for it I'm doing the laser plus RF on the front and the back of the neck. I've also been treating the hands which is a total home run. One woman had sclerotherapy and then I did her hands with the laser, it was like night and day. In one session, a 20- year difference.Dr. Burgess: I'm doing a case, skin type V, where the elbows were very dark and somewhat keratinized. What a difference. I used level five or six.Dr. Saedi: I’m considering this for knees as well.Dr. Roberts: So, would you have the elbow bent, to stretch everything out? Dr. Burgess: I do the laser treatment with elbow bent. I like to stretch the skin. My assistant holds it taut so that we cover more surface area.Dr. Roberts: That's a very good point.Dr. Saedi: I do that for the neck to maximize the surface area and get into all the creases.Dr. Roberts: What about positioning? Dr. Burgess: I have my patients lying down that–will extend their neck backwards over a covered pillow.Dr. Campbell-Chambers: I've had fantastic results combining the laser in an alternated regimen with dermal needling and PRP for skin rejuvenation.Dr. Roberts: This laser seems to have real synergy with other modalities. For photorejuvenation in general, I recommend the 650-microsecond 1064nm laser to promote collagenesis and to improve pigmentation and vascularity; this provides greater power and less discomfort compared to fractional lasers. To replenish the epidermis, I suggest a full-field 300-microsecond 2940nm Er:YAG laser.
Other Indications
Dr. Saedi: I've had really good experience with plaque psoriasis patients who have either failed topical therapy, have hard-to-treat areas, or been sick or non-compliant with topicals. We see improvement shortly after initial treatment. For example, I had a woman, skin type II, with it on the ear. I used the 6mm spot at level six, four passes. A week after her first treatment there's barely anything left.Dr. Chilukuri: I like the laser for bruising. I generally use IPL with a cutoff filter between 650 and 710nm for skin types I through IV, but with SOC you have to turn down the fluence so low we don’t get good results. I saw Dr. Michael Gold using the laser at one of the live injection courses. It does take two to three treatment sessions rather than one or two for other devices, but it's not just for bruising from toxins or fillers, but from running into something or falling down. We can use it all over the body. My treatment pearl is to go ahead and heat it up, do anywhere from three to eight passes, and massage the area in between to improve blood flow and break up hemosiderin.Dr. Roberts: The table below summarizes the treatments we recommend for skin of color patients. 
