Laser: Herpetic Lesions/ Cold Sore

• $50-75 for D9110 Emergency palliative TX, or
• $150 for D7465 Destruction of lesion via laser therapy…must be >=3mm and have to send in a picture, not for prodromal
• 1.5 watts/ pulse / NON initiated tip (If necessary repeat at 1.7, then if necessary at 2.0)
• Have pt use disposable eyeliner pencil to outline area
• Start 5 mm away from itching/burning area.
• Do small circles approaching up to 1 mm away
• Use HIGH SPEED suction next to area: 1. Captures viral particles & 2. Cools tissue = more energy can be pumped into tissue = more comfortable for patient
• Keep treating until prodromal feeling is done (pt will feel like it is a little piece of numb tissue)

How herpetic lesions begin:

• Virus lives in the ganglion on the face.
• Stimulated by stress: patient will start with an itching feeling
  

  How we treat them:

• We Kill the viral particles.
• If we catch it in the prodromal “itchy” stage: you can keep it from ever appearing
• If we catch it after lesion appears: Instantly kills it and it will heal faster, Immediately out of pain. Goes away 3-5 days post-op instead of 1-2 weeks
• May come back in same spot in the future – We haven’t cured them

• Cauterizing nerve ending: Itching burning to not itching burning

• Biostimulation: Enhancing healing (increased circulation, collagen formation, osteoblasts, fibroblasts)

               
*DO NOT USE TOPICAL = You won’t know when you are done because they won’t be able to see if sensation is gone.