesions in Q-switched mode results in a slight white crust which resolves in about 4 days. And, the device’s endless power supply and range of treatment options make it possible to achieve results that satisfy patients with only one or two treatments.

VRM II is clearly the laser of choice for tattoo removal. I had a tattoo patient recently who had been treated a dozen or more times by everyone in a 2-3 state area. She heard that I had a new laser and wanted a treatment for residual staining on the lower extremity. I was skeptical that I could help her, but when she returned after the treatment we were both impressed with how much the deep stains of the tattoo had cleared.

When it comes to tattoos, VRM II offers a number of advantages including its incredible reserve of power. I have observed significantly less epidermal scatter with this laser compared to others. I treat tattoos with fluences of about 5 j/cm2 with a 4 mm spot. Significant dermal bruising appears about 30 seconds later, demonstrating the photo acoustic power of this laser. The added power makes treatments very effective. VRM II’s ability to treat any color is extraordinary. The 585 and 650 hand pieces are the best available for orange, sky blue and green.  The true 585 and 650 wavelengths are much better than so called blended wavelengths.  The small spot size makes it easy to treat cosmetic tattoos that may have had problems with the application process. Depending on ink type, I see much more improvement in significantly less time. And, the VRM II is very quick. It has an instant start up so there is no wait time, and treatment of an 8 cm tattoo takes less than a minute. The number of treatments is dependent on the ink and how much energy the skin will tolerate, not the laser. I am anticipating great results with one treatment once the Freedom II ink is available.

The fact that the VRM II is a 110 device is also an absolute advantage. If need be, it can be moved from one location to another and is ready for use in any office location.  I previously owned an older soft light Qswitched YAG that I used for skin rejuvenation and tattoo removal. The power was very limited which restricted my ability to treat multicolored tattoos, but this unfortunate circumstance actually allowed me to rent and work with virtually every available Q-switched Nd:YAG laser. As a result, I am not without authority when I say nothing works like the VRM II. The laser is never disappointing and consistently gives good results. It is hands down the best when it comes to tattoo removal and pigmented skin lesions.

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Dr. Duplechain has a facial cosmetic surgery and skincare practice in Lafayette, Louisiana.

After more than three years of living with discolored spots on my face, I was ready to get rid of them! I’m not sure if the discoloration is a result of hormones from birth control pills or all the experimenting I have done over the years trying to rectify it. In any event, they are not good advertising for an aesthetician, and I have tried EVERYTHING to get rid of them! Not only has nothing worked, but most treatments I have had (including laser treatments) have made the condition worse!

Due to my history, I wasn’t sure what would happen with VRM. We started with a very low-energy, non-clinical test treatment just to see how I’d respond. My skin was very red and hot for about 2 hours; then the color dropped off and my skin felt fine. I did not notice any changes in the following days. The treatment was too light to expect an improvement, but I was concerned that the spots could get worse, which is what always happens after a laser is used on me. That didn’t happen so I was encouraged.

When I started clinical treatment about 7 days later, the feeling was definitely more intense, but wow, I definitely noticed a difference! After only this one treatment my spots started to break up and get lighter. Within days of this treatment I headed to the Caribbean for vacation. I tried my hardest to avoid sun on my face. I wasn’t 100% successful, but even with some sun exposure, my skin looked better than it did before starting treatments!

Between my second and third treatments, my skin improved so much that I even got carded when I went out, and that hasn’t happen in a long time! My skin is looking really amazing, and I am very excited to see what happens with additional treatments.

More Patient Perspectives

I am a Spectra VRM II convert, and all you have to do is look at my before and after pictures to know why.

I didn’t really have a problem with acne as a teenager, so the appearance of cystic acne at 25 was extremely frustrating. As a designer and business owner, I deal with the public and make regular media appearances.  I feel like I have it all together as a professional, and it bothered me that my skin did not match that image.  From prescribed medication (which only seemed to exacerbate the problem and dry out my skin) to the most expensive cleansers to weekly facials to special diets, for the past 6 years, I’ve tried everything I could to get control of this.

Kelly Before

Kelly After

A lot of things worked for a short time, but the breakouts always returned. For a while I used Proactive, which did cleared up the acne, but had the unfortunate side effect of giving me dry, lifeless skin that made me look five years older than when I started. Spectra VRM II treatments are the only thing that has really worked on a long term basis and given me the bright, clear, healthy complexion that I want.

After my first SpectraPeel, I began to see little differences right away. My skin was softer and several blemishes disappeared immediately.  During the next week many remaining blemishes also disappeared, and I did not have any major new blemishes. I came in for treatments about every 10 days and by the fourth treatment, the change was significant. My existing blemishes dried up, and I was able to go for a month between treatments and still look good. Miraculously, I had no serious new breakouts, even though it was a month filled with excessive travel and stress.

Since then my treatments have been less frequent. My skin looks so good that I do not feel the urgency to come as often. I still experience minimal normal acne, but nothing like the large oozing cystic blemishes of the past. At this point my treatments are really about maintenance and helping with a bit of left over scarring and redness, and I’ve already seen an improvement in these too.  It’s an incredible relief to finally find something that clears the blemishes while making my skin look healthy.

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Kelly , 31 year-old acne patient, received seven SpectraPeel treatments over a period of 19 weeks.

Hear Kelly Speak About her Spectra VRM II Treatments