Treatment information

Fotona Dynamis – skin improvement, scars, blood vessels and skin conditions

Well prepared for your appointment

Soon we will welcome you at Fine LaserClinic for a treatment with the Fotona Dynamis laser.

This laser system combines two different laser techniques: ND:YAG and ER:YAG.

This allows us to treat various skin indications, including scars, skin rejuvenation and certain vascular and skin conditions.

Depending on your skin and treatment indication, the treatment can be performed as non-ablative, fractional ablative or fully ablative.

With a non-ablative treatment, the skin surface in principle remains intact. With fractional ablative and fully ablative treatments, the skin is controllably damaged or removed to stimulate skin renewal or to treat unwanted skin tissue.

Because each treatment technique has a different effect on the skin, skin reactions and recovery can differ considerably.

You will receive this information at your appointment. Please read this page carefully in advance and always follow the personal advice of your practitioner.

If your treatment plan differs, other arrangements are made or additional advice is needed, we will confirm this by email.

Safety in brief

protect your skin from sun and sunbeds, come with clean skin and report new medication or skin problems. After treatment, use only the recommended skincare. With ablative treatments, scabs must not be removed and the wound surface must be carefully cared for. Contact us if the skin reaction worsens or if you are unsure about the recovery.

Before your treatment

To carry out the treatment safely and effectively, we ask you to take the following into account:

✓Avoid direct sun exposure and sunbeds for at least 4 weeks before the treatment. Some treatments may require a longer period.
✓Do not use self-tanner on the treatment area.
✓Come with clean skin, without make-up, body lotion, deodorant or other skincare products.
✓Stop retinol, acids, scrubs and other exfoliating products 1 week before, unless advised otherwise.
✓For certain fractional ablative or fully ablative treatments, we advise preparing the skin with AOX Ferulic serum or MelanTranex serum. Use these only according to your personal product advice and keep to the stop dates indicated.
✓Report new medication, antibiotics, anticoagulants and substances that may affect light sensitivity or wound healing.
✓Do you have an active cold sore, wounds, a skin infection or inflammation? Please contact us in advance.
✓Let us know if you have previously had problems with wound healing, pigmentation or scarring.
✓Have you had cold sores before and is the face going to be treated fractionally or fully ablatively? Please report this in advance. Sometimes preventive antiviral medication is needed.
✓When anaesthesia is needed, you will receive a form for your GP in advance. You bring the prescribed numbing cream to the appointment yourself. We apply it in the clinic according to the agreed protocol.
✓Preventive antiviral medication may sometimes be advised, for example if there is an increased risk of a cold sore recurring. We will discuss this with you in advance. Any medication is prescribed by a doctor.
✓Let us know if you are pregnant or breastfeeding.

Before each appointment we assess your skin condition and determine whether the treatment can be carried out safely.

For fractional and fully ablative treatments, we discuss in advance what recovery period you can expect and what wound care is necessary.

After your treatment

The skin reaction depends on the laser technique used, the treatment intensity and the area being treated.

The Fotona Dynamis can be used for treatments in which the skin remains intact, but also for treatments in which microscopically small openings or a complete wound surface are created.

As a result, the recovery period can vary from a few hours to several weeks.

Non-ablative skin improvement – ND:YAG and ER:YAG

In a non-ablative treatment, the skin is treated in a controlled way without deliberately creating an open wound surface.

Depending on the laser technique and settings used, energy is delivered into the skin to stimulate, among other things, the processes involved in collagen formation and skin renewal.

After the treatment, the skin may feel temporarily warm, red, slightly swollen or sensitive.

The skin may also feel slightly tight or drier.

These reactions usually subside within a few hours to a few days.

Because the skin barrier generally remains intact with this treatment, usually little recovery time is needed.

Important:

✓Cool if necessary, only in a gentle and indirect way.
✓Avoid intensive exercise during the first 24 to 48 hours.
✓Avoid hot showers, saunas and extreme heat while the skin is red, warm or sensitive.
✓Do not use irritating skincare products such as retinol, acids or exfoliants for the time being.
✓Use mild, hydrating skincare according to your personal product advice.
✓Protect the skin daily with SPF 50+.
✓Avoid direct sun exposure.

Fractional ablative ER:YAG

With a fractional ablative ER:YAG, microscopically small treated zones are created in the skin. The surrounding skin remains partly intact and supports the healing process.

The ER:YAG works differently from the CO₂ laser.

The energy of the ER:YAG is very strongly absorbed by water in the skin. As a result, skin tissue can be removed precisely.

With comparable ablative treatments, the ER:YAG usually produces less residual heat and coagulation in the surrounding skin than the CO₂ laser. The exact amount of heat depends on the laser settings used.

As a result, small blood vessels are often less strongly sealed during the treatment.

This means that after an ablative ER:YAG treatment the skin may produce more wound fluid and small pinpoint bleeding may be visible.

Immediately after the treatment, the skin may feel red, swollen, sensitive or burning. This can be comparable to a strong sunburn.

In the first hours and days, clear or light pink wound fluid may come from the small treated openings. Small pinpoint bleeding may also occur.

These are skin reactions that may be consistent with the first phase of wound healing.

In the days that follow, the skin may become darker, feel dry and tight, or develop a rough texture.

Small dark dots, flakes of skin or scabs may form. These come off on their own as the skin renews itself.

With a lighter treatment, the skin surface often recovers within about 3 to 7 days.

With more intensive or deeper treatments, this can take 7 to 14 days or longer.

Although the ER:YAG usually causes less residual heat than the CO₂ laser, this does not mean that the skin always recovers more quickly.

The depth, intensity and size of the treated area remain decisive for wound healing.

Redness or a pink skin colour may remain visible for longer, sometimes for several weeks.

A pattern of small dots may also remain temporarily visible on the treated skin.

This pattern usually fades gradually during natural healing.

If visible dots or differences in texture remain after full recovery, we will assess whether additional skin improvement treatment is needed.

In certain cases a peel may be suitable. This is only considered when the skin has recovered sufficiently.

Important:

✓Use only the recommended aftercare products.
✓The skin may produce more wound fluid during the first period.
✓Dab excess wound fluid only gently with a clean, preferably sterile gauze pad, if this is permitted according to your aftercare instructions.
✓Do not rub the treated area.
✓Do not pull at scabs or flakes of skin.
✓Do not scrub the skin.
✓Do not use retinol, acids or other active ingredients until the skin has fully recovered.
✓Do not wear make-up until the skin is completely closed and your practitioner has given permission.
✓Avoid exercise, sauna, swimming pools and jacuzzis during the first recovery period and for as long as the skin is still open or sensitive.
✓Cool only gently and indirectly where this is permitted.
✓Protect the skin carefully from sunlight.

Fully ablative ER:YAG

With a fully ablative ER:YAG, the superficial layer of skin is controllably removed in the treated area.

This creates an open wound surface that must heal again.

With customary ablative settings, the ER:YAG usually produces less residual heat and coagulation than the CO₂ laser.

As a result, small blood vessels may be less strongly sealed during the treatment.

This means that during the first phase of recovery the treated area may produce more wound fluid. Small pinpoint bleeding may also occur.

Directly after the treatment, the skin may be red, raw, swollen and sensitive.

The wound surface may look moist and red. Clear or light pink wound fluid may also be released.

This can be a normal reaction during the first phase of wound healing and does not automatically mean there is an infection.

It is important that the wound surface is carefully cared for.

The wound must not dry out unnecessarily, but excess wound fluid must be collected or removed in the correct way according to the personal wound care protocol.

If wound fluid remains on the skin for a long time or dressing material becomes soaked, this can soften the skin around the wound.

It is therefore important to follow the recommended wound care precisely.

Depending on the depth and size of the treatment, it often takes about 1 to 2 weeks before the skin is closed again.

With deeper or more intensive treatments, this may take longer.

Even after the skin has closed, the treated area may remain pink or red for weeks to months.

The newly formed skin is fragile and needs time to recover further.

Important:

✓Follow the personal wound care protocol precisely.
✓Use only the recommended wound products and dressing materials.
✓Keep the wound clean as instructed and prevent it from drying out unnecessarily.
✓Dab away excess wound fluid gently if this is permitted according to your aftercare instructions.
✓Replace dressing material according to the instructions provided and do not leave soaked dressings in place unnecessarily.
✓Only touch the wound surface with clean hands.
✓Do not pull at scabs or loosening skin.
✓Do not use make-up, scrubs or active skincare products on the wound surface.
✓Avoid swimming pools, jacuzzis, saunas and activities that increase the risk of infection until the skin has fully healed.
✓Avoid friction, scratching and unnecessary touching.
✓Do not use sunscreen on an open wound, but physically protect the area from sunlight.

A fully ablative treatment requires a careful recovery period.

Although the ER:YAG may cause less thermal damage than the CO₂ laser, there remains a risk of pigment changes, infections, prolonged redness and scar formation.

Aftercare

The right aftercare depends on the intensity of the treatment, the laser technique used and the condition of the skin.

For non-ablative treatments

Use gentle skincare and temporarily avoid irritating ingredients for as long as the skin is still red or sensitive.

A hydrating or skin-repairing cream may be advised to support the skin barrier.

Alhydran may be part of your personal product advice where this suits your skin condition.

For fractional ablative treatments

During the first few days, use only the aftercare products that we have personally advised.

With a fractional ablative ER:YAG, small openings may form in the skin, from which wound fluid is temporarily released.

It is important to keep the skin clean and use suitable wound care, so that the skin can recover calmly.

A skin-repairing cream can help support the skin barrier and limit moisture loss.

Alhydran can be part of your skincare where this is suitable according to the treatment protocol.

If the skin is still clearly releasing wound fluid, additional wound care or a different product may be needed.

Do not use your own skincare products while the skin is still open, moist or clearly damaged.

For fully ablative treatments

After a fully ablative ER:YAG treatment there is an open wound surface.

Because this treatment usually causes less coagulation than a CO₂ treatment, the wound may produce more wound fluid, especially in the first days.

It is therefore important to care for the skin according to the wound care protocol provided.

Depending on the treatment, a specific wound ointment, a protective dressing or a wound product that collects excess wound fluid may be advised.

The aim is to support wound healing and to prevent the wound surface from drying out or remaining too moist.

Do not use other creams, oils, disinfectants or active skincare products on the treated area on your own initiative.

Once the skin has fully closed, you may switch to restorative skincare according to the advice of your practitioner.

Alhydran may be part of your personal product advice at this stage.

Not sure whether you may use a product? Always contact us first.

Scars and skin improvement

Various Fotona techniques can be used for the treatment of scars and skin improvement.

Depending on the type of scar and the skin condition, a non-ablative, fractional ablative or combined treatment may be chosen.

With non-ablative treatments, temporary redness, warmth or slight swelling usually occurs.

With fractional ablative treatments, small wounds, pinpoint bleeding, wound fluid, scabs and flakes of skin may occur.

The skin needs time to form new skin structures and collagen.

The visible healing of the skin surface is therefore not the same as the final result of the treatment.

Improvement can develop over several months.

For scars that have formed recently, additional scar care may be advised.

Silicone gel may be suitable, for example, once the skin is fully closed. Use it according to your personal product advice.

The effect of the treatment depends on the type of scar, its depth, the age of the scar and individual wound healing.

Deep or adherent scars may require several treatments and do not always disappear completely.

The aim of the treatment is to improve the skin structure and appearance of the scar where possible.

Vascular treatments – ND:YAG

With the ND:YAG, selected superficial and deeper-lying blood vessels can be treated.

After the treatment, the skin may be red, warm, swollen or sensitive.

The treated blood vessels may become less visible straight away, but sometimes they first darken or temporarily appear more clearly visible.

Small blue or red-purple discolourations may also occur. These may remain visible for a few days to about 2 weeks.

The body needs time to gradually clear the treated blood vessels.

Important:

✓Cool if necessary, in a gentle and indirect way.
✓Avoid intensive exercise during the first 24 to 48 hours.
✓Avoid hot showers, saunas and extreme heat while the skin is red, warm or swollen.
✓Do not use scrubs, retinol or exfoliating products while the skin is sensitive.
✓Protect the skin daily with SPF 50+ once it has closed.

Through daily influences such as temperature differences, smoking, alcohol, flushing, hormonal changes and hereditary factors, blood vessels may become visible again or new ones may develop.

As a result, a maintenance treatment may be needed.

The number of treatments needed depends on the size, depth and location of the blood vessels.

Benign skin blemishes

When selected benign skin blemishes are removed with the ablative ER:YAG, a small wound is created at the treated spot.

Because the ER:YAG usually causes less coagulation than the CO₂ laser, this wound may produce somewhat more wound fluid or bleed slightly in the first period.

The skin may be red and sensitive directly after the treatment.

In the days that follow, a scab may form. This protects the underlying skin during recovery.

Let the scab come off on its own. If you pull at it, the skin may be damaged again and the chance of pigment changes and scar formation increases.

Depending on the size, location and depth of the treatment, the wound may close within about 1 to 3 weeks.

After healing, the skin may remain pink or red for some time. A lighter or darker discolouration may also temporarily occur.

Important:

✓Follow the personal wound care advice.
✓Keep the wound clean according to the instructions provided.
✓Do not pull at scabs.
✓Do not use make-up or irritating skincare products on an open wound.
✓Avoid swimming pools, saunas and jacuzzis until the skin has fully closed.
✓Protect the recovered skin carefully from sunlight.

There is a risk of permanent changes in colour or scar formation.

We therefore assess in advance which skin blemishes are suitable for a laser treatment.

Skin changes whose benign nature has not been sufficiently established are not removed for cosmetic reasons without medical assessment.

Actinic keratosis and medically assessed skin conditions

Actinic keratosis is a skin condition that develops through prolonged exposure to UV radiation.

This condition may be a precursor to squamous cell carcinoma, a form of skin cancer. Medical assessment and a suitable treatment and follow-up plan are therefore necessary.

Once a doctor has determined that an ablative laser treatment is suitable, the ER:YAG may be used according to the established treatment plan.

After the treatment, a superficial wound is created.

The skin may be red, sensitive and slightly swollen. Wound fluid may also be released or a scab may form.

Depending on the treated area and the depth of treatment, healing often takes about 1 to 3 weeks.

Important:

✓Follow the personal wound care protocol.
✓Do not pull at scabs.
✓Avoid irritating skincare products until the skin has fully closed.
✓Protect the area carefully from sunlight.
✓Attend the agreed medical check-ups.

Even once the skin has become calm after the treatment, follow-up remains important.

Long-term sun damage can lead to new actinic keratoses.

Moles and other pigmented skin conditions

Moles and other pigmented skin conditions must be carefully assessed in advance.

Not every pigmented change is suitable for a laser treatment.

If there is doubt about the nature of the skin condition, or if tissue examination may be necessary, the condition must not be lasered away for cosmetic reasons.

For pigmented moles, laser removal is generally not the preferred method, because tissue for examination may be lost and pigment cells may remain behind.

Treatment of such a skin condition therefore only takes place once a doctor has established the diagnosis and the suitability of the treatment technique.

For suspicious or changing moles, we will refer you to a doctor for further assessment.

Fractional ablative ER:YAG for tattoo removal

For certain tattoo treatments, the fractional ablative ER:YAG may be used in addition.

Microscopically small openings are created in the skin in this way.

This technique can be combined with a laser treatment aimed at removing tattoo pigment.

The aim of this combined technique is to influence the skin reaction during treatment and possibly to support the removal of treated pigment particles.

Whether this actually leads to a faster or better final result varies from case to case and cannot be guaranteed.

Because the ER:YAG creates small openings in the skin, an additional wound reaction occurs.

Directly after the treatment, redness, warmth, swelling, pinpoint bleeding and wound fluid may occur.

Because the ER:YAG usually causes less coagulation, the small openings may release visible wound fluid in the first period.

In the days that follow, small scabs or flakes of skin may form.

Depending on the intensity of the treatment, the skin may need a few days to about 1 to 2 weeks to recover.

Important:

✓Use only the recommended aftercare products.
✓Keep the treated area clean according to the instructions provided.
✓Dab away wound fluid only gently if this is permitted according to the aftercare protocol.
✓Do not pull at scabs or flakes of skin.
✓Do not burst any blisters.
✓Do not use scrubs or active skincare products while the skin is recovering.
✓Avoid swimming pools, saunas and jacuzzis until the skin has fully closed.
✓Avoid intensive exercise for the first 48 hours and longer while the skin is still open or sensitive.
✓Protect the treated area from sunlight.

When the fractional ER:YAG is combined with a tattoo laser treatment, the skin reaction may be more intensive than with a separate tattoo treatment.

It is therefore important to follow the complete personal aftercare protocol.

For tattoo removal we generally maintain at least 8 weeks between consecutive treatments, unless your personal treatment plan prescribes a longer interval.

The skin must always have recovered sufficiently before a next treatment is carried out.

Sun & safety during your treatment plan

After a Fotona laser treatment, the skin may be temporarily more sensitive to UV radiation.

How long this sensitivity lasts depends on the laser technique used and the intensity of the treatment.

For non-ablative treatments we advise avoiding direct sun exposure and sunbeds for at least 4 weeks.

For fractional ablative and fully ablative treatments we advise avoiding direct sun exposure for at least 8 weeks.

For intensive treatments, persistent redness or an increased risk of pigment formation, a longer protection period may be necessary.

Do not use a sunbed during recovery.

Use SPF 50+ daily once the skin has fully closed.

On sunny days we advise reapplying sunscreen regularly, preferably every 2 hours when you are outdoors.

With prolonged sun exposure, sunscreen alone is not sufficient. Make sure the treated area is also well protected or covered with suitable clothing or other physical protection.

While the skin is still open, sunscreen must not be applied directly to the wound surface.

Even when the skin appears to have healed on the outside, it may remain sensitive to UV radiation for a long time.

Good sun protection supports the healing process and reduces the chance of pigment shifts and other unwanted skin reactions.

Important to know

Every skin reacts differently to laser treatments.

The intensity of the treatment, the technique chosen, the skin type and individual wound healing determine how quickly the skin recovers.

With non-ablative treatments, skin reactions are usually mild.

With fractional ablative and fully ablative treatments, a wound reaction occurs and a longer recovery period is needed.

Because the ER:YAG usually causes less coagulation than the CO₂ laser at comparable ablative settings, wound fluid and small pinpoint bleeding may be more noticeable.

This may be consistent with the characteristics of this treatment and does not automatically mean that the skin is reacting incorrectly.

Possible complications include infections, prolonged redness, hyperpigmentation, hypopigmentation and scar formation.

With intensive or deeper ablative treatments these risks may be greater.

The average number of treatments that we mention on the website or during the intake consultation is always an indication only.

Factors such as skin type, scar depth, skin condition, age, lifestyle, hormones, medication, sun exposure and following the aftercare advice may affect recovery and the final result.

The result achieved may also be temporary. Depending on the skin indication, maintenance treatments may be needed.

Because every skin and every body reacts uniquely, we cannot guarantee an exact end result or the number of treatments needed.

If your treatment plan differs, other arrangements are made or advice is not followed, we will confirm this by email.

Pregnancy

Are you pregnant or breastfeeding? Please let us know.

During pregnancy we postpone cosmetic laser treatments.

When breastfeeding, we assess which treatments and any additional products or medication are suitable.

When to contact us

After a fractional or fully ablative ER:YAG, wound fluid may temporarily be released. This can be a normal reaction as long as it fits the expected recovery.

✓The pain increases instead of decreasing.
✓The skin becomes increasingly red, warm or thick.
✓The wound fluid clearly increases or continues to persist while the wound should be healing.
✓Pus, an unpleasant smell or cloudy wound discharge develops.
✓You develop a fever.
✓There is persistent bleeding.
✓Extensive blistering develops.
✓The skin does not heal as expected.
✓You are unsure whether the wound is healing normally.

Preferably send a clear photo so that we can better assess the skin reaction.

In case of serious complaints, a suspicion of infection or if you cannot reach us, contact your GP or out-of-hours GP service on the same day.

Questions?

If you have questions or doubts about anything after reading this information, please feel free to contact us at info@finelaserclinic.nl. We are happy to help and look forward to welcoming you soon at Fine LaserClinic.

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Amersfoort · 033 202 26 47 Arnhem · 026 206 21 47 Amsterdam · 020 244 59 27