Hair Removal

Before laser and IPL devices entered the market, electrolysis was the only form of permanent or long-term hair removal available. Electrolysis is still performed today, but it is painful and invasive to the skin, allowing for a chance of infection. Unfortunately, this painstaking process is performed one hair follicle at a time. During the electrolysis procedure, a fine needle is inserted into the hair follicle, delivering a galvanic current to destruct the follicle stem cells. Regular maintenance procedures are often required for years after the initial treatment.

In contrast, with laser and pulsed light technology, hundreds of hair follicles are treated at a time and vary upon the spot size (the size of the tip of the device delivering energy). These hair removal procedures are non-invasive and take only minutes to perform instead of the many hours with electrolysis.

What is Melanin?

Laser hair removal is based on selective photothermolysis (using light and heat for destruction of a hair follicle) with melanin being the target chromophore (chemical grouping that produces color).The most important consideration prior to hair removal procedures is the patient's hair color and skin type. The difference between the absorption of laser or light energy by melanin in the hair follicle and melanin in the epidermis determines the amount of energy that can be safely used without harming the skin.

A patient with very dark skin and gray or white hair, would have little if any response, while light-skinned patients with dark hair are considered to be the ideal patients for hair removal Since melanin in the hair shaft and follicle are the target source for laser and IPL hair removal procedures, patients should be advised during their initial consultation not to tweeze, wax or use any depilatory device prior to hair removal. Hair which is protruding from the skin can singe during a laser or light treatment which causes an unpleasant smell and possible flares. The patient can shave the area to be treated or can use hair removal creams, which preserves the chromophore in the follicle

Procedure

Most laser hair removal devices technically operate the same way when performing a treatment. The parameters (joules, milliseconds, pulse, etc.) on the device should be set according to the patient's skin analysis and history. Patients should not wear dark clothing near the area to be treated as the pigment in the clothing can be absorbed by the laser resulting in a burn. The patient should be advised to refrain from using any lotions, body washes, cosmetics, or skin medications the day of treatment. A topical anesthetic may be applied prior to the procedure, but if any residue of the anesthetic remains, it should be wiped clean from the skin. A patch test should be performed on the targeted treatment area. Several treatments are required at monthly intervals for the best outcome and yearly maintenance procedure is highly recommended.

March 28 2009 | Cosmetic Surgery | No Comments »

Laser Skin Tightening: How Does it Work?

Performed by an aesthetician under the direct supervision of a physician laser skin tightening treatments don't require much down time for the patient. While devices used for skin tightening do vary in their modality; the procedures do not require topical anesthetics. These procedures are typically performed in monthly intervals and results can be seen gradually over several months. Because of the gradual improvement, it is important to obtain before photos of the intended treatment area(s) before the procedure, with subsequent photos taken immediately prior to performing each consecutive treatment. A final results photo should be taken one month after the last treatment. This photo journal can show the patient their improvement.

Skin Tightening Devices

The goal of this procedure is to encourage more collagen production in the skin. The source of energy used to produce thermal damage can be either lower wavelength laser, radio waves, infrared light, or any combination of the three.

Light wavelengths, specifically in the infrared spectrum, are used to promote tightening of the skin by heating the dermis. This starts the body's natural healing response. This manner of treatment is called "selective thermal damage". If the dermis becomes "damaged", the body will begin to heal itself by encouraging increased collagen production and the remodeling of the existing collagen. As the layer of collagen builds upon itself, the underlying tissues of the skin contract. The results are a tighter appearance to the skin. The majority of infrared devices deliver their light source in one grid, resulting in a large area of controlled thermal damage. One device on the market is the Palomar LuxDeepIR Fractional which delivers light in an array of columns into the target area of tissue and leaves the surrounding areas untouched. The manufacturer notes that this type of technology reduces discomfort and also promotes faster healing time as the new developing areas of collagen can attach to and build upon the untouched areas. In the use of radio frequency devices, a variance exists from one source of energy to bipolar devices constituting two wavelengths.

Collagen

Collagen is an important protein and structural component of skin. Large amounts of collagen are contained in the dermis. Collagen fibers build a strong mesh responsible for maintaining the texture, strength and resilience of skin. As we get older, our collagen fibers start to break down and the epidermal layer thins. The results are visible sagging, wrinkles and folds. Even though fibroblasts can produce more collagen fibers, the human body's ability to do so decreases as we age.

What to Expect

Although not comparable to plastic surgery, on average, the most dramatic results of skin tightening treatments are seen in the neck and jaw line where the dermal layer is thinner. However, results are not seen until months after one treatment or more. Results are also varied depending on differences in skin texture and thickness and a patient's lifestyle (alcohol, smoking, sleep patterns). Each device states different claims of how painful the procedure is, so some patients may choose to use a topical anesthetic or an analgesic to decrease pain. Side effects may include edema, erythema, or skin blanching immediately following treatment. Rarer side effects of laser skin tightening may include blistering, skin depressions and even slight pigment changes.

March 27 2009 | Cosmetic Surgery | No Comments »