Posts Tagged ‘Laser burns’
I have been getting a lot of emails from people all over the world that have received burns from an aesthetic laser or IPL (photofacial) treatments. I should clarify, that these are not people that have been treated by me. The question I am always asked is “what should I do to treat laser burns?” I can’t really give an accurate treatment protocol without seeing someone in person. What I will do, is tell you what I usually recommend to clients I have seen that have been burned. I also want to explain why burns may occur. The information here and any where on the internet does not replace replace personal treatment by a trained professional.
How to tell if you have been burned?
It is normal for skin to feel hot during laser and IPL treatments, but you should expect the skin to cool down quickly. Your laser technician can give you an idea how long you should expect the skin to feel hot. For example if you are having a laser hair removal treatment or a photofacial, your skin should cool down almost immediately. It should feel something like a hot rubber-band snap, without any lingering pain or heat. If it feels extremely hot and is not cooling down you should alert your technician as they are doing the treatment. This will allow the technician to adjust the treatment settings. The technician can also take immediate action to cool the skin and possibly prevent a burn, or reduce the severity.
If you suspect that you have been burned, be sure to discuss it with your Laser Technician before you leave the office. Make sure you understand what to expect and how to treat your skin at home. Schedule an appointment for a post treatment follow-up, and never hesitate to call the office if you have questions or concerns.
Usually, you will know almost immediately if you have a burn. In some cases however, the skin may feel hotter shortly after treatment. As soon as you suspect a burn, you should call your and speak to the laser technician.
If you are not satisfied or confidant with the post -treatment care you are receiving from the laser technician, ask to speak to the medical directer. Hopefully, there is a doctor is the office. If you have gone to a med-spa chain, there may be a medical directer for several locations. You should first make every attempt to work with the staff at the clinic where the laser treatment was provided. If you are not satisfied with the level of care, then seek a second opinion. You want to get professional treatment as soon as possible. Information provided here or anywhere on the internet can not replace personal treatment by a skin professional.
I have a burn, now what?
The recommended treatment for burns, will depend on the degree of the burn. In most cases a burn from an aesthetic laser is a first degree burn. Second degree burns can also occur from laser treatments and third degree burns are not likely. If you suspect that you have been burned severely and find the pain intolerable or if the burn covers a large portion of the body, you may want to go to the emergency room. In most cases, it is not necessary to make a trip to the emergency room, however in rare cases you may need some medical attention. Be sure to let the laser technician know as soon as possible. They should be aware so they can review the treatment settings used and asses if there is an issue with the equipment. They should have you return to the clinic as soon as posable, so that see the burned area, and give you post treatment instructions. You may also be scheduled to see the doctor or a nurse if necessary. It is the patients responsibility to communicate with the provider, return to the clinic for post treatment visits, and follow post treatment instructions.
Actual treatment will depend on the type of burn.
– Cool the skin as quickly as possible (within the first few hours). This is critical!
– While driving home after the treatment, aim the air conditioner toward the treated area if possible.
– When you get home soak a washcloth in a bowl of ice water, ring out the excess water and apply the cold wash cloth to the treated area. Switch out the cold cloths every couple minuets. When you feel the wash cloth become warm, it is the time to switch it out.
– Do not apply ice directly to the skin, and do not leave cold packs on the skin for an extended period of time. On for ten minuets, off for ten minuets.
– Only apply occlusive ointments such as aquaphor or vas aline if instructed, as it can trap in the heat. After the skin has had time to cool, and the skin begins to heal you may then be instructed to use an ointment to protect the skin. If you have had an ablative laser you will need an occlusive ointment.
– Do not open or pop blisters. Opening the blisters will make the area more vulnerable to infection
– It may be recommended to loosely wrap the area in gauze
– You may be instructed to apply a topical hydrocortisone cream and/or antibiotic cream to the burn.
– Watch the skin for signs of infection
After the burns have healed:
Once the burns have healed, the concern becomes how to treat and prevent scars. The most important thing you can do is protect the area from further injury, this includes avoiding sun exposure. Be sure to use a Physical SPF 35 or higher with Zinc Oxide. You can also prevent and treat hyper pigmentation ( dark skin discoloration) by using a 4% Hydroquinone cream and Tretinoin (Retin-A). Topical Serums that contain Vitamin – C , and products with growth factors can aid in collagen production, improve skin healing and reduce inflammation. If the burn marks are old you may need something like a medium depth chemical peel, to treat the scars.
Medical skin care systems such as Obagi Nu-derm or ZO Medical incorporate the use of prescription strength Hydroquinone and Tretinoin, which will even skin discolorations. These are prescription strength skin care lines, available at many dermatology and plastic surgery offices. The treatment protocol is patient specific and a skin care professional will determine the best way for you to use these products. If you have had a recent burn it may be suggested that you avoid products that contain AHA’s or any other exfoliants, until the skin the epidermis has been restored. The strength of Tretinoin and frequency is something that needs to be determined after a personal consultation. Non-facial areas such as the neck, chest, hands and arms are treated differently than facial areas, this is another reason you need to be seen for a follow-up.
Skin Medica’s TNS Recovery Complex has a potent growth factor blend that strengthens the skin’s natural ability to regenerate itself. Although this product is not specifically indicated in treating burns, in my experience it seems to aid in healing. I was in a car accident and the air bag left me with several abrasions and burns. The areas that I treated with TNS seemed to heal much quicker. I use this product any time I am trying to improve skin healing, and it never disappoints.
The top ingredient in TNS Recovery Complex is Human Fibroblast Conditioned Media (TNS®) → A physiologically balanced, naturally secreted and stabilized combination of multiple human growth factors, cytokines and natural proteins responsible for the production of collagen and other extracellular matrix proteins.
Obagi-C Rx contains a patented combination of 4% hydroquinone and 10% Vitamin C. It reaches the dermal layers of skin to address discolorations and has powerful antioxidant therapy. The vitamin-C will also help reduce inflammation.
Is Clinical Pro Heal is a vitamin serum with a 15% Vitamin C, Vitamin E and Vitamin A. It also has 0.5% kojic acid that evens skin pigmentation. It has soothing and healing properties and reduces inflammation. Pro Heal is recommended for treating sunburns, rosacea and insect bites.
Is Clinical Hydro-Cool Serum contains Hyaluronic Acid ,Vitamin B5, Kojic Acid and Menthol. It is a hydrating serum that calms cools and soothes irritated skin. You can use this product alone or add it to another product.
Why you may have got burned
There are several variables that can lead to laser and IPL burns. One of the most common reasons, is that the skin is tan at the time of treatment. It’s important to understand that IPL and all lasers are absorbed by a specific chromophor. In many cases the targeted chromophor is color. We want the energy to be absorbed by the color in hemoglobin to target blood vessels and the color in melanin when targeting unwanted hair or skin discolorations such as freckles. When your skin is tan at the time of treatment, the energy is not just absorbed by the intended target, it is also absorbed by the surrounding tissue as well. Tan or dark skin will absorb more energy (heat), resulting in a burn. This is also a concern for skin of color. People with darker skin tones need to be careful to go to a skin professional that understands how to treat their skin type. This is not to say that if you have dark skin you are not a candidate for laser, however there are some lasers that are more appropriate for dark skin. It may also be recommended to precondition skin in advance.
I don’t find machine malfunction to be the most common reason that laser burns occur, however it does happen. In my opinion some of the most severe burns are a result of a problem with the equipment. I believe that this can be hard to prove.
In some cases the technician performing the treatment may be at fault. Technician error is a growing cause of laser burns, simply because the industry is growing. There are a large volume of new laser technicians entering the industry. Some of these new technicians will be knowledgable and talented, unfortunately a some will not. A “good” laser technician needs to have a good understanding of laser technology and skin. This comes with experience and continued education. Not all lasers work exactly the same, so a laser technician needs training for each laser they work with. The more experience a technician has with lasers in general as well as a specific laser will reduce the possibility that their clients will be burned. In addition to understanding the technology being used, the technician should understand how skin will react and determine if someone is a good candidate for treatment. They should also determine if someone needs to precondition their skin before treatment and what is a good post treatment protocol. Keep in mind that even the best laser technician can encounter an unexpected complication, and burns are an inherit risk of laser and IPL treatments.
I can not stress enough the importance of going to a qualified, experienced laser technician with a good reputation.
You Play A Role
Nobody wants to hear that they have some responsibility, but in many cases it is the truth. I don’t think anyone deserves to have a burn or complication and I am sincerely sorry when it happens. However, everyone should except the role they play in their treatment. For example, you should not be tan when you have a laser treatment. It is the patients responsibility to inform the laser technician if they have had ANY sun exposure or even spray tan to the treated area. Patients are also expected to inform the laser technician of any medication or skin care products they are using. You also need to communicate with the laser technician during and after the treatment, and let them know what you are feeling. Be sure to follow all pre and post treatment instructions, such as avoiding heat and sun exposure. If you don’t follow the pre and post treatment instructions, you run the risk of a complication. You play an active part in your own treatment, and that begins with choosing a qualified and experienced laser technician. If you chose to go to a specific med-spa based on price or location, you should understand the risk involved.
Burns and other complications are an inherit risk of aesthetic and laser treatments, you should understand and except all risks before you consent to treatment. You should also understand that additional products or treatment may be needed at an additional cost to you. It is important that you communicate with your laser technician and return to the clinic for follow-up visits.
Cosmetic Laser Warning!
What you need to know before choosing to do a cosmetic procedure.
On one complaint website, there were 1,437 complaints regarding laser treatments and over 600 for one specific laser center. If you decide to go to a discount laser center because you are looking for a low cost, you are taking a gamble. Some clinics hire inexperienced, even unqualified technicians to do treatment and rarely have a Doctor on site. A clinic may have a “medical director” on staff whom acts as a medical director for several locations. A med spa with a medical director on staff does not mean it is the medical practice of that person and the medical director may never actually be in the clinic. I have even heard of cases where the “medical directer” was in another state. Med Spas often set sales quota’s for employees, so technicians are pressured to rush treatments. I call this type of practice ” turn em’ & burn em’ “. I don’t blame the technicians, it’s just a poor way to do business. These types of laser centers usually have a very high employee turn over rate and many unhappy customers.
Increasing popularity for Laser, IPL and RF treatments has lead to an increase of treatment complications. A poorly done laser treatment can lead to burns, hyperpigmentation, hypopigmentation, ocular injury, scars and a simple lack of results. Most complications are preventable and all are manageable. The increase in complications is primarily due to lack of training, experience, and medical supervision. It is important to know that it is not just the technology, it is also the technique that determines the result of a treatment. Cosmetic and laser treatments can be complicated and are best done by an experienced technician. Laser and IPL treatments all come with some inherent risk, which you should understand and except before you consent to treatment. Burns and other side effects can result even when treatment is performed by the best and most experienced laser technicians.
With all the new products and technology available today it is easy to be confused, when choosing a treatment. Laser, IPL, LED, Infrared, Radiofrequency and fractional resurfacing are all energy based technologies and each have different indications. A knowledgeable esthetician / laser technician can educate you on energy based treatments in addition to other treatment options. In some cases a chemical peel, Botox, or a cosmetic filler may be a better option than laser. A consultation with an experienced esthetician can help you to make an educated decision on treatment.
It’s easier to stay out of trouble than to get out of trouble.
Patients play an active role in their treatment.
Tanning is a contraindication to most laser and IPL treatments, it is the patients responsibility to use proper protection from UV rays and inform technician of any possible sun exposure. Follow all pre and post treatment instructions, including keeping skin cool. Patients that are noncompliant may be responsible for treatment complications. Anyone with dark skin is at increased risk for complications, and should look for an experienced technician that specialize in treating dark skin.
When choosing to do a cosmetic procedure always look for someone who is experienced with proper training and a successful reputation. Do not base decisions regarding laser treatments, solely on price. A poorly done treatment will cost you more in the long run. Laser clinics should not operate the same as a tanning salon or health club. Laser treatments are serious and should be treated as such.
Are they telling you what you want to hear?
Regardless of the technology, laser hair removal usually requires a minimum of 12 treatments on the face and 8 treatments on non-facial areas. In most cases periodic treatments are needed to maintain results. Laser technicians that tell you that you will only need 5 treatments are not necessarily lying to you intentionally, this is often what they are told by the companies that manufacture lasers. Same applies to claims of safely treating tan skin or effectively treating light hair, although it may be possible don’t count on it.
Questions to ask:
Are you a licensed esthetician and certified laser technician in this state?
Is there a Doctor on location?
How long have you been doing laser treatments?
How long have you been in this clinic?
Have you treated my skin type before?
If you have been burned
Most complications are manageable, and can often be completely resolved. Treatment protocol will depend on severity of burn. In some cases the “burns” are not as severe as they look. If it is just superficial redness with speckles of dark, you may even get a nice result. Unfortunately some burns may need medical attention and can lead to scarring. If you have been burned, return to the laser clinic immediately for follow up care. Proper treatment of the skin post treatment can make all the difference.
The marks in the above photo appear to be from an IPL treatment, however I would not say this is anything to be alarmed about. The marks may look bad, however with appropriate home care she may even have a nice result.
Laser and IPL Burns
These are photo’s found on the internet that show various examples of burns from laser and IPL.