When it comes to the results we are always aiming to achieve the best for our patients. In this presentation I would share my experience in hybrid laser treatments.

In the case of combining lasers and IPL, it is worth following the principle resulting from the depth of penetration of a given device,  and start with the treatment on the one that penetrates the deepest. Combinations of non-ablative lasers, IPL with fractional ablative lasers are well described, (1)

The combination of IPL and infrared lasers with continuous multipolar and fractional RF has been well described in the literature. It is safe and allows you to correct various changes on the face using the devices available in the office. (2.3)

This combination allows to eliminate the clinical features of photoaging, including changes in skin texture, flaccidity, erythema, pigmentation changes and vascular changes, such as erythema and telangiectasia. (4) however, it is not sufficient to eliminate wrinkles and furrows or dischromia.

Fractional laser therapy is a unique ablative method that has the ability to partially evaporate the epidermal, dermal and subcutaneous layers in a predictable and controlled manner, which results in a potential increased penetration of topical substances, including drugs (LADD - Laser assisted drug delivery). Acting in this way, the resulting micro-damages serve as absorption channels for the applied substance until they close with local wound repair without scarring. (6)

Studies have also shown that vitamin C, E and ferulic acid introduced in this way correlate with faster wound healing after a fractional ablative laser and promote collagen induction with the simultaneous ability of faster convalescence. (7)

Hydroquinone, alpha-arbutin, kojic acid, tranexamic acid, glycolic acid, azaleic acid, non-crosslinked hyaluronic acid, triple combination cream (TCC), Jessner peeling, vitamin C, platelet-rich plasma were described in a review study (8) describing combining laser and IPL treatments with microneedling treatments, iontophoresis, sonophoresis, microdermabrasion, mesotherapy as combined treatments. In total, 49 scientific studies have been selected here, according to which combined treatments using the Qswitched Nd:Yag laser with subsequent home therapy using hydroquinone, alpha-arbutin, tranexamic acid, azaleic acid, non-crosslinked hyaluronic acid, triple action cream give very promising results. Similarly, combining the Qswitched Nd:Yag laser with vitamin C sonophoresis treatments similarly proves to be very effective in treatments targeted at hyperpigmentation - including melasma.