Using new technology for skin therapies

Stroll down any trade room floor at an esthetics show and you quickly recognize the overwhelming extent of machines and skin care products. It baffles the mind. Whether you are a first-time visitor or a well-seasoned skin care professional, first and foremost is the need to understand all the requirements of your business and the long term impact and relevancy of any purchase. If it is NOT in the plan, don’t buy it. Secondly, prior to purchasing anything, you should have a good sense as to how you intend to build both existing and future business. Demands of an aging population require that we be able to offer not just a one-time experience but an on-going long term skin management system for each client. Defining your market needs will direct many of your choices. Thirdly, and of high importance, is that you have the knowledge and scientific background to make good judgments for providing the most advanced and corrective therapies available. A quick study in light physics is also beneficial. We have at our fingertips a surplus of choices. They should, however, be selected and used within the scope of your own knowledge, licensing and practice. The exciting new technologies available provide us with many choices and can accelerate the results of our work. They include: • Newer cosmeceutical ingredients (peptides, special inhibitors for anti-aging) • Simple chemical treatments, i.e., peels, dermal stimulators (non-peels), enzymes • Microdermabrasion • Ultra-sound (sonophoresis) for face • Photobiostimulation (non-laser light therapies) • Non-ablative lasers and IPL used for hair removal and skin rejuvenation • Microcurrent • Neutraceuticals The expanse of newer treatments also poses a large challenge to many who have up until now only had basic training but require post-graduate studies to enhance their knowledge. There may be confusion as to how to safely integrate the numerous modalities in order to produce maximum and satisfying results that are above the normal facial treatment. Keep in mind that continuing education in the dermal sciences is a life-long process. Cosmeceuticals The arrival of newer raw materials and delivery systems has allowed for extraordinary newer formulations in our current skin care systems. The term “cosmeceutical” manifested in the late 1990s with the introduction of products that contain more “function” or “high performance” ingredients, in particular, those that make a significant difference in the appearance of the skin. Today, there is a greater understanding of the skin’s function and its ability to positively respond to certain topical ingredients that help to restore normal skin function and promote skin health. For example, vitamins C, A, E, peptides, alpha lipoic acid, licorice extract, green and white tea, beta glucans, melanin suppressants, antioxidants, certain enzymes, collagen stimulators salicylic acid, benzoyl peroxide, AHAs and others can be classified in a quasi category of cosmeceutical. In the United States, the FDA indicates that a drug is a substance that treats disease. The laws that were compiled regarding cosmetics were initially written in the earlier part of the 20th century. Cosmeceuticals are not drugs. There is evidence, however, that the scientific community will eventually change and rewrite many older documents pertaining to cosmetics. There are modern methods of scientifically quantifying and studying the effects of the high performance ingredients and their positive effects on the skin show remarkable skin enhancements. Professional product lines – those that are sold strictly through professionally trained skin therapists and the medical community – have made quantum leaps in their performance and indeed have contributed to the health of the skin. Keep in mind that carefully selecting a home care regimen for your customer helps to extend the life of your in-clinic treatments. The benefits are long term. Enzymes and chemical peels Refer to the July 2008 issue of BeautyNZ to read an extensive article on the advantages of enzymes and chemical peels. Enzymes and chemical peels are non-ablative and offer a greater advantage when addressing the needs of aging, pigmented, oily and problematic skin. They are but a part of an entire system of care. Microdermabrasion There are several contributions that microdermabrasion makes to the skin. Most – not all – skin types can tolerate this treatment. It is a powerful tool to help improve aging skin, pigmentation, and hyperkeratinized conditions. Clinical studies have indicated that it helps to stimulate collagen synthesis and helps reduce fine lines and wrinkles. There are numerous machines available with newer features such as being computerised with more powerful motors to keep delivery and vacuuming mechanisms consistent. Microdermabrasion is a powerful tool to support skin improvement especially in aging skin. It can be performed as a complete “microdermabrasion facial” whereby special high performance ampoules (serums) may be applied after the skin has been micro-dermabraded. The power of light and energy Non-ablative lasers and ipl The inauguration of improved non-ablative photo (light) therapies since 2000 has revolutionized the medical aesthetics market. Classified as “non-ablative,” energy wavelengths will vary depending upon the purpose of an end result, i.e., hair reduction, laser skin rejuvenation, vascular and pigmentation (“reds” and “browns”). Additionally, LED (light emitting diode) lights and microcurrents have been placed into the mix of aesthetics procedures treating numerous facial and body contouring conditions. The difference between lasers/IPL vs. microcurrents/LED is that lasers/IPL use a process of thermolysis (heat) to obtain an end result. On the other hand, microcurrents resonate with the body’s own electromagnetic system working along body meridians (nerve pathways), stimulating cell mechanisms to augment repair. Somewhat like acupuncture but without needles. They are used in sports medicine and also now in the beauty industry to provide non-surgical lifting. LED systems target cell receptors to help stimulate and increase collagen synthesis, and reduce pigmentation and acne bacteria, and are all dependent upon the specific wavelength used. Since their inception, lasers and Intense Pulsed Light (IPL), microcurrents and LEDs have provided the aesthetics market with light years of technology to address the cosmetic needs of an aging population. It is imperative that users of these devices practice safety at all times as well as understand the physics behind the technology. A one-day training course will not provide enough knowledge to operate the devices accurately and safely. You must be well trained and certified, no matter what your level of aesthetics education. History Research and development of lasers began with Einstein in the earlier part of the 20th century. In the 1950s, Einstein’s theories were expanded to explore laser use for the military, space exploration, medicine, and by the mid 1990s, the aesthetics market. Ablative (cutting) lasers were initiated into medicine such as ophthalmology during the l960s and l970s. Leon Goldman, M.D. is coined as the Father of Lasers in Medicine and was awarded a Nobel Prize for his work on lasers in medicine. During the 1990s, earlier generations of non-ablative lasers and IPLs were developed for hair removal, photo rejuvenation, and cosmetic vein therapies. The original IPL intense pulsed light machines arrived into the United States from Europe around 1995 under the name “PhotoDerm.” Its use provided a breakthrough for the treatment of vascular lesions such as port wine stains and more superficial veins. They were also used for treating dyschromias. IPL had been used to treat erythema, helping to reduce post-laser neovascularisation and vessel edema. Normally they are initiated two weeks after facial resurfacing (or when re-epithelisation is complete). The effectiveness of a laser and/or IPL is based on its wavelength and affinity to a chromophore – melanin (pigment), blood, and water. Earlier machines were calibrated with several settings to address Fitzpatrick I – V. The ability to treat higher Fitzpatrick types was limited. During the late 1990s, Patrick Bitter, Jr. M.D., a renowned California laser dermatologist, and R. Stephen Mulholland, M.D., a Toronto plastic surgeon, contributed to developing what was known as FotoFacial™. They both pioneered the methodology for non-invasive facial rejuvenation treatments blending it with the WrinkleLite™, and the Vasculight™ (laxity vector therapy). These machines purported wrinkle improvement without epidermal reaction as well as making improvement for dyschromias and vascularities. Dr. Bitter created what is known as a “Panfacial IPL Fotofacial™ meaning that IPL is used over the entire face, neck, décolleté and other areas such as arms and back of hands. IPL systems are under the trademark MultiLight™ and Quantum SR™. They address the hemoglobin and melanin based aging findings, but will not deliver adequate collagen production parameters. Permanent hair reduction was first researched and developed in the early 1990s using the NdYag 1064 laser. By the mid 1990s, other hair removal lasers and IPLs were offered to the market. Through a process of thermolysis, the laser/IPL light wavelength is attracted to a chromophore such as hair color, to effectively destroy the hair follicle (bulb/bulge) during the anagen (growth) stage. It is important to realise the differences in the non-ablative wavelength ranges and their effect on the skin and affinity to skin color. During hair removal, lower wavelengths tend to target skin melanin in Fitzpatrick skin types V-VII. The Ruby (694nm) and Alexandrite (745nm) lasers were helpful for Fitzpatrick I-III but not very effective for darker skin types due to a strong affinity with melanin. Blistering and burns were experienced as an end result in darker skin types. The Diode (810nm) laser was developed and proved to be effective for the lighter Fitzpatrick skin types and some darker types. One of the most effective wavelengths, however, for all skin types is the NdYag 1064 since it has a lower affinity for skin pigment yet is still effective in targeting the pigment in the hair follicle. This advantage allows for effective hair reduction in the higher Fitzpatrick types. Pigmentation Using a correct wavelength setting, an IPL light shatters the clumps of melanin by firing an intense pulsed light. The setting is determined by Fitzpatrick scale and condition of the skin. The melanin slowly travels to the skin’s surface after each treatment. Depending upon the depth and condition, improvement takes place over several weeks to several months. A gentle pass of microdermabrasion 7-10 days after treatment helps to remove the appearance of the pigment. Home care should include tyrosinase inhibitors and other treatment creams and serums appropriate to skin type. Telangiectasia IPL helps to eliminate superficial vascularities (spider veins) through thermolysis (heating of the vein) causing it to collapse and disintegrate. The result is that the appearance of the skin is improved. Presently, great improvements in the technology have placed the use of non-ablative lasers and IPL into the forefront of aesthetic medicine. Newer machines offer multi-platform devices with the choice of using both the NdYag 1064, and IPL lights programmed to various wavelengths to support multiple treatments. Light therapies can be combined with skin care treatments to achieve a more effective end result for many different types of skin conditions, hence offering alternatives to an aging population seeking ways of maintaining a youthful appearance. Contraindications for ipl and lasers • History of abnormal response to sunlight – conditions such as polymorphous light eruption or solar urticaria • Photo-sensitising medications or drugs • Patient on Accutane: DO NOT PERFORM FOR 6-12 MONTHS POST USE. On occasion, wound-healing complications may arise from the use of Accutane • Pregnancy: Avoid aesthetic therapies of any kind during pregnancy • Suspicious moles or skin lesions require a skin biopsy to confirm diagnosis of benign pathology Photobiostimulation LED (light emitting diodes) treatments are non-invasive and extend great beneficial effects to the skin. They are not a laser and do not emit heat. Instead, they work by emitting specific wave lengths of energy measured in nanometers (nm) to create biological reaction in the skin to help stimulate collagen, tighten and tone, reduce bacteria in acne, and reduce pigmentation and redness. The colour has to be coming from a true LED device that has been researched and manufactured properly in order to emit enough energy to produce results. When LED and microcurrent are combined they approach skin issues from a multi-platform approach. MICROCURRENTS – beauty from within All body systems are controlled by our own electromagnetic energy systems. These impulses help contract and relax muscles, are responsible for nerve function, the heart beat, glandular secretions, brain activity, healing and regeneration. These electrical control systems are based on very subtle electrical signals that are in the nano and microamperage levels. They are responsible for numerous metabolic cell processes and body functions including protein synthesis, the stimulation of ATP in the cell and restoration body regeneration and balance. If you are familiar with the principles of Chinese acupuncture, the flow of this energy is called Chi or Qi. Energy travels through nerve pathways known as meridians. There is substantial research that describes the benefits of microcurrent technology. In sports medicine, microcurrents can help augment faster healing of injuries. They are used in pain management to reduce inflammation and augment the body’s own healing capabilities. Physiological and psychological stress is reduced through the application of microcurrent. Inflamed tissue (including disease and wound healing) renders an imbalance and distortion in the polarity patterns. The application of polarised microcurrents can re-establish the proper patterns and cell function augmenting self-healing. In beauty therapies microcurrents are used to help enhance muscle tone and tightening. Microcurrents can reach the Golgi tendon organ in the muscles supporting the lifting, firming and toning of gravitational muscles. Microcurrents help to “re-programme” and tone as well as stimulate collagen synthesis in tissue. Additionally, there is an increase in blood and lymphatic circulation. It is a great support to very sun damaged skin. The more advanced systems can help make remarkable improvement in the appearance of scars and stretch marks. There are several excellent machines on the market including one advanced unit that incorporates artificial intelligence, cybernetics and biological feedback. It provides a more customised and safe programme for the client. Microcurrents are also an excellent for pre- and post-surgery since they enhance the healing process. When microcurrents are combined with LED technology, it is a very powerful way of delivering optimal beauty treatments, especially for aging skin. This technology will continue to grow as practitioners understand how to integrate them into their practices. They provide a higher degree of technology to non-invasively augment the skin’s natural reparative mechanisms. Health, food and neutraceuticals Aging is about inflammation and degeneration. Glycation is a process by which sugar molecules attach to proteins causing cross linking resulting in skin sagging and loss of skin quality. The importance of prevention, lifestyle modification including evaluating proper nutrition intake becomes essential in order to mitigate the effects of a changing body. Maintaining a healthy weight is also vital. All biological processes in the body begin at the cell level. In 1991, Researchers Erwin Neher and Bert Sakmann were awarded a Nobel Prize for their discoveries concerning the function of single ionic channels in cells. They were able to study the workings of a single cell through inserting a glass pipette through a cell affirming the importance of the cellular membrane in a single cell and total body. What they also discovered is that the electrical polarisation and depolarisation of cellular membranes is so important for life that 80% of the energy produced from food is used just to maintain this polarisation. In a world of over-processed and fast food what is lacking is literally killing us and adding to the cascade of degenerative diseases and early death. In the US 69% of the population is overweight to obese. Sadly, this is on the rise in many other parts of the world as well. Obesity can lead to poor circulation, heart disease, elevated cholesterol levels, diabetes, cancer and degeneration of our body and quality of life. Air and water purity are being threatened by local and global pollution. It will take a global effort to increase the consciousness level of the Earth’s almost 7 billion inhabitants. If we are going to live into our 90s or beyond, the quality of lifestyle and health is of utmost importance. An important topic to consider is that the aging process can be accelerated by smoking. Here are some statistics from the Health on the Net web site: • Half of long-term smokers will die from tobacco. Every cigarette smoked cuts at least five minutes of life on average – about the time taken to smoke it. • Smoking is the single largest preventable cause of disease and premature death. It is a prime factor in heart disease, stroke and chronic lung disease. It can cause cancer of the lungs, larynx, oesophagus, mouth, and bladder, and contributes to cancer of the cervix, pancreas and kidneys. • More than 4,000 toxic or carcinogenic chemicals have been found in tobacco smoke. • One British survey found that nearly 99% of women did not know of the link between smoking and cervical cancer. • At least a quarter of all deaths from heart diseases and about three-quarters of world’s chronic bronchitis are related to smoking. • Smoking-related diseases cost the United States more than $150 billion a year. • Smoking is additionally responsible for imbalance of the mind, body and spirit which can lead to an early death. The list can go on and on and the effects on the skin are startling. Research indicates that smoking one cigarette decreases blood flow up to 24%, and 29% after two. Studies have found that smoking for 20 minutes decreases tissue oxygen tension for almost an hour and that a pack-a-day smoker would remain hypoxic for most of each day. Keep in mind that the skin’s ability to remove waste products is greatly impaired. Elastin fibers are broken down leaving a yellowish, irregular thickened skin with more wrinkles. Imbalance of the mind, body and spirit inevitably can lead to an early death. People associate aging with disease but this is not necessarily correct. According to the Academy of Anti-Aging Medicine, a worldwide organisation, a greater understanding of the physiology of aging through scientific research places a greater emphasis on preventative medicine. It is far less expensive to practice prevention than to spend billions of dollars on disease. Many medical, community and health authorities are beginning to emphasise the importance of individuals taking responsibility for their health. According to E.A. Ordonez, M.D. who owns the Centre for Regenerative and Aesthetic Medicine in Jacksonville, Florida, “Aging is essentially a process in which your cells lose their resilience, they lose their ability to repair damage; however, it is in your power to boost that resilience. Our bodies were not designed to fail; they were designed with great efficacy and organisation, and possess the ability to repair.” In conclusion, our skin, health and overall quality of life can be enhanced by changing lifestyle and our eating habits. It is important to consume whole fresh foods that contain natural enzymes, anti-oxidants, vitamins and minerals. It is almost impossible to obtain all of our nutrients from food these days, given our frenetic lifestyle. The need for daily supplementation including probiotics and omegas manufactured from whole food sources is essential for optimum health. While we can treat the surface of the skin through dynamic technologies, beauty begins from within. All of us within the beauty industry can play a very important role in educating our clients. We must also “walk our talk” and give good example to our clients.

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