Nicole Altavilla
Medical Spa Report: September 2014
Proper Procedures
Offering minimal discomfort and downtime, non-invasive cosmetic treatments have increased by more than 13 percent in 2013 with 9.5 million procedures, according to a report by the American Society for Aesthetic Plastic Surgery (ASAPS). Laser treatments are among the more popular non-invasive procedures available at medical spas today. “Laser technology is evolving to address a number of issues in a safe and effective fashion,” says Whitney Bowe, M.D., assistant medical director for cosmetic and laser services at Advanced Dermatology, P.C. (Ossining, NY). “The lasers we use are able to achieve dramatic results with relatively little downtime, which is something that resonates with the modern cosmetic patient.” Here are some of the most common hair and skin issues addressed by lasers, as well as a look at the ideal lasers for treatment:
Blemishes
Laser treatments can help clear acne, and there are several different types of lasers available today that can do the job, such as diode, infrared, and intense pulsed light (IPL) lasers. Isolaz, from Solta Medical, combines a gentle vacuum with IPL to help fight the root causes of acne and reveal a more radiant appearance. The painless laser helps to destroy acne-causing bacteria, while the vacuum clears pores of blackheads, oil, and debris. Blemishes, including those caused by broken blood vessels or age spots, can be treated by lasers that target the offending tissue and spare the normal surrounding skin, according to Susan Stuart, M.D., founder and medical director at La Jolla Dermatology (CA). Alma Lasers HarmonyXL’s Advanced Fluorescence Technology (AFT) laser handpiece, for example, helps clear blemishes using intense blue wavelengths to rapidly destroy acne-causing bacteria without damaging the surrounding tissue.
Wrinkles
When it comes to fine lines and wrinkles, lasers can help restore a more youthful appearance by creating tiny micro-wounds in the skin that trigger collagen formation. Fraxel is a non-invasive laser treatment that stimulates collagen production and diminishes the visible effects of aging. Essentially, the outer layers of damaged skin are eliminated, and as new cells form, smoother, younger-looking skin appears. Pixel by Alma Lasers is a resurfacing laser that targets small areas to help tighten and smooth out the surface of the skin with little-to-no downtime. According to Bowe, Fraxel is recommended for treatment of fine lines, while Pixel is more effective in treating deep lines and wrinkles, though they both work similarly. “These lasers basically create a tic-tac-toe board on the skin, producing heat damage that creates collagen and in turn repairs wounds and tightens fine lines,” she says.
Skin Resurfacing
From dark spots, sun spots, and age spots to uneven pigmentation, there are several skin resurfacing issues that can be treated with lasers. The Fraxel Dual 1550/1927 is an effective skin resurfacing device to treat acne scarring, fine lines and wrinkles, and skin discoloration, as it creates micro-wounds in the superficial layers of skin to reveal healthy glowing skin underneath, according to Bowe. “Brown spots turn into coffee ground-like material that gently exfoliates off the skin in the following week, and pore size also decreases,” she says. Also an efficient option, CO2RE by Syneron-Candela is a fractional CO2 laser resurfacing device that targets and effectively treats the skin’s surface, middle, and deep dermal levels to help remove sun damage, age spots, fine lines and wrinkles, acne scars, enlarged pores, and uneven skintone.
Cellulite
Lasers can also be a useful form of treatment for trouble spots on the body, such as cellulite. Allure Medical Spa (multiple locations in Michigan) uses a radiofrequency device called Exilis, from BTL Aesthetics, in combination with Acoustic Wave Therapy (AWT) for non-surgical cellulite treatments. Exilis is a non-invasive laser treatment that helps to reshape the body by reducing fat, improving skintone and elasticity, and reducing the appearance of cellulite. It can be used on the breasts, abdomen, face, jowls, neckline, arms, thighs, hips, buttocks, and knees. AWT involves tightening the skin with intense pressure pulses that target fibrous bands of connective tissue that cause the cellulite. Applying pressure waves to the connective tissue can help reduce cellulite by increasing circulation, collagen production, and tissue elasticity. For surgical treatment of cellulite, Allure Medical Spa uses Cellulaze from Cynosure, which is similar to liposuction, and works by breaking up cellulite dimples and tightening the skin. “The Cellulaze laser directly contacts the loose tissue as well as the tiny bands that cause dimpling for more noticeable results and has a built-in heat sensor so it can’t get too hot and burn the tissues,” says Charles Mok, D.O., owner of Allure Medical Spa. “It also monitors movement to ensure the treatment is even.”
Scar Treatment
Unfortunately, according to Bowe, there aren’t treatment options for every type of scar. She recommends that clients schedule a consultation to see whether the scar of concern is amenable to laser treatment. For certain types of acne scarring, for example, the Fraxel Dual 1550/1927 can be helpful, as it targets acne scars and signs of aging with microscopic laser columns that help resurface the skin by stimulating the growth of new, healthy skin cells from the inside out. Fractional CO2 laser resurfacing devices, such as CO2RE, TotalFX, and Matrix CO2, can also be effective forms of treatment. The TotalFX fractional CO2 laser device helps reduce deep wrinkles, acne scarring, and sun spots by tightening skin, stimulating collagen, and fading skin discoloration. Matrix CO2 also helps treat skin issues, such as acne scarring, by stimulating the skin’s own collagen, increasing elasticity, and creating a smoother and tighter texture. For surgical or new scars, Fraxel and the pulsed-dye VBeam Perfecta by Syneron-Candela laser are both popular devices. VBeam is a non-invasive laser treatment that involves intense, yet gentle, bursts of light that destroy the blood vessels being treated. “It targets red blood cells, so it reduces redness and remodels the scar to help it smooth and even out faster,” says Bowe.
Hair Removal
Unwanted hair on the face and body can be both an embarrassing and frustrating issue for many clients. That makes laser treatment desirable, as it can help eliminate the need to wax, shave, or bleach unwanted hair. “Sugaring, waxing, threading, or plucking only provide a short-lived, temporary fix for hair growth,” says Andréa Young, owner of Beam Laser Spa (New York City). “They are not permanent and often further irritate the skin by causing painful ingrown hairs. Laser hair removal provides a drastic reduction in hair growth over the course of several treatments.” GentleLase Pro-U and GentleMax Pro, both by Syneron-Candela, can be used to target the root of the hair and create heat damage that kills off hair that is in the growing stage. Other popular hair removal lasers include the Cynosure Apogee Elite System, the Lumenis LightSheer Diode Laser System, and the InMode Aesthetic Solutions Diolaze. Because each hair strand grows at different cycles—some hair is in a resting stage during the treatment—multiple visits might be needed about every six weeks for the best hair-removal results. “The light emitted by the lasers penetrates the skin and settles in the follicle, and the follicle absorbs the light energy as heat,” says Young. “Over time, the absorption of heat from the laser kills the majority of the follicles, and the follicles that are not killed get significantly weaker, providing much finer and slower growth.”
Hair Growth
According to Francesca Dubsky, director of marketing at HairMax, there are four types of hair loss: telogen effluvium, anagen effluvium, traction alopecia, and androgenic alopecia. Telogen effluvium hair loss can occur after pregnancy, major surgery, drastic weight loss, extreme stress, and physical and emotional shock. Anagen effluvium hair loss results from damage to the hair follicle and is commonly associated with chemotherapy or as a side effect to certain medications. Traction alopecia is a condition caused by localized trauma to the hair follicles from tight hairstyles. Androgenic alopecia is male- or female-pattern baldness—the most common cause of hair loss. No matter the reason for the hair loss, more and more clients are seeking solutions and ways to regrow their hair, and lasers can be part of the solution. The HairMax LaserComb is a low-level laser device, which utilizes visible light in the red spectrum that has been clinically proven to stimulate hair growth. The LaserComb works by a process called photo bio-stimulation and delivers a safe, nourishing laser light directly to the scalp, infusing hair follicles with energy to treat hair loss and grow denser, fuller hair. Designed to treat thinning hair and hair loss in men, iGrow by Apira Science is another popular hair growth device. This portable in-home hair growth system incorporates a dual light laser and LED light diodes to stimulate and energize cellular activity to help reverse thinning hair and hair loss and grow new healthy hair.
As laser treatments become even more popular among clients, it is imperative that medical spas implement proper education and safety procedures to ensure both the patient and laser operator are safe from harm. “The main safety concern with lasers is making sure the people using them are properly trained and licensed to avoid burns and scars,” says Stuart. “There is no substitute for education and training, especially when it comes to your body.” Some safety precautions include discussing medical history with the patient, performing a laser patch test to make sure the patient does not have a bad reaction before going forward with a procedure, and using protective gear such as eye shields. “Lasers are only as safe as the person who is doing the procedure,” says Bowe. “Almost any laser can cause burns, discoloration, or scars if not done properly. I always personally evaluate every patient and choose the settings myself. Sadly, I frequently treat laser complications from procedures done by people who were not well qualified.”
Fortunately, evolving technology is making lasers increasingly safe. “The newest trends in lasers are those which are non-ablative or do not damage the overlying skin and just target the damaged tissue,” says Stuart. “With new technology, these lasers are being designed to be more effective and safer than ever before.”
(via American Spa)