The dual power of Alma Hybrid™: integrating ablative and non-ablative lasers for superior outcomes

In medical aesthetics, the quest for more effective patient-tailored treatments has led to a notable shift in industry trends. Traditionally dominated by injectables such as botulinum toxin and hyaluronic acid (HA) dermal fillers, the aesthetics market is witnessing a growing demand for regenerative treatments. This includes the treatment of complex conditions like hypertrophic scars, vitiligo, and melasma using advanced technologies like the Alma Hybrid™ laser (Arellano-Huacuja, 2023; Arellano et al, 2023a; Steiner et al, 2011).

According to a 2021 report by the American Society for Aesthetic Plastic Surgery (ASAPS), non-surgical skin tightening procedures increased by over 58% from 2017-2020, reflecting a significant movement towards non-invasive treatments that promote natural skin rejuvenation (ASAPS, 2021). This shift is further supported by data from the Global Aesthetic Devices Market Report 2023, which indicates that the market for energy-based devices, including lasers, ultrasound, and radiofrequency treatments, is expected to grow at a compound annual growth rate (CAGR) of 10.3% from 2021-2028 (Grand View Research, 2023).

This trend towards energy-based and regenerative treatments aligns with consumer preferences for more natural-looking results and minimal downtime. Patients are increasingly seeking treatments that stimulate the body's own regenerative processes rather than relying solely on temporary fixes provided by injectables. The Alma Hybrid™ system, with its unique combination of ablative and non-ablative laser technologies, is at the forefront of this evolution in aesthetic medicine.

It offers a versatile, highly customisable solution that addresses both superficial and deep skin concerns while promoting long-term skin health through natural regenerative mechanisms.

The Alma Hybrid™ not only bridges the gap between traditional ablative and non-ablative laser treatments but also introduces enhanced transdermal delivery through the Impact Handpiece, utilising ultrasound technology. This integration allows for the effective treatment of a wide range of dermatological concerns, including scar revision, skin rejuvenation, and resurfacing (Arellano-Huacuja, 2023; Arellano et al, 2023b).

This article aims to provide an examination of the clinical evidence supporting the Alma Hybrid™ system, with a focus on its integration into treatment plans for aesthetic and dermatological practices. Through an analysis of patient case studies and a review of the literature, this paper will demonstrate how the Alma Hybrid™ can be employed to enhance patient outcomes, particularly in challenging cases such as hypertrophic and atrophic scars. Furthermore, we will explore the system's efficacy across diverse patient demographics, with an emphasis on its safety profile in treating different Fitzpatrick skin types.

Technology overview

CO2 laser

The CO₂ laser has long been a cornerstone in dermatological treatments since its introduction in the 1960s. Operating at a wavelength of 10,600 nm, this laser is highly absorbed by water, which constitutes a major component of skin tissue. Upon absorption, the laser energy causes rapid heating and vaporisation of the targeted tissue, leading to precise ablation. This makes the CO₂ laser particularly effective for skin resurfacing, scar revision, and wrinkle treatment. The depth of penetration and the extent of thermal damage can be controlled by adjusting the laser parameters, allowing for customised treatments tailored to the patient's specific needs (Alster, 1999).

The efficacy of the CO₂ laser in treating deep wrinkles and scars is well-documented. However, it is also associated with several risks, including prolonged downtime, erythema, and potential for post-inflammatory hyperpigmentation (PIH), especially in patients with darker skin types (Fitzpatrick IV-VI) (Nouri et al, 1999). The healing process involves re-epithelialisation from the edges of the ablated areas, which typically takes about one week, but complete recovery of the skin's natural pigmentation and texture can take several months (Hantash et al, 2007).

1570 nm Erbium Glass laser

In contrast, the 1570 nm Erbium Glass laser represents a newer, non-ablative technology that targets water in the dermal layers while sparing the epidermis. This laser operates at a wavelength that allows for deeper penetration into the dermis, where it induces controlled thermal injury without causing significant surface damage. This makes it particularly suitable for patients who require skin tightening and wrinkle reduction with minimal downtime.

The 1570 nm Erbium Glass laser has gained popularity due to its efficacy in treating conditions such as acne scars, fine lines, and skin laxity. Studies have shown that this laser stimulates neocollagenesis and elastin remodelling, contributing to improved skin texture and tone. Moreover, its non-ablative nature reduces the risk of adverse effects, making it a safer option for patients with higher Fitzpatrick skin types.

Impact handpiece (ultrasonic delivery)

The Impact Handpiece, an integral part of the Alma Hybrid™ system, utilises ultrasound technology to enhance the penetration of cosmeceutical products into the skin.

Ultrasound has been employed in medical and cosmetic applications for decades, primarily due to its ability to increase skin permeability. This is achieved through cavitation, a process where the formation and collapse of microbubbles temporarily disrupt the lipid bilayer of the stratum corneum, allowing for enhanced transdermal delivery of active ingredients (Smith, 2008).

Ultrasonic delivery offers several advantages over other transdermal delivery methods such as iontophoresis and microneedling. It is non-invasive and can be used frequently without causing significant damage or irritation to the skin, making it particularly suitable for patients with sensitive skin or those requiring repeated treatments.

Histological effects of Alma Hybrid™ technology

The Alma Hybrid™ system's effectiveness in skin rejuvenation and scar revision is underpinned by its dual-action mechanism, which combines the histological effects of both ablative and non-ablative lasers. This unique combination allows for comprehensive treatment that targets both the superficial and deep layers of the skin, facilitating a range of therapeutic outcomes.

CO2 laser-induced histological changes

The immediate histological effect is the removal of the epidermal layer and the creation of a controlled thermal injury zone in the dermis. This thermal injury initiates a wound healing cascade characterised by collagen denaturation and subsequent collagen contraction. The coagulative necrosis within the dermis acts as a stimulus for fibroblasts, leading to the production of new collagen fibres (collagen type I and III), a process known as neocollagenesis. Over time, this remodelling process results in an improved skin texture, reduction of wrinkles, and scar softening (Hantash et al, 2007).

The controlled thermal damage also promotes re-epithelialisation, beginning at the periphery of the ablated area and progressing centripetally. This process is typically complete within 7 to 10 days, though the full maturation of new collagen and the visible improvement in skin quality may take several months (Smith, 2008).

1570 nm Erbium Glass laser-induced histological changes

The 1570 nm Erbium Glass laser induces its effects primarily in the dermis without damaging the epidermis. This non-ablative laser targets the water content within the dermal layers, generating heat that causes controlled thermal injury. Unlike the CO₂ laser, the Erbium Glass laser does not ablate the tissue but rather induces sub-epidermal heating, which triggers a wound healing response similar to that observed with ablative lasers, but with a different histological pattern.

The thermal injury caused by the Erbium Glass laser leads to the stimulation of fibroblasts and the production of new collagen and elastin fibres. This remodelling process results in the thickening of the dermis and the improvement of skin laxity and texture over time. The lack of significant epidermal damage reduces the risk of PIH, making this laser particularly suitable for patients with darker skin tones (Fitzpatrick IV-VI).

Combined histological effects

The combination of the CO₂ laser and the 1570 nm Erbium Glass laser in the Alma Hybrid™ system allows for a synergistic effect that enhances the overall treatment outcome. The CO₂ laser provides immediate and significant ablation and thermal damage, which is essential for treating deep scars and wrinkles. Simultaneously, the Erbium Glass laser complements this by stimulating deeper dermal remodelling with minimal surface damage. This dual mechanism not only addresses superficial skin concerns but also promotes deeper, long-lasting changes in skin structure.

This combination is particularly beneficial for treating complex skin conditions such as hypertrophic and atrophic scars, where both epidermal and dermal remodelling are necessary. The system's ability to customise the ratio of ablative to non-ablative energy allows for personalised treatment protocols tailored to the specific needs of each patient, thereby optimising clinical outcomes (Arellano et al, 2023a).

Treatment indications and patient selection

Scar treatments

Scarring is a common and often distressing result of the body's natural wound healing process. The formation of scars is a complex, multifaceted process that involves the replacement of normal skin with fibrous tissue.

Scars can be classified into several types, each with distinct histological characteristics and clinical manifestations:

• Hypertrophic scars: these are raised, red scars that remain within the boundaries of the original wound. Histologically, hypertrophic scars are characterised by an excessive accumulation of collagen fibres arranged in a haphazard fashion (Sharma and Bhanot, 2005).
• Keloid scars: keloids are similar to hypertrophic scars but extend beyond the original wound margin. They are more common in individuals with darker skin and are associated with a more pronounced fibrotic response. Keloids can be challenging to treat due to their tendency to recur even after intervention (Kim et al, 2004).
• Atrophic scars: these are sunken scars that occur when the skin fails to regenerate sufficient tissue, leading to a depression in the skin's surface. Atrophic scars are often associated with acne or varicella (chickenpox) and are characterised by a loss of collagen and elastin in the dermis (Jacob et al, 2001).

Melasma treatment

Melasma, a chronic hypermelanosis, presents a challenging condition to treat. However, the use of fractional non-ablative lasers, as demonstrated in a prospective study, has shown significant efficacy in reducing pigmentation and improving skin appearance in patients with this condition (Steiner et al, 2011).

Psychological impact of scars

The psychological impact of scars, particularly those on the face, can be profound. Scars can significantly affect an individual's self-esteem and quality of life, often leading to social anxiety, depression, and a distorted self-image. Adolescents and young adults are particularly vulnerable to the psychological effects of scarring, as this is a critical period for the development of self-identity and social relationships (Rumsey and Harcourt, 2012).

In many cultures, there is a strong societal preference for flawless skin, and individuals with visible scars may face social stigma or discrimination. This cultural context can exacerbate the emotional burden of scars, making effective treatment not only a cosmetic concern but also a critical aspect of psychological well-being (Brown et al, 2008).

Appropriate skin types

One of the standout features of the Alma Hybrid™ system is its efficacy across all skin types, from Fitzpatrick I to VI. This inclusivity is critical in a globalised society where aesthetic practices cater to a diverse patient demographic. The combination of ablative and non-ablative technologies within the Alma Hybrid™ system ensures that patients with different pigmentation levels can benefit from treatment without an increased risk of adverse effects, such as post-inflammatory hyperpigmentation (PIH), which is a common concern with other laser treatments (Wanitphakdeedecha and Manuskiatti, 2010).

Treatment protocol

Pre-treatment planning

Effective treatment with the Alma Hybrid™ system begins with thorough pre-treatment planning. This step is crucial for assessing the patient's suitability for the procedure and for setting realistic expectations regarding the outcomes.

• Patient assessment: a detailed patient history should be taken, including a review of any prior skin treatments, history of keloid formation, and any photosensitising medications currently in use. Patients with a history of herpes simplex infections may require prophylactic antiviral treatment to prevent outbreaks post-treatment (Alster and West, 1997).
• Skin analysis: a thorough skin analysis should be conducted to determine the patient's Fitzpatrick skin type, as this will influence the laser settings used. For example, patients with Fitzpatrick IV-VI skin types may require lower energy settings and a higher proportion of non-ablative laser use to minimise the risk of post-inflammatory hyperpigmentation (Fitzpatrick, 2000).
• Patch test: conducting a patch test in a less visible area is advisable, particularly for patients with darker skin types or those prone to hypersensitivity reactions. This helps to gauge the skin's reaction to the laser and fine-tune treatment settings.
• Pre-treatment skin care: patients should be advised to avoid sun exposure and to use a broad-spectrum sunscreen in the weeks leading up to treatment. Pre-treatment skincare regimens often include the use of retinoids or other topical agents to enhance the skin's responsiveness to laser therapy (Kornhauser et al, 2010).

Treatment

The treatment protocol with the Alma Hybrid™ system is highly customisable, allowing practitioners to tailor the approach based on the patient's specific needs and the area being treated.

• Laser settings: the Alma Hybrid™ system allows for the adjustment of laser parameters, including energy levels, pulse duration and treatment depth. For deeper scars, a higher energy setting with the CO₂ laser may be employed, while the 1570 nm Erbium Glass laser is used to stimulate deeper collagen remodelling with minimal epidermal disruption.
• Treatment areas: the laser can be applied to multiple areas of the face and body. For example, in facial treatments targeting acne scars, both ablative and non-ablative components can be used in tandem to achieve optimal results. Care should be taken when treating areas with thinner skin, such as around the eyes, where lower energy settings and careful technique are required to prevent complications.
• Impact Handpiece: after the laser treatment, the Impact Handpiece can be utilised to enhance the penetration of topical agents, such as hyaluronic acid, growth factors, or peptides. This step is particularly beneficial for boosting the skin's recovery and maximising the overall aesthetic outcome (Smith, 2008).

Post-treatment care

Post-treatment care is essential for ensuring proper healing and maximising the treatment's effectiveness. Patients should be given detailed instructions to follow during the recovery period.

• Immediate post-treatment care: immediately after the treatment, the skin will typically exhibit redness, swelling, and a sensation similar to sunburn. These symptoms are normal and generally subside within a few days. Applying a cold compress and using a mild emollient can help soothe the skin.
• Wound care: for the first few days post-treatment, patients should avoid touching the treated area to prevent infection. A gentle cleansing routine using a non-irritating cleanser is recommended. Patients should avoid the use of active ingredients like retinoids or acids during this period to prevent further irritation (Alster and West, 1997).
• Sun protection: sun protection is critical in the weeks following the treatment. Patients should apply a broad-spectrum sunscreen with an SPF of at least 30 to protect the skin from UV damage, which can exacerbate post-inflammatory hyperpigmentation (Fitzpatrick, 2000).
• Follow-up care: patients should be scheduled for a follow-up appointment within 1-2 weeks to assess the healing process and address any concerns. Additional treatments can be planned based on the patient's response and the severity of the skin condition being treated.

Results and improvements timeline

Patients typically begin to see improvements in their skin's appearance within a few weeks after the first treatment session. The initial wound healing response includes the contraction of collagen fibres, leading to a reduction in scar visibility and an improvement in skin texture.

• Short-term results: within 2-4 weeks, most patients will notice a significant reduction in redness and swelling, with the skin beginning to exhibit a smoother texture. This is primarily due to the immediate effects of collagen contraction and the re-epithelialisation process (Hantash et al., 2007).
• Long-term results: optimal results are generally observed between 3-6 months post-treatment as collagen synthesis continues. The skin's appearance will continue to improve as the newly formed collagen fibres mature and the skin undergoes further remodelling.
• Maintenance treatments: for best results, a series of 3-6 treatment sessions is typically recommended, spaced 6-8 weeks apart. This allows the skin adequate time to heal and remodel between sessions, ensuring cumulative improvement in skin quality and scar reduction.

Case studies

Case study 1: surgical scars | Alex

• Patient history: a 32-year-old female with a post-surgical scar following an unprovoked dog bite attack.
• Clinical presentation: Alex suffered a traumatic, unprovoked dog attack in March 2023.
• Alex was very conscious of her appearance and concerned that the scar would be a prominent feature to her face, causing disfigurement and not even be disguised with the use of makeup. Alex expressed post traumatic stress when she looked in the mirror and had noticed a severe impact on her mental health.
• Treatment protocol: 5 sessions with Alma Hybrid™ spaced 6-10 weeks apart.
• 2023: 9th May - Hybrid 27th June - Hybrid (+ 7 weeks) 29th August - Hybrid (+10 weeks) 3rd October - Hybrid (+ 7 weeks) 21st November - Hybrid (+ 6 weeks)
• 2024: 26th March - Botox (glabella, frontalis, crows feet, lateral brow) 16th April - Plinest 12th May - Plinest
• Outcomes: significant reduction in scar thickness and redness, with a smoother texture and improved overall appearance.

Case study 2: traumatic scars | Amy

• Patient history: a 42-year-old female with a traumatic scar on the forehead following a fall.
• Clinical presentation: hypertrophic scar with pigmentation changes.
• Treatment protocol: 3 sessions with Alma Hybrid™ spaced 5-7 weeks apart, combined with TrivWaveMD and botulinum toxin.
• 2023 19th Sept - Hybrid 29th Sept - TriWave 6th Oct - TriWave 7th Nov - Hybrid (+ 7 weeks) 21st Nov - Botulinum toxin (2 areas) 12th Dec - Hybrid (+5 weeks) 29th Dec - TriWave
• 2024 27th Feb - Botulinum toxin (2 areas) 20th June - Ph Formula Facial
• Outcomes: substantial improvement in scar elevation and pigmentation, leading to a more uniform skin tone and smoother texture.

Case study 3: acne scarring and skin texture, to treat open pores | Izzy

• Patient history: a 23-year-old female with a acne scars and open pores.
• Clinical presentation: uneven skin texture due to acne scarring.
• Treatment protocol: 2 sessions with Alma Hybrid™ spaced 8 weeks apart, combined with ZO Skin Care (ZO Clearing Complexion Programme and Wrinkle + Texture Repair)
• Outcomes: visible improved to skin texture, with a reduction to pore size.

Incorporating the product into the aesthetic patient journey

Benefits for aesthetic nurses

Incorporating the Alma Hybrid™ into the aesthetic patient's treatment plan offers several benefits. It provides a versatile and effective solution for scar treatment, addressing both superficial and deep skin layers. This dual-action capability can enhance patient satisfaction by delivering more comprehensive results.

Integration into treatment plans

Aesthetic nurses leverage the Alma Hybrid™ by carefully assessing the unique requirements of each patient and tailoring treatment protocols accordingly. Educating patients about the advantages and anticipated results fosters trust and encourages adherence to the treatment plan.

Moreover, integrating Plinest Polynucleotides, TriWaveMD technology, cosmeceuticals, and specialised skincare further augments the efficacy of the treatment, thereby optimising overall outcomes. This comprehensive approach ensures that patients receive personalised care that addresses their specific cosmetic concerns and enhances their satisfaction with the results.

Enhancing practice offerings

Offering Alma Hybrid™ treatments can differentiate an aesthetic practice by providing advanced scar treatment options. It can attract a broader patient base and position the practice as a leader in innovative aesthetic solutions.

Discussion

Clinical significance of Alma Hybrid™ technology

The integration of both ablative and non-ablative laser technologies in a single device allows for tailored treatments that can address superficial skin issues, such as fine lines and pigmentation, as well as deeper concerns like acne scars and skin laxity.

The dual-action capability of the Alma Hybrid™ system not only broadens the scope of treatable conditions but also enhances the precision with which these conditions can be addressed. By customising the ratio of ablative to non-ablative energy, practitioners can fine-tune the treatment to meet the specific needs of each patient, thereby maximising efficacy while minimising downtime and side effects.

Versatility in combination therapies and integrated skincare

One of the Alma Hybrid™ system's standout features is its versatility when used in combination with other advanced therapies. The integration of the Impact Handpiece facilitates the enhanced transdermal delivery of various active agents, such as polynucleotides, mesotherapy products, exosomes, and medications. This capability allows practitioners to create comprehensive, personalised treatment plans that address not only superficial and deep skin concerns but also optimise overall skin health.

The ability to combine laser therapy with these adjunctive treatments enhances the skin's regenerative processes, leading to superior clinical outcomes. For instance, the use of exosomes, which are rich in growth factors, in conjunction with the Alma Hybrid™ system can significantly accelerate healing and enhance the production of collagen and elastin. Similarly, mesotherapy products, when delivered using the Impact Handpiece, can penetrate deeper into the skin layers, ensuring more effective and uniform distribution of active ingredients.

This integrated approach to treatment is complemented by a robust skincare regimen, which can include retinoids, antioxidants, and other topical agents designed to prepare the skin for laser treatment and support post-treatment recovery. By adopting a holistic approach that incorporates advanced skincare along with laser therapy, practitioners can achieve more dramatic and long-lasting results, leading to higher patient satisfaction and retention.

Impact on aesthetic practice and business benefits

For aesthetic practices, the Alma Hybrid™ system can be a game-changer. It allows clinics to offer a broader range of services, from mild skin rejuvenation to intensive scar revision, all with a single device.

The Alma Hybrid™ system's ability to integrate with complementary treatments creates opportunities for clinics to offer comprehensive care packages that extend beyond single-session treatments. This approach not only enhances clinical outcomes but also promotes recurrent visits, thereby generating ongoing revenue and fostering long-term patient relationships.

The ability to offer such a holistic and effective treatment experience can differentiate a practice in a competitive market, making the Alma Hybrid™ system a valuable investment for clinics looking to grow their business.

Limitations and future research

While the Alma Hybrid™ system represents a significant advancement in the field of aesthetic medicine, there are several important limitations that must be acknowledged.

Firstly, the device's versatility and customisability, while beneficial, also present a challenge. The Alma Hybrid™ system requires significant expertise to utilise its full potential effectively. It is not a device recommended for beginners; rather, it demands a deep understanding of laser technologies and their applications in different skin types and conditions. Practitioners must undergo extensive training to master the intricacies of the system, ensuring safe and effective treatments for patients.

Secondly, there is a lack of established protocols regarding the combination of various products with the Alma Hybrid™ system. Currently, the choice of products, such as polynucleotides, mesotherapy agents, and exosomes, is largely left to the clinician's judgment and experience. This variability can lead to inconsistent results across different practices and patients. As the technology evolves, standardised protocols would be beneficial to guide practitioners in achieving optimal outcomes.

Moreover, while there is anecdotal evidence suggesting improved outcomes with combination therapies, robust clinical research in this area remains limited. Future studies should focus on quantifying the benefits of these adjunctive treatments, particularly in accelerating healing and enhancing the overall efficacy of the laser procedures.

Another significant consideration is patient education, particularly regarding post-operative care. Given the sophisticated nature of treatments involving the Alma Hybrid™ system, it is crucial that patients are well-informed about the necessary aftercare to avoid complications and ensure optimal healing. This aspect of patient management cannot be overstated, as inadequate post-operative care can compromise results and increase the risk of adverse effects.

Downtime remains an issue with the Alma Hybrid™ system, especially when higher energy settings are used for more intensive treatments. While the system offers significant results, patients must be prepared for a recovery period, which can vary depending on the intensity of the treatment and the individual's skin type. Managing patient expectations regarding downtime is essential to maintain satisfaction and adherence to post-treatment care protocols.

Finally, the Alma Hybrid™ system represents a considerable financial investment for aesthetic practices. This cost must be carefully weighed against the potential benefits and revenue streams it can generate. Practices considering the acquisition of this technology should conduct a thorough cost-benefit analysis, taking into account not only the initial purchase price but also the costs associated with training, maintenance and potential downtime.

Conclusion

The Alma Hybrid™ system stands out as a pivotal advancement in the field of medical aesthetics, offering a unique blend of ablative and non-ablative laser technologies that can address a wide spectrum of skin concerns. Its dual-action mechanism allows practitioners to customise treatments to meet individual patient needs, making it an invaluable tool for achieving significant aesthetic improvements with minimal downtime.

The versatility of the Alma Hybrid™ system is further enhanced when used in combination with other advanced therapies, such as polynucleotides, mesotherapy products, exosomes, and integrated skincare regimens. This capability to combine laser treatments with transdermal delivery of active agents opens up new possibilities for achieving optimal clinical outcomes. The system's ability to cater to all Fitzpatrick skin types also makes it an inclusive solution for a diverse patient demographic.

In addition to its clinical benefits, the Alma Hybrid™ system offers substantial business advantages for aesthetic practices. By positioning the system as a central offering and complementing it with other treatments, clinics can attract a wider range of patients, enhance treatment outcomes, and generate recurrent revenue streams. This holistic approach not only elevates the standard of care but also positions the clinic as a leader in advanced aesthetic solutions. In summary, the Alma Hybrid™ system is a powerful, flexible, and safe tool that is set to play a central role in the evolution of aesthetic medicine. By integrating advanced laser technology with a comprehensive treatment approach, it enables practitioners to deliver exceptional care that meets the ever-evolving needs of their patients.

Key points

• Growing demand for regenerative treatments: the aesthetics market has seen a notable shift towards treatments that promote natural skin rejuvenation, with technologies like the Alma Hybrid™ laser gaining popularity for conditions such as hypertrophic scars, vitiligo and melasma.
• Alma Hybrid™ technology: the Alma Hybrid™ system integrates ablative and non-ablative laser technologies, providing customisable treatments for skin resurfacing, scar revision and rejuvenation. It also features the Impact Handpiece for enhanced transdermal delivery using ultrasound.
• CO2 laser: the CO2 laser, with its ablative action, is effective for treating deep wrinkles and scars but can result in prolonged downtime and risks like post-inflammatory hyperpigmentation (PIH), especially in darker skin types.
• Erbium Glass laser: the 1570 nm Erbium Glass laser offers non-ablative treatment with minimal downtime, targeting the dermal layers to stimulate collagen production, making it suitable for acne scars and skin laxity.
• Combined effects of CO2 and Erbium lasers: the dual-action combination of ablative CO2 laser and non-ablative Erbium Glass laser enhances treatment efficacy by addressing both superficial and deep skin layers for long-lasting results.
• Impact Handpiece: this device enhances the delivery of cosmeceutical products into the skin using ultrasound technology, improving outcomes by increasing skin permeability.
• Treatment of various scars: Alma Hybrid™ is effective for different types of scars, including hypertrophic, keloid and atrophic scars, through its ability to promote dermal and epidermal remodelling and laser assisted delivery via the Impact handpiece.

CPD reflective questions

• How does the Alma Hybrid™ system improve scar treatment outcomes compared to traditional laser systems?
• Why is the Alma Hybrid™ system particularly suitable for patients with darker skin types (Fitzpatrick IV-VI)?
• How can a comprehensive skincare regimen enhance the results of Alma Hybrid™ laser treatments?
• What is a potential risk associated with the CO2 laser component of the Alma Hybrid™ system, and how can it be minimised?
• What is the psychological benefit of effective scar treatment for patients?