Pigment & Redness: Sciton BBL Treatment Parameters
/Sciton BBL Treatment Parameters: Pigment & Redness
Hi everyone, Just started with BBL.I have a Q regared the 515 filter and lentigines. With the 10ms pulse widths I have seen moderate rxns at 11-12J with 25 cooling in type 2s ( moderate erythema with accentuation and darkening of lentigines). When I moved to 20ms 9-10J with 18 cooling in type 3 and 4s I saw no immediate response (eythema or darkening). I spoke with a patient today who stated minimal darkening 24hr out. These are the recommended settings but they do not appear to have the punch. Has anyone tried lowering pulse widths to 15ms or even 10ms with cooling let's say 15 to protect surrounding skin?? I have lot's of type 3-4s with lentigines. Your suggestions appreciated
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Hey Sal, these are notes that I made.
They are settings that I used on a few difficult patients.
I am trying to figure out how to best use the BBL.
Not really sure why some worked but I am beginning to play with all parameters of the BBL
Interested in your thoughts as well as the thought of the others.
Jeff E
Pt #1:
I just did a BBL on an age spot that was difficult to get to darken.
It had faded about 60% with two previous treatments but would not fade further.
I increased the wavelength to get deeper.
I increased the energy to 22 j/cm2.
I increased the temperature to 25 degrees.
The pulse duration was 20 ms.
I need to check these settings. Not sure about the exact pulse duration or temp.
Perhaps 515 ms would have worked if energy and temp were high enough?
JEE
Dark Circles Under Eyes with BBL
Patient #2:
Finally got darkening with 515-20ms-20d-15j
increased energy, lengthened pulse duration and increased temperature.
He had PIGMENT as the cause of his dark circles
prior settings were:
The first 4 treatments did not produce any lightening.
515-13j-15ms-20: Rx #1
515-16j-15ms-18: Rx #2
560-16j-15ms-18
560-18j-10ms-18
515-15j-20ms-20: Rx #5: worked
515-15j-20ms-20: Rx #6: worked
Patient #3
Rx # 2: 590-11ms-21j-20d
She had Vascular Etiology of her dark circles
Rx #1 showed no improvement with 560-10ms-16j-20d
I used a longerwavelength and increasedthe energy to get the response.
Did this work because longer wavelengths go deeper?
JEE
Pt #4:
Just did a BBL for pigment. Skin type 4 (looked like Asian but from Russia).
Test spots at 590 nm, 20 ms, 12-18 j, 20 degreesdid not react. (smallest round spot size)
I turned MS down to 15 ms and did test spots at 15, 16 and 17 and the 17 j reacted. (used the square mask)
Gota nice darkening with the square mask, 17 j , 590 nm, 15 ms.
Not sure whether using larger spot size made the difference or turning to lower pulse duration.
Probably lower pulse duration!
JEE
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Ithink it depends. I will use higher settings if I am spot treating and a little lower when doing full face chest etc. I agree that the "safe" numbers given by Sciton are a little under treating. I think on a Fitz 3 you can drop to 15msec and increase your joules. I tend to do a test spot and watch the reaction for a few minutes. If I do see a response then I will increase the Joules. I also tend to always use 20 to 25 degrees cooling.
Lornell
