Posts Tagged ‘Laser’
If you are considering laser hair removal, you should know how many treatments you will truly need, and what type of a financial investment you will be making. I want to explain how many treatments you may need and why, so that you can make a more informed decision before you invest in laser hair removal.
I have people come in to our clinic after they have had a series of laser hair removal treatments at another clinic, and they are disappointed because they think it didn’t work. The problem is that many laser technicians will over promise and under deliver. The common misconception is that you will only need (let’s say 5) treatments. I don’t care what “they” tell you, this is almost never true! Don’t be surprised if you are told that “they” have the most effective laser on the planet and they can give you better results with only a few treatments. Maybe you will be told that you are perfect candidate, so you will need less than other people. If you buy this, I have a bridge to sell you. I do think that some technologies are more effective than others, however, even with the best technique and most effective equipment, you will still need several treatments. Even if you are the most ideal candidate in the entire world, you will still need several treatments.
Growth Cycle of Hair
Hair follicles go through a cycle of activity commonly refered to as the hair growth cycle. Each active hair follicle will continuously cycle through three phase of growth ( anagen, catagen and telogen). It is also important to understand that each hair follicle acts independently, so not all of the hair is in the same stage of growth at the same time. This is why it is necessary to have a series of laser hair removal treatments, scheduled at specific intervals.
Anagen Stage- Active Growing Stage
Catagen Stage – A Brief Transitional Stage
Telogen Stage – Resting Stage ( hair sheds at end of telogen stage)
With laser hair removal we are most concerned with hair in the anagen stage, because this is when the hair is at it’s maximum depth. The laser energy is absorbed by the melanin or water in the hair and we need to deliver the energy to the maximum depth of the follicle. This means that hair in the catagen or telogen stages of growth may singe and fall out with treatment, but they are not at thier maximum size or depth so they will likely grow back. So…. to reiterate, hair that is in the anagen stage of growth responds the best to laser hair removal.
The length of each cycle will depend on the region of the body, it will also vary from person-to-person and from time-to- time. Unfortunatly, in most areas the number of telogen hairs out number the amount of anagen hairs. For example the axillae (under arm) area is estimated to have about 70% of the hair in a telogen stage and the telogen stage in this area typically lasts for about 3 months. Again, this is not an exact science because there are several variables with the growth of hair and each idividual hair acts indepentaly. This means that the best you can hope for in this area is about 20% reduction per treatment and if by some sort of miracle your personal cycle of hair growth corasponds perfectly with your scheduled treatments you can complete your hair removal process with 5 treatments. However… you probably have a better chance of getting struck by lightining.
Potenial Follicals
We all are born with a certain amount of hair follicals which do not increase with age, however the activity of the follicles do increase. We all have many, many potential hair follicles. Potential follicals are dormant hair follicles that are not active (currently producing a hair), but have the ability to produce a hair if stimulated by the appropriate hormone. Trust me when I tell you that you will likely see new hairs pop up in areas that you have never had them before. This is important to understand because laser hair removal only effects hair follicles that have a hair in the follicle at the time of treatment. Laser hair removal treatments can not prevent potential follicals from having the ability to produce a hair in the future. This is another reason that everyone needs to plan on having maintanance treatments after the intial series of treatments.
How Many Hair Removal Treatments Will I Need?
An initial series of treatments are necessary and occasional maintenance treatments are almost always needed after the initial series. For facial areas, you should expect to do an initial series of 12 treatments (once a month for a year). For body areas, you should expect to do an initial series of 8 treatments (scheduled about 6-8 weeks apart over a year).
There is no way to predict exactly how many maintenance treatments you will need. Some people need one every year or so, while others require several treatments for several years. This is due mostly to genetics and hormones, however other factors include technique, technology, and patient compliance. There are some things you can do to help improve your results. Keep your treatments on the appropriate schedule, avoid tanning, search for an experienced laser technician and a reputable clinic that is known to use better equipment. Do not wax, tweeze, or remove the hair from the follicle before or between treatments. If you have excessive hair growth, you should consult with your doctor to address any medial conditions that may contribute to hair growth.
Questions you should ask before you pay
Who will be performing your treatment?
Will you always see the same person or will you have somebody new each time? Do they have the appropriate certification and training, how long have they been doing laser hair removal and how long have they been at that specific clinic ?
Who is the medical director?
Are you having treatment in a medical practice or a med spa ? What are the credentials of the medical director ? Is it a Nurse, Dermatologist, Plastic Surgeon, Chiropractor, Dentist, Veterinarian? Is the medical director on site? How often are they in the office and are they available to see you if you experience a complication?
What is available for pain management?
Yes, laser hair removal hurts. The good news is that we can do things to help. Usually, we will apply a topical numbing cream before treatment, and in our clinic we use a proprietary formula that is extremely effective. I have a few other tricks that I will not share.
How much will it cost?
Many med spas have tricky packages or “plans”. Find out how many treatments are included in your package and how you are expected to pay. Do you need to pay for a full package all up front, or can you make payments? How much will additional treatments cost after your initial series? Is there a discount? Do you need to buy another package or can you pay as you go? If you are offered some sort of contract or membership, be careful, and be sure to read between the lines! You should also be warned that it is not uncommon for a med-spa to go out of business, and not tell clients or employees. You may show up one day with the doors locked, and, if you prepaid for a package, you can kiss your money good-bye.
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Rosacea is primarily a facial vascular disorder in which blood vessels are functionally and structurally abnormal. Currently rosacea can’t be cured, however it can be effectively treated and controlled. Rosacea is a progressive skin disorder, that should be treated when symptoms first begin. Treatment should be aimed at treating the underlying vascular issues associated with rosacea. Vascular Lasers and IPL treatments are extremely effective at treating existing redness and broken blood vessels. In addition to avoiding rosacea triggers, topical products can be used to prevent flushing and further damage that can accelerate the progression of the disorder.
[Rosacea 101: Understanding Rosacea and it's triggers]
Laser and IPL Therapy
Both Laser and IPL therapy are very effective at treating telangiectasia (broken blood vessels), generalized redness and flushing. IPL therapy can also be enhanced with Levulan to get the added benefit of treating acne, rosacea papules and pustuals.
Laser
Lasers that are absorbed well by hemoglobin are used to treat vascular concerns. The laser energy is absorbed by the blood vessel and creates heat within the vessel which damages the vessel wall and permenatly closes that vessel. The treated vessels are then absorbed by the body. Although there isn’t a cure for rosacea, studies show that laser treatment can permantly remove damaged facial blood vessels and with repeated treatment blood vessels will not always be created to replace the old vessel. Facial blood vessels treated with lasers are sometimes replaced with connective tissue. This is good news, because this will permently reduce the number of blood vessels in the face, near to the level of vessels found in healthy skin.
Lasers have a single wavelength that work at a very specific depth. So any idividual laser has it’s limitations. KTP 532 nm and Pulsed Dye: 577 -585nm lasers are well absorbed by hemoglobin and are very effective at treating superfical blood vessels in the face, while Nd:YAG 1064nm lasers are also well absorbed by hemoglobin, they are effective at treating vessels that are located deeper in the skin.
[ Lasers 101: Learn more about aesthetic lasers]
Intese Pulsed Light (IPL)
IPL skin treatments are known by many names including Fotofacial, Photofacial, Photoderm and Photo rejuvenation. Intense Pulsed Light (IPL) differs from lasers because IPL uses a wide spectrum of wavelengths at the same time (for example: 500nm — 1200nm) that can target any chromophore in that range, while lasers have a single wavelength. You can think of the laser like a sniper that can precisely hit a single target with one shot, and IPL is like a grenade that hits several targets at once. IPL uses special cut-off filters that can be selected to target chromophors in a certain range within the skin. When treating rosacea or any vascular concern, the intended target is hemoglobin. The advantage IPL treatments have over laser treatments is that IPL can target vessels at different depths.
[ Intense Pulsed Light (IPL) 101: Learn more about IPL treatments]
Combined Laser and IPL Therapy
Best results are achieved when you combine IPL and Laser treatments. IPL and Laser treatments can be done independently, however combining technologies at the same treatment time will provide a better result. This type of treatment is fairly aggressive and should only be done by someone that is very experienced in combining these technologies.
Oral and Topical Products
Topical Metronidazole Gel
Metronidazole is topical agent used to treat rosacea, available only by prescription. The primary action of Metronidazole is anti-inflamatory. Metronidazole is effective at reducing papules and pustules and has a fairly minimal effect at reducing inflammation. Unfortunately, it isn’t effective for treating broken blood vessels or flushing.
Antibiotics
Antibiotics have long been used to treat rosacea, however they work primarily through their anti-inflammatory properties rather than antibacterial. Antibiotics are effective at reducing papules, pustules, and inflammation. The limitation with antibiotics is that they are not effective at treating telangiectasia or flushing.
Antihistamines
Antihistamines are effective at reducing facial inflammation, swelling and burning associated with rosacea. Histamine contributes to swelling, itching and burning. Histamine has also been shown to play a role in inflammation and redness.
Sunblock with Zinc Oxide
UV rays can penetrate the skin and activate sensory nerves that release potent vasodilators, as well as creating heat in the skin causing facial flushing. Zinc oxide reflects both UVA and UVB rays, blocking out heat from the sun. Topical zinc oxide also has significant healing properties when applied to damaged skin and has been shown to decrease inflammation in both the epidermis and dermis.
Dimethicone
Dimethicone is a silicone based ingredient with moisturizing ability. Dimethicone is also a protective ingredient that has been shown to reduce flushing caused by skin irritants.
Antioxidants
Free radicals have been shown to cause structural damage to vascular walls and many free radicals are potent blood vessel dilators. Dietary and topical antioxidants help to block the damaging effects of free radicals.
Studies show that vitamin C can protect blood vessel walls from free radical damage and reverse existing vascular damage. People with rosacea should get plenty of vitamin-C in their diet, and may want to consider a vitamin-C supplement. In addition to being a great antioxidant, topical vitamin-C has anti-inflammatory qualities.
*This post is intended for informational purposes only.
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Radio frequency is not the same as laser, however it is often used in conjunction with laser treatments in a clinical setting. Radio frequency (RF) usually refers to oscillations in electrical circuits. Aesthetic treatments use non-ablative (RF) energy in short intense pulses that oscillate through the skin to heat targeted tissue. Radio frequency (RF) is often used to tighten the skin. The (RF) energy penetrates the skin and stimulates the contraction of collagen and the production of new collagen for skin tightening.
[ Read more about Laser technology ]
Radio frequency devices use a variety of delivery systems and penatrate to varying depths. Radio frequency can be monopolar or bipolar. Bipolar devices are often combined with other types of technology such as infrared light.
Monopolar vs Bipolar
Monopolar
For the purpose of aesthetic treatments Monopolar radiofrequency is delivered by applying a single electrode to the treated area and an opposing electrode that is relatively far removed so that the current goes deeply through the body. Unipolar (RF) penetrates deeper and more intensely than bipolar( RF). Thermage uses monopolar radiofrequency (RF) energy to tighten and contour skin.
Bipolar
For the purpose of aesthetic treatments bipolar radiofrequency is delivered by applying two closely positioned electrodes to the treated area. The electric current travels from one electrode through the tissue and back up to the other electrode, the current that goes between the electrodes is small and shallow. As a result, the tissue in the treated area is heated less deeply and less intensely than monopolar (RF). In aesthetic treatments bipolar RF is usually combined with light or energy based sources, including lasers, intense pulsed light, infrared light, or vacuum assisted. Infrared light heats the tissue down to the deep dermis and acts to “pre-heat” tissue, for improved (RF) penatration.
Bipolar Radiofrequency used with Laser and IPL
Unlike laser and Intense Pulsed Light (IPL) energy, radio frequency is not absorbed by a specific chromophore. When RF is combined with other energy sources such as lasers and IPL, the laser or IPL energy will be absorbed by the targeted chromophore (melanin or hemoglobin), resulting in an increased temperature in the target areas. The increases in tempeture lowers the tissue impedance to those areas and the RF energy will stream preferentially to the warmer areas with lowered impedance. Elōs is the first and only technology that simultaneously harnesses the power of bi-polar radio frequency (RF) and optical energy.
The ReFirme™ ST procedure combines safe and effective levels of infrared light and bipolar radiofrequency energies to remodel the dermal layer of the skin by stimulating new collagen growth.
Bipolar Radiofrequency(RF) used with Suction
Bipolar radiofrequency can also be combined with negative pressure ( suction), to help improve and control the absorption of the RF energy. The tissue is suctioned into the hand-piece and the RF energy passes through. The Aluma uses a vacuum-assisted and bipolar radio-frequency (RF) handpiece for skin tightening methods.
VelaShape uses a combination of Infrared light, bi-polar radio frequency (RF) and negative pressure (suction) to heat deep adipose (fat) tissue. Infrared light, tissue mobilization, and suction, all work synergistically with RF to reduce cellulite.
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Intense Pulsed Light (IPL) is used in photo-rejuvenation for the skin and hair removal treatments. Broad Band Light (BBL) is essentially the same thing as IPL and is used in the same way. Intense Pulsed Light (IPL) is not actually a laser. IPL emits a non coherent, broad spectrum light, rather than a monochromatic single wavelength like a laser. Basically lasers have one wavelength ( for example: 800nm) with a very specific target, and IPL uses a wide spectrum of wavelengths at the same time (for example: 500nm — 1200nm) that can target any chromophore in that range. You can think of the laser like a sniper that can precisely hit a single target with one shot, and IPL is like a grenade that hits several targets at once.
IPL uses special filters that block unwanted wavelengths. The filters can be changed to “cut off” the shorter wavelengths. The appropriate filter will depend on the depth of the intended target.
intense pulsed light
The cut off for the wavelength at the deeper end is predetermined, but can vary with each devise.
For example: Lumenis One has a wavelength of 515 – 1200nm,
and has 7 filters: 515, 560, 590,615, 640,695, and 755.
The 515 filter would block out wavelengths above and below 515nm – 1200nm, while the 560 filter would block out wavelengths above and below 560 -1200nm. The deeper wavelength, in this case 1200nm remains the same, while the “cut-off” filter can be changed to block out specific shorter wavelengths.
Each devises may use different wavelengths.
Sciton BBl: 420 -1400nm
Lumenis One: 515-1200nm
iPulse 1200: 530 – 1200nm
LimeLight: 520 – 1100nm
E-Light: 470-980nm
Cynergy XPL: 560 -950nm
[ Read more about Aesthetic Lasers ]
SELECTIVE TARGET
IPL is well absorbed by chromophores that have color such as melanin, hemoglobin. The concentration of a specific chromophore peaks at different depths in the skin. The filter used in treatment is decided based on the depth of a desired target and the color of skin. A deeper cut off filter would be used for hair removal, while a shallow filter would be used when treating vascular issues such as rosacea. It is important to remember that IPL targets color in the skin, so tanning must be avoided before treatment. Patients with darker skin should seek treatment from someone experienced in treating their skin type, to avoid complications. IPL treatments can provide beautiful results, but can also cause serious burns. It is the patients responsibility to choose an experienced professional, be honest about sun exposure and follow all pre and post treatment instructions.
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There are many variables involved in aesthetic lasers, including the active laser medium, wavelength, and targeted chromophore. Aesthetic lasers can be ablative, non-ablative or fractional. There are also other (non-laser) technology based treatments used in aesthetics such as Intense Pulsed Light (IPL) and Radio Frequency (RF).
Lasers
The term “laser” originated as an acronym for Light Amplification by Stimulated Emission of Radiation. A laser generates a beam of very intense light. The light emitted by a laser is monochromatic, coherent and collimated.
Monochromatic – the light is of a single wavelength
Coherent - the light beam waves are in the same phase
Collimated - the light beams travel in parallel, all are parallel to each other.
Active Laser Medium Types
The lasing medium is the source of optical gain within a laser. The Active Lasers Medium can be a solid crystal, liquid dye, gas, or semiconductors.
Gas Lasers
Carbon dioxide (Co2) are gas lasers that are commonly used in aesthetic treatments.
Solid State Lasers
Generally, the active medium of a solid-state laser consists of a glass or crystalline material.
Solid state lasers include Ruby, Aexandrite and Erbium.
Semiconductor
Semiconductor-based lasers are also in the solid state, but are considered as a separate class. Diode is a semiconductor based laser used in aesthetic treatments.
Dye Lasers
A dye laser is a laser which uses an organic dye as the lasing medium. A dye can usually be used for a much wider range of wavelengths which makes them suitable pulsed lasers. Pulsed Dye Lasers are used in aesthetic treatment.
Electromagnetic Spectrum
Electromagnetic spectrum is the range of all possible wavelengths and frequencies. Wavelength is the distance over which the wave’s shape repeats ( peak to peak).Wavelenghths are measured in micrometers (microns) and nanometers (nm) Frequency is the number of oscillations per second, measured in hertz.
Energy is the amount of joules (J/cm) delivered. A laser technician adjusts the energy of each treatment, based on factors such as skin type and condition. The laser technician can also control other factors such as spot size and the length and duration of the pulse.
Selective Target
Lasers used in aesthetic treatments target a specific chromophore generally melanin, hemoglobin or water in the tissue. The targeted chromophore is determined by the wavelength. The concentration of a specific chromophore peaks at different depths in the skin. For example hemoglobin in the blood is best absorbed at a shallow wavelength and water is best absorbed at deep wavelengths. Melanin is best absorbed somewhere in the middle (500nm-1064nm), the exact depth can vary, depending on the desired target. For example if you are targeting pigment in the hair follicle a deeper wavelength (640nm-1064nm) would be used, however most lasers used for hair removal are Diodes (800nm-900nm).
Melanin and hemoglobin in blood vessels have color that absorbs the light emitted by specific lasers. Lasers that target color are usually used for hair removal, treating vascular issues such as rosacea and broken blood vessels, and skin discolorations such as freckels. Tanning is contraindicated with laser treatments that target color, tan skin will absorb more heat, increasing the probability of a burn. Tanning can also interfer with the desired results of treatment, because there is less contrast between the intended target and the surrounding tissue. Lasers that are used for hair removal target the color in the hair, so grey or blond hair will not respond well. (There are some lasers that claim to treat grey or light hair).
Water constitutes 80% or more of soft tissue, so lasers that target water are generly used for resurfacing. Lasers with deep wavelenghts such as Co2 or erbium lasers are strongly absorbed by water. The Smoothbeam laser is a 1450nm diode laser that targets water in the skin and is used to treat acne by shrinking the oil gland.
Argon 488 and 515 nm, is a gas laser that emits a blue green light which is strongly absorbed by both hemoglobin and water,used for photocoagulation. Argon lasers are rarely used for aesthetic or dermatologic treatments.
KTP 532 nm, a brilliant green light well absorbed by hemoglobin and melanin used photoablation and photocoagulation. The Iredex DioLite 532 nm KTP that is Diode Pumped, it is used to treat vascular lesions and hyperpigmentation.
Pulsed Dye: 577 -585nm, a yellow light that is well absorbed by hemoglobin in blood. Pulsed Dye Lasers (PDL) are especially useful for the treatment of vascular lesions, including spider veins, strawberry birthmarks and port wine stains.
Ruby 694 nm, uses a synthetic ruby crystal that emits red light that is strongly absorbed by blue and black pigment, and by melanin in skin and hair.
Ruby lasers are used for laser hair removal, tattoo removal and treating pigmented lesions including freckles, liver spots.
Alexandrite Laser 755nm, emits a deep red light and is absorbed by melanin. Alexandrite permits deeper penetration into skin than the ruby, and is used for Laser Hair Reduction.
Diode 800-900nm, emit near-infrared light. Diodes in the 800-900 nm range are absorbed by melanin and used for laser hair removal. The Smoothbeam uses a diode with a 1450nm, it targets water in the skin and is used to treat acne and build collagen.
Nd:YAG 1064nm, laser emits a near infrared beam that can be absorbed by all tissue chromophores, however it is strongly absorbed by hemoglobin. Nd:YAG lasers are used for photocoagulation and photoablation, commonly used to treat broken blood vessels.
Er:YAG 2940nm, emits a mid-infrared beam which has an absorption peak for water. Its used is to ablate tissue for cosmetic laser resurfacing. Also known as Erbium.
CO2 10,600nm, is a gas laser emitting a mid infrared beam which is strongly absorbed by water. Co2 lasers are capable of cutting or vaporizing tissue, and are used for deep laser resurfacing.
Ablative, Non-ablative an Fractional
Non-ablative lasers heat the layers of skin beneath the surface without removing the epidermis (top layer of skin).
Ablative procedures remove the epidermis. Carbon dioxide and Erbium lasers are ablative lasers used in aesthetic treatments. Ablative laser treatments are used for resurfacing, and leave skin raw.
Fractional lasers can be ablative or non-ablative treatments, and target only a fraction of skin at a time, leaving the surrounding tissue intact.
[ Read more on Fractional lasers ]
Some of the lasers used in aesthetic treatments:
Iredex DioLite – 532 nm KTP Diode Pumped – Non-Ablative
Candela Vbeam – 595nm Pulsed dye laser (PDL) – Non-Ablative
Candela GentleLASE – 755 nm Alexandrite – Non-Ablative
Lumenis LightSheer – 800nm Diode – Non-Ablative
Syneron eLaser / Comet – 810nm diode laser ( with RF) – Non-Ablative
Syneron Matrix IR – 915nm diode (with RF )- Non-Ablative/Fractional
Sciton Profile – Nd:YAG 1064 nm – Non-Ablative
Lumenis Multi-Spot – 1064 Nd:YAG – Non-Ablative
Candela GentleYAG – 1064nm Nd:YAG – Non-Ablative
Fraxel re:fine – 1410nm Erbium – Non-Ablative/Fractional
Cynosure Affirm – Nd:Yag 1440nm – Non-Ablative/Fractional
Candela Smoothbeam – 1450 nm diode laser – Non-Ablative
Fraxel re:store – 1500nm Erbium laser – Non-Ablative/ Fractional
Sciton Profile -2940nm Er:YAG – Ablative /(additional attachment to Profile base)
Sciton ProFractional – 2940 Er:YAG – Ablative/Fractional
Lumenis UltraPulse – 10,600nm Co2 – Ablative/ Fractional
Fraxel re:pair – 10,600nm Co2 laser – Ablative/ Fractional
Sometimes a little information can be a dangerous thing.
This is intended to help provide some very basic information of cosmetic / aesthetic lasers. There are many factors involved with laser aesthetic treatments and not everything can be included in this post. Aesthetic laser treatments can be complicated and should only be performed by a qualified and experienced technician.
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Laser peels, also known as a laser resurfacing, is the removal of the top layers of the skin via focused laser light energy. Some types of lasers may penetrate into deeper layers of skin to provide correction at a deeper level. Fully ablative laser resurfacing is used to remove moderately deep lines, scars, birthmarks and enlarged oil glands on the nose (rhinophyma). Laser resurfacing is usually performed using a Co2 (carbon dioxide) or Erbium laser, both lasers vaporize superficial, damaged skin cells.
CO2 is thought to give the best skin tightening, unfortunately it also creates the most downtime, pain and risks of adverse side effects. CO2 laser can use short pulsed light energy (ultrapulsed) or continuous light beams that are delivered in a scanning pattern to very precisely remove thin layers of skin with minimal heat damage to the surrounding structures.
Erbium laser resurfacing creates minimal burning of surrounding tissue allowing for quicker recovery time than CO2 resurfacing procedure. Recovery time from the CO2 resurfacing is up to two weeks, compared to about one week with an Erbium laser. Erbium lasers cause minimal side effects, such as swelling, bruising and redness. Those with darker skin are usually a better candidate for erbium laser resurfacing compared to CO2. Laser resurfacing is an outpatient procedure that usually requires local anesthesia, and often done at the same time as surgical procedures.
MicroLaser Peel
The Sciton MicroLaser Peel is partial to full epidermal peel ( typically, 20 – 50 microns). The Sciton Erbium Yag laser is used for MicroLaser Peels and has the capability to treat at depths as minimal as 10 microns to as deep as 120 microns (full resurfacing). Microdermabrasion generally only removes the stratum corneum (10 microns). This is a versatile procedure because the settings can be adjusted to control the depth of the desired peel, while a computer guided scanner ensures maximum precision and treatment uniformity. Because this treatment ablates deeper into the epidermis, it is perfect step between microdermabrasion and full resurfacing.
Fractional Laser Resurfacing
Fractional resurfacing procedures have gained in popularity because their delivery systems dramatically reduce downtime compared to full resurfacing. Fractional laser skin resurfacing treatments can utilize the same energy of ablative resurfacing lasers, while providing the safety of non-ablative laser treatments. As a result, patients can undergo a corrective procedure, without the down -time. Fractional laser treatments target only a fraction of skin at a time, leaving the surrounding tissue intact, allowing the skin to heal faster. Fractional laser procedure are usually done in a series of treatments. Active FX and Fraxel are the most widely used fractional laser treatments.
Active FX, Deep FX and Total FX
The UltraPulse fractional CO2 (10,600nm) laser system is capable of offering the full range of fractional resurfacing. The Active FX and Deep FX are both part of the UltraPulse Fractional laser, they are however separate handpieces that work differently. Patients are often confused by before and after photos, assuming they represent an Active FX treatment, when they may actually show results from a Deep FX or Total FX treatment.
DeepFX offers a small, deep spot microablative treatment
ActiveFX offers a large, superficial spot treatment.
Total FX is a treatment that combines both the DeepFX and ActiveFX.
Fraxel
Fraxel currently has four fractional systems.
Fraxel re:fine® treatment—for prevention and maintenance
This is the most gentle option, and is a cosmetic procedure that treats minor skin damage, with little to no down time.
1410nm Erbium
Fraxel re:store® treatment—for mild to severe skin damage
The original and most popular Fraxel treatment, this treatment is used to resurface damaged skin and treat wrinkles around the eyes, acne scars, surgical scars, age spots/sunspots, melasma and Actinic Keratoses. There is minimal downtime , usually redness and some swelling. Most return to regular activities within a day or two.
1500nm Erbium laser
Fraxel Restore Dual uses both 1500nm Erbium laser and 1927 Thulium fiber laser
Fraxel re:pair® treatment—surgery-like results for the most severe skin damage
This is the most aggressive Fraxel treatment, it tightens skin, corrects severe damage, wrinkles, irregular texture, age spots/sunspots, sun-induced redness. There is increased downtime with this treatment, most return to routine activities after a week.
Fraxel Repair 10,600nm Co2 laser
If you are considering a laser resurfacing procedure, whether it be fully ablative or fractional, you can schedule a consultation with skin professional at Paradise Valley Skin Klinic.
www.shapiroplasticsurgery.com
480-421-1701
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There are many people that have embraced their freckles and love them, while others would prefer spotless skin.
Freckles are clusters of concentrated melanin, ranging in color from red, tan and brown. Some people have a genetic tendency to develop freckles, however sun exposure is the main cause of freckles. Freckles generally appear on sun-exposed areas, and will appear darker or more prominent after sun exposure. Ephelides is a freckle which is flat, light brown or red, and fades when protected from UV light. Ephelides are more common in those with light complexions. Liver spots (also known as sun spots and Lentigines) are freckles that develop after years of sun exposure, and are more prominent with age.
If You Want To Remove Freckles
The best way to remove freckles is to have a series of photofacial treatments, combined with bleaching creams containing 4% hydroquinone and tretinoin (Retin-A). A good UVA/UVB sunblock is also recommended, because UV exposure will make freckles more prominent.
Photafacial (Fotofacial) uses IPL (Intense Pulse Light) to treat skin discoloration, redness and broken capillaries. There generally isn’t any down time associated with IPL treatments, however pigmented spots will appear darker temporarily. After a photofacial any freckles or pigmented lesions will darken up and flake off. It can take up to two weeks for spots to flake off. The number of treatments needed will vary depending on the skin condition.
Photofacial / IPL Treatments
If You Like Your Freckles
If you are not concerned with removing freckles you can use lightening and brightening products. These products brighten the skin without removing freckles. Freckles will fade slightly, but will not go away.
OBAGI C-RX System
If you love your freckles, you may want to skip the Therapy Night Cream from this system. The Therapy Night cream has a 4% hydroquinone, which will further fade freckles and pigmentation. The Clarifying Serum also has a 4% hydroquinone, however this C- serum is only used in the morning and is not enough to eliminate freckles. The Clarifying Serum is great for anyone that wants brighten their skin tone, and still keep their freckles.
iS Clinical White Lightening Complex
Brightens and lightens skin with beneficial moisturizing properties. Utilizing an innovative blend of proprietary lightening ingredients and pharmaceutical-grade botanicals, this high performance formula exfoliates, reduces inflammation, and provides strong antioxidant protection.
White Lightening Complex will brighten the skin, and freckles will fade, but not go away completely.
Prevent Freckles
To prevent freckles, you need to use a good sunblock. I recommend a UVA/ UVB sunblock with an SPF 30 or higher. I also recommend sunblocks with Zinc, because it is a broad band physical block. SPF only measure UVB protection, and even if a product is labeled to have UVA protection, it may not protect from the full UVA spectrum. Topical Vitamin C ( L- ascorbic acid) can also help prevent sun damage because it neutralizes UV radiation.
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Picture Perfect Skin In Time For The Holidays!
$600: Six weeks to beautiful skin!
All treatments include face, neck and chest!
Fotofacial
Rejuvenize Peel
2 Microdermabrasion Treatments with Custom Facial
Package Value $1525.
Recommended protocol, one – two weeks between treatments.
#1 Fotofacial
#2 Rejuvenize Peel
#3 Microdermabrasion
#4 Microdermabrasion
All treatments must be used by 12/24/10
Offer expires 11/12/10, Excludes all other offers, No substitutions.
Call Paradise Valley Skin Klinic, to schedule your treatment with Stephanie or Kristy. 480 421.1701
Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com
Jane Iredale Is The Skin Care Makeup
Jane Iredale mineral makeup is recommended by plastic surgeons, dermatologists and estheticians.
Benefits of Jane Iredale Mineral Foundation
- Can be used after cosmetic procedures such as chemical peels and laser treatments.
- Has a natural SPF 20 ( UVA/ UVB physical block), that is non-irritating and can be used after procedures when
other sunscreens may cause irritation or are not recommended.
- Water resistant, won’t crease or smear even during the most strenuous exercise.
- Anti-inflammatory and Anti-microbial, making it ideal for acne, rosacea, and post procedure skin.
- No Talc, most powder is 50% – 80% talc. Talc is a cheep filler that will exaggerate peeling or further dry skin after cosmetic procedures.
- No oils, chemical, fillers, preservatives or FD&C dyes
- Natural & Organic : Paraben-free, PETA, 100% Natural
Why Jane Iredale
Jane Iredale brand of minerals is highly pigmented and are micro-pulverized. Other mineral make-up brands are milled on average of 3x, compared to Jane Iredale minerals that are micro-pulverized 11x and then sifted thru a silk screen. This allows for more coverage while using less product, as well as eliminating the need to buff or “work in” minerals. Jane Iredale also has a huge selection of color choices, including global shades for ethnic skin.
Pure Mineral Makeup vs. Mineral Based
The growing popularity of mineral makeup, encouraged a second generation of mineral based cosmetics, however, drugstore and discount mineral makeup products usually aren’t “pure” minerals. Simply adding minerals to a cosmetic does not create the same benefit of a true mineral makeup. The top two ingredients should be Zinc Oxide and Titanium Dioxide, as they are the basis for a great mineral makeup. Mineral “based” cosmetics may also contain ingredients such as talc or preservatives, that are contraindicated to some cosmetic procedures.
PurePressed® Base SPF 20 Light Beige
The look is sheer and semi-matte. The feel is weightless. Pressed mineral powder is fast, easy
and mess free.
UVA/UVB SPF 20 broad-spectrum sun protection
A foundation, powder, concealer and sunscreen all in one
Very water-resistant and highly pigmented
Applies evenly and easily, providing long-lasting, gorgeous coverage
Light diffusing properties make skin look flawless, healthy and younger
May be applied wet or dry to complement any look
Great for shading, highlighting, contouring and lining
Handi Brush
A hand-tied goat hair brush for Jane Iredale PurePressed Base.
Ultra-soft and high-quality
Applies PurePressed Base with flawless ease
Hand-tied goat hairs pick up the perfect amount of product and distribute it simply and evenly
Amazing Base® SPF 20 Light Beige
An incredible loose mineral foundation with UVA/UVB broad-spectrum sun protection. The look is creamy and luminous. The feel is like silk.
Provides exceptional coverage of any distraction including redness and brown spots
Ideal for those who suffer from skin conditions such as eczema and rosacea
UVA/UVB SPF 20 gives broad-spectrum sun protection
Very water-resistant formula
Chisel Powder Brush
Applies Amazing Base ( loose powder) like no other brush.
Hand-tied from goat hair
Flocked Sponge
A sponge with a nap that glides across the skin. Applies and blends minerals.
Non-Latex
Washable and will last forever
Use to take off any excess minerals or to add more minerals where needed for camouflage
When using minerals wet, use flocked sponge and D20 spray.
D2O™ Hydration Spray
This facial spritz resists evaporation and helps to hydrate and plump the cells. Also containing ingredients that calm the skin and fight free radicals, D2O is a must for post-laser or after any kind of peel! Some makeup artists believe that D2O is the quintessential last step in applying our makeup. It sets the minerals in seconds.
Celebrities that use Jane Iredale include:
Renée Zellweger
Nicole Kidman
Julianne Moore
Meg Ryan
Victoria Beckham
Halle Berry
Uma Thurman
Diane Deborah Messing
Megan Mullally
Angela Bassett
Ivana Trump
Melissa Gilbert
Lee Ann Womack
Bonnie Hunt
Exclusive Mineral Makeup for the Screen Actors Guild Awards Presenters Only.
Exclusive Makeup for “As The World Turns” cast.
Exclusive Mineral Makeup for “Organic Odyssey 2003.”
Mineral makeup always looks better when you use the proper tools and technique.
Paradise Valley Skin Klinic carries Jane Iredale Products. Call and schedule an appointment, to be color matched for Jane Iredale mineral foundation.
480 421-1701
www.shapiroplastic surgery.com
You can follow Paradise Valley Skin Klinic on facebook.
Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com
Kim Cattrall’s character Samantha, has a chemical peel in a memorable episode of Sex in The City. Unfortunate timing left her with a dark and peeling face the day of Carries Launch Party. It looks as if she had a medium – deep peel. If she were better informed she could have timed her peel so that she looked as gorgeous as usual for her event or just opted for a more superficial peel. Now in her mid-fifty’s, Kim Cattrall looks amazing, I would not be surprised if she has chemical peels to maintain her skin.
Action and Benefits of Chemical Peels
Chemical peeling is used to improve the skin’s appearance by applying a chemical solution to the skin, causing the top layers of skin to separate and peel off. The new skin is smoother, less wrinkled, more even in color, peels can also be used to improve acne. Chemical peels can be performed at different depths, depending on the layer of correction desired. Deeper peels will cause the skin to peel for a longer period of time and provide more improvements in the skin. There are also a variety of acids and peeling agents that can be used alone or together, depending on skin conditions to be treated.
Chemical exfoliation and peels involve using destructive chemical agents to create a controlled wound.
All peels (whether they are chemical or laser) create a mild burn. They improve skin by the wound healing process, new tissue is created and damaged tissue is quickly replaced. Chemical peels stimulate the fibroblasts wound healing activity, the proliferation of fibroblast activity increases collagen and elastin. The depth of the wound determines the amount and intensity of healing. The body’s response to the burn is what yields the results, a deeper peel will result in more correction.
The terms exfoliation and chemical peel are often used interchangeably, however superficial peels are technically exfoliation not a true peel. True chemical peels are generally performed under medical supervision, and penetrate into the papillary dermis.
Chemical exfoliation and peels are a way to speed up the natural migration process of skin cells. When the bonds between cells are dissolved and epidermal cells begin to shed more rapidly. The shedding skin cells send signals for more cell division, which in turn forces keratinocytes to the top of the stratum corneum. This process helps treat acne, fade skin discoloration and leave the skin with a fresh new layer of skin on the surface.
*Dark skin types are more prone to complications such as hyperpigmentation and should go to a professional that is experienced in treating dark skin.
[ Read: Chemical Peel Do’s and Don’ts ]
Skin Layers
Epidermis (Epidermal layers)
Stratum corneum horny layer
Stratum lucidum horny layer – only present on palms of hands, soles of feet
Stratum granulosum horny layer
Stratum spinosum basal layer
Stratum mucosum basal layer
Stratum germinativum / basal layer
Dermis ( Dermal layers)
Papillary dermis
Immediate reticular dermis
upper reticular dermis
mid dermis
lower reticular dermis
Hypodermis/Subcutaneous Tissue
Adipose Tissue ( fatty tissue)
Epidermis
The epidermis is completely cellular, meaning it is in a constant cycle of producing new cells while older dead skin cells are pushed to the surface to exfoliate or slough off. The epidermis is made up of keratinocytes, lymphocytes, melanocytes, Langerhans cells and Merkel cells. Approximately 80% -90% of the cells in the epidermis are keratinocytes, with all others interspersed among them.
Dermis
The dermis is a layer of connective tissue, composed mainly of collagen fibers as well as about 5% elastin. The Dermis is subdivided into the superficial papillary dermis and the reticular dermis. The papillary dermis is a thin layer of connective tissue fibers, the reticular dermis is thicker and contains collagen and elastin fibers.
Collagen constitutes 75% of dry skin weight, giving the skin volume. Fibroblast cells lie among collagen fibers and are known to synthesize (produce) collagen. Fully mature collagen fibers have a low turnover rate. Elastin fibers maintain tension in the skin and provide elasticity ( snap back after being stretched). Metabolic turnover for elastin fibers are very slow and only make up about 2% – 4% of dermal volume. Damage or alterations to the elastin fibers network cause skin to become loose, saggy and wrinkled. Fibroblasts are responsible for producing collagen, elastic fibers, and the ground substance of the dermis. Fibroblasts also control the turnover of connective tissue, unfortunately with age they become smaller and less active.
Understanding the depth of a chemical peel
With chemical peels, the depth is determined by the agent used, concentration of agent, and time applied. {click to view photo’s of peeling}
Very Superficial
Penetrates to Stratum Corneum, Peeling is complete in 0-3 days. Very superficial peels can usually be done as often as once a week. This type of “peel”, generally produces little to no peeling and is ideal for anyone that can’t afford any downtime.
[ Chemical Peels: Superficial Peels Create Little To No Peeling ]
Superficial
Penetrates between the stratum granulsome and stratum germinativum basal layer of epidermis. Peeling is complete in 3-7 days, superficial peels can usually be repeated in 4 weeks. Ideal for most skin types including acne prone skin. This is the most common form of chemical peel performed by estheticians. There isn’t any true “down time” with superficial peels, only what is referred to as “social down time”. You can generally continue normal activities including work, however superficial peels should be done a week before any special events. You can expect to be slightly red or bronzed and have a few days of superficial peeling. On day 1 and 2 skin is slightly red or bronzed, skin starts to peel around day 3 and continues to peel for 2-3 days, may have minimal areas of superficial peeling on day 7. You may be red or pink first few days after peel.
Medium
Penetrates papillary dermis, performed under medical supervision. Peeling is completed in 7-8 days, medium depth peels can be repeated as soon as 6-8 weeks, however it isn’t usually necessary. Peeling skin will be darker and thicker with medium peels vs. superficial peels. Skin will start to darken on day 2 or 3, slight peeling around mouth on day 3, skin will continue to peel until day 7 or 8, starting around mucus membrane ( eyes, nose , mouth) and the forehead usually peels last. Toward end of peel you may just have slight peeling in the hairline. Often times you look okay the first 2 days and last 2 days, it is day 3- 6 that look bad. Exfoliating products and treatment need to be avoided for at least six weeks after a medium depth peel. You can start to see complications at this level, skin should be precondition before peel, especially for darker skin types. Should not be performed on skin with active acne. Follow post treatment instructions to avoid complications. Treats: skin discolorations, epidermal melasma, skin roughness, large pores, fine lines. If peel is medium – deep you may see improvement in stretchable scars and wrinkles. The “Standard Obgai Blue Peel” is a medium depth peel.
Deep
Penatrates to Intermediate Reticular Dermis (IRD). Peeling is completed in 8-10 days. Must be performed under medical supervision. Skin should be preconditioned in advance, and skin should not have any active acne. Following proper post treatment care is important, to prevent complications. This level of peel can be done with phenol, however TCA and lasers have largely replaced phenol peels. This treats: lines, wrinkles, deep melasma, and some scars, The” Designed Blue Peel” is a deep peel. With deep peels the skin will start to darken very quickly and may not start peeling until day 4 or 5, peeling skin will look very dark and thick almost like a thin scab. It is important that you do not assist the peel by picking or pulling skin off, loose peeling skin should be cut of with small sterile scissors to prevent inadvertently removing skin prematurely.
Very Deep
Penetrates upper to mid reticular dermis. Peeling takes up to 3 weeks.
Special training is required, done by a physician. Lasers have largely replaced very deep peels.
Acids and Chemical Peeling Agents
Chemical peels use several types of acid solutions to improve and smooth the texture of skin. Acids come in different strengths and can be used individually, combined or layered. A variety of acid compounds can be used. There are many branded peels, however an experienced esthetician can also create custom peels.
CO2 (cryogen therapy)
Cryotherapy, also called Co2 slush or acne slush, has been used in dermatology for over a quarter of a century. Co2 slush is created at the time of treatment, liquid Co2 is made into a “snow” ball and wrapped in gauze or cheese cloth and then dipped into acetone. The “slush” is the lightly swiped over the treated areas. Cryogenic “slush” can cause mild exfoliation and has antibacterial and anti-inflammatory abilities. Cryogen therapy is added to some superficial peels at the end of treatment
Also known as: Dry ice treatment, acetone slush and slush peel
Glycolic acid
AHA (alpha hydroxy acid), AHA’s are water soluable. Glycolic acid is formulated from sugar cane, and has the smallest AHA molecule, giving it great penetration ability and softening ability. Glycolic acid works by loosening up the horny layer and exfoliating the superficial top layer, also stimulates collagen growth. Needs to be neutralized to stop action, and can cause irritation.
Lactic Acid
AHA, derived from sour milk and bilberries, mild action, often used in conjunction with other acids.
Malic Acid
AHA, derived from apples, mildly invasive peel It can open up the pores, allow the pores to expel their sebum and reduce acne.
Tartaric Acid
AHA, derived from grapes, mildly invasive, similar benefits to other AHA’s
Salicylic acid
BHA (beta hydroxy acid), derived from wintergreen and birch bark. Differs from AHA’s, because it is oil soluble and penetrates the lipid plug in a congested follicle. Salicylic acid is also less irritating than glycolic acid and doesn’t alter skin barrier properties. Has antimicrobial properties.
Retinoic Acid
derived from retinoids; which is denatured vitamin A. It is chemically similar to Retin-A. It is a deeper peel than the Beta Acid peel and is used to remove scars as well as wrinkles and pigmentation problems. It is usually performed in conjunction with other acids to a cause peeling at a deeper level.
Resorcinol
A dihydroxy phenol produced from resins. Used externally resorcinol is an antiseptic and disinfectant, and is used in ointments in the treatment of chronic skin diseases such as psoriasis, and eczema. Resorcinol has been used as a peeling agent as far back as 1800 in strengths up to 30%, the problem with high concentrations of resorcinol is it’s corrosive ability and tenancy to depigment. Currently it is used at low concentrations in chemical peel compounds such as Jessner’s Peels.
TCA (Trichloroacetic acid)
TCA is a chemical cauterant, an agent that coagulates skin proteins. TCA can be used in different strengths and has the ability to penetrate past the papillary dermis and should be used with caution. TCA in concentrations less than 25% can be used in superficial peels. Medium depth peels are achieved with 30-40% TCA, and 50% TCA should only be used by a physician to achieve a deep peel and has greater chance for complication. TCA is used in the Obagi Blu Peels.
Phenol
Phenol is a very strong and toxic chemical, phenol peels require general anesthetic and heart monitoring. Lasers and TCA have largely replaced deep phenol peels, however low concentrations are often added to superficial and medium depth peels.
The Medical Estheticians at Shapiro Plastic Surgery, Paradise Valley Skin Klinic are experienced with chemical peels at all levels.
Call to schedule a treatment or consultation.
480 421-1701
www.shapiroplasticsurgery.com
You can follow Paradise Valley Skin Klinic on facebook
Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com
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