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Emerging Technology  and  Advanced  Treatments     Professional  skin  therapists  know  that  while  our  roles  in  the  world  of  skincare  are   of  high  importance,  there  is  an  extensive  list  of  products,  treatments  and  procedures   that  we  are  not  legally  allowed  to  use  or  perform.    This  especially  goes  for  electrical   modalities.    However,  this  does  not  mean  we  don’t  need  to  learn  about  them!    It  is   our  responsibility  to  learn  as  much  as  possible  about  the  treatments  that  are   available  out  there,  as  many  of  our  clients  undergo  these  procedures  then  come  to   us  for  assistance  with  the  after  care.    Knowing  what  is  out  there  will  not  only  help   the  client,  it  will  help  your  own  business  as  well.         Let’s  take  a  closer  look  at  some  of  the  electrical  modalities  available,  including   Ultrasonic,  Oxygen  Therapy,  Light  Therapy,  Intense  Pulsed  Light  Therapy  (IPL)  for   hair  removal,  Light  Emitting  Diodes  (LED)  and  Radio  Frequency.    Keep  in  mind  that   some  of  these  modalities  may  be  allowed  for  use  by  skin  therapists  depending  on   your  license  or  qualifications.         Ultrasonic   Ultrasonic  utilizes  low  frequency  sound  waves  in  a  three-­‐stage  system  for  safe   mechanical  exfoliation,  molecular  penetration  and  healing  micro-­‐amp  therapy.    The   device  helps  a  variety  of  skin  challenges,  including  aging  skin,  wrinkles,  acne,   rosacea  and  hyperpigmentation.     Ultrasonic  uses  a  crystal  (contained  in  the  sound  head),  which  converts  normal  110-­‐ volt  energy  from  the  outlet  using  a  transformer.    The  conversion  of  energy  to   Ultrasonic  occurs  through  a  scientific  principle  called  the  piezoelectric  effect.    This  is   when  an  electrical  charge  is  delivered  to  the  crystal,  creating  mechanical  pressure   and  causing  the  crystal  to  vibrate  and  produce  sound  waves.         When  discussing  the  use  of  Ultrasound  in  skin  care,  we  are  of  course  referring  to   therapeutic  Ultrasound  as  opposed  to  diagnostic.    Diagnostic  Ultrasound  uses  a   completely  different  frequency  than  that  used  for  therapeutic  purposes.    In  our   industry,  Ultrasound  is  referred  to  as  Ultrasonic.         Ultrasonic  for  Penetration   In  addition  to  Ultrasonic  offering  a  deep  cleansing  treatment  and  allowing  for  the   release  of  dead  surface  skin  cells  and  loosening  of  comedones,  Sonophoresis  (or   Phonophoresis)  uses  Ultrasonic  energy  to  enhance  the  skin  penetration  of  active   substances.     When  skin  is  exposed  to  Ultrasonic,  the  waves  increase  to  a  certain  level  and  cause   several  effects  that  assist  skin  penetration.    One  of  these  effects  is  the  formation  of   gas  bubbles,  referred  to  as  Cavitation.    Ultrasonic  pulses  penetrate  into  the  skin,   fluidizing  the  lipid-­‐bilayer  by  the  formation  of  the  bubbles.    The  force  of  Cavitation  


causes the  formation  of  holes  in  the  Corneocytes,  the  enlarging  of  intercellular   spaces  and  the  disorder  of  Stratum  Corneum  lipids.         Heating,  another  effect,  is  mainly  a  result  of  the  energy  loss  of  the  increasing   ultrasound  wave  due  to  scattering  and  absorption  effects.    The  resulting  elevation  of   the  skin’s  temperature  is  typically  in  the  range  of  several  degrees  centigrade.    This   temperature  rise  will  increase  the  fluidity  of  the  Stratum  Corneum  lipids  as  well  as   directly  increase  the  diffusivity  of  molecules  through  the  skin  barrier.               Ultrasonic  may  be  used  for  cleansing,  exfoliation,  Desincrustation,  and   Iontophoresis.    In  some  cases,  incorporating  Ultrasonic  into  all  of  these  procedures   in  one  treatment  could  be  too  stimulating  for  the  client.    Always  consult  the   consultation  card  and  assess  your  client’s  skin  closely,  keeping  in  mind  that  you   should  never  leave  a  client  alone  when  using  an  electrical  modality.         Oxygen  Therapy   The  theory  of  applying  oxygen  to  the  skin  is  controversial  and  no  peer-­‐reviewed   independent  studies  have  been  published  to  prove  it  works.  Still,  many  skin   therapists  use  this  equipment  and  stand  by  the  results  they  see.  The  Oxygen   Therapy  provided  by  us  as  skin  therapists  is  not  to  be  confused  with  Hyperbaric   Oxygen  Therapy,  which  is  used  by  doctors  to  treat  and  heal  damaged  skin,  to  treat   compression  sickness  and  to  kill  bacteria.       Oxygen  is  filtered  from  the  air  into  a  compressor,  which  is  then  applied  to  the  skin   via  a  mask  or  handheld  applicator,  much  like  an  airbrush.    Usually  a  product  or  mask   is  applied  first  to  enhance  the  results.    Another  method  for  application  is  a  nebulizer   that  takes  an  active  ingredient  and  infuses  atmospheric  oxygen  into  it,  producing  a   liquid  that  is  then  dispensed  much  like  the  mist  from  a  Dr.  Lucas  Pulverizer.         Oxygen  therapy  can  benefit  the  skin  by:     • Assisting  in  the  penetration  of  products.     • Creating  an  antibacterial  environment  on  the  skin.   • Increasing  cellular  respiration.     • Improving  skin  texture.   • Increasing  cell  metabolism  and  microcirculation.     The  use  of  oxygen  also  kills  anaerobic  pathogens,  increases  the  skin’s  ability  to  heal   and  may  enhance  collagen  production.    But  this  is  where  the  controversy  begins:   95%  of  the  metabolic  processes  of  the  skin  are  anaerobic.    For  oxygen  to  have  a   biological  effect,  it  must  reach  the  basal  layer.  But  on  the  surface,  it  is  an  effective   bleaching  agent  and  gentle  germicide;  this  is  how  possible  benefits  are  seen.    There   is,  however,  a  belief  that  bombarding  the  skin  with  oxygen  can  lead  to  more  skin   aging,  due  to  the  generation  of  Reactive  Oxygen  Species  (free  radicals).        


Light Therapy  

Light Therapy  can  cover  various  methods  of  application,  including  laser  (Light   Amplification  by  Stimulated  Emission  of  Radiation),  IPL  (Intense  Pulsed  Light)  and   LED  (Light  Emitting  Diode).    Skin  therapists  can  use  some  of  these  machines,  but   others  are  restricted.    In  the  US,  most  states  do  not  allow  the  use  of  lasers  and  IPL.     However,  it  is  important  to  still  understand  the  modalities  to  ensure  we  are  able  to   advise  what  is  available  and  how  it  works.     Ablative  Lasers   An  ablative  laser  is  one  that  ablates,  or  removes,  skin.    Ablative  or  skin  resurfacing   lasers  briefly  direct  an  intense  burst  of  laser  energy  onto  the  surface  of  the  skin.    The   ablative  laser  light  is  absorbed  by  water,  oxyhemoglobin  and  melanin  within  the   skin  to  accomplish  the  task.    The  more  tissue  to  be  removed,  the  higher  the  energy   used  and  the  more  passes  performed  during  the  procedure.    The  procedure  is   painful  and  may  require  topical  anesthesia,  or  in  some  cases,  general  anesthesia,  and   pain  medication.    Recovery  time  and  skin  healing  could  last  from  a  few  days  to  a  few   weeks  or  more.     Non-­ablative  lasers   Non-­‐ablative  lasers  have  been  a  more  recent  addition  to  aesthetic  equipment  for   skin  improvement.    These  lasers  have  lower  energy  levels  than  ablative  lasers   (which  resurface  or  remove  the  outer  layer  of  the  skin  completely)  and  cause   damage  to  the  dermal  layer  of  the  skin  without  removal  of  the  outer  epidermal   layers.    In  other  words,  the  laser  treats  the  dermis,  mainly  through  heat,  to  increase   thickness  through  new  collagen  and  elastin  synthesis,  therefore  firming  and   regenerating  the  skin.      The  epidermis  is  not  damaged.    This  lessens  the  recovery   period  after  the  procedure  and  reduces  the  number  of  complications  that  can  occur.         Intense  Pulsed  Light  (IPL)   Intense  Pulsed  Light  (IPL)  systems,  although  technically  not  lasers,  use  flashes  of   light  that  work  in  a  similar  way  to  non-­‐ablative  lasers,  thus  causing  heat  damage  to   dermal  tissues  without  disrupting  or  removing  the  outer  epidermal  layers  of  the   skin.    Medical  offices  and  medical  spas  usually  describe  treatments  using  both  non-­‐ ablative  lasers  and  IPL  systems  as  a  procedure  called  photo  rejuvenation.         Intense  Pulsed  Light:  Hair  Removal   Hair  removal  by  means  of  Intense  Pulsed  Light  (IPL)  works  by  heating,  damaging   and  destroying  the  melanin  in  the  skin  (which  occurs  naturally  in  both  the  skin  and   hair).    Melanin  is  considered  the  primary  chromophore  (a  chemical  group  capable  of   selective  light  absorption  resulting  in  the  coloration  of  certain  organic  compounds)   for  all  hair  removal  lasers  currently  on  the  market.       During  an  IPL  hair  removal  treatment,  a  wand  is  used  to  apply  the  light  to  the   surface  of  the  skin,  which  penetrates  through,  reaching  the  hair  shafts  or  the  bulb   (root)  of  the  hair.  Of  the  bulb  and  the  hair  shaft,  the  bulb  typically  contains  the  


highest amount  of  melanin.  As  the  light  converts  to  heat,  the  bulb  and  most  of  the   hair  shaft  are  instantly  vaporized.  In  addition,  the  hair  radiates  heat  that  also   destroys  the  hair-­‐producing  papilla  or  the  entire  hair  follicle.       Due  to  the  selective  absorption  of  photons  of  laser  light,  short  wavelength  lasers   (500-­‐800nm)  are  used  to  treat  individuals  with  light  skin  and  light  brown  or  blonde   hair;  lasers  with  a  thin  diameter  and  long  wavelength  (800-­‐120nm)  are  used  for   darker  skin  and  coarse  dark  brown  or  black  hair.         Light  Emitting  Diodes  (LED)   Light  Emitting  Diode  (LED)  photomodulation  emulates  photosynthesis  in  human   skin  cells,  using  the  cell’s  own  cytochromes  to  build  new  proteins  just  as  plants  use   chlorophyll  to  convert  sunlight  into  structural  building  blocks.    Low  wattage  light  is   directed  through  the  skin’s  epidermis  and  aimed  at  fibroblast  cells,  which  produce   collagen  and  elastin.    The  light  stimulates  the  cell’s  own  energy  transport  system,   therefore  helping  to  stimulate  and  renew  the  skin.    The  low  wattage  produces  cool   temperatures,  reducing  the  risk  of  burns  or  scars  potentially  caused  by  laser   treatments.         Blue  410-­417nm  (nanometers)     Blue  LED  is  the  most  expensive  because  it  is  harder  to  create.  The  FDA  has  cleared   this  as  an  acne  device  that  may  be  used  in  15-­‐20  minutes  of  exposure  three  times   per  week.    It  works  like  Benzoyl  Peroxide  in  that  it  kills  bacteria.    It  is  used  for  acne   suppression  and  is  successful  when  paired  with  photodynamic  therapy.       Amber  580-­600nm   Amber  LED  is  performed  for  35  seconds  with  gentle  waves  devices.    The  FDA  has   cleared  it  for  wrinkle  reduction  and  skin  rejuvenation.    It  stimulates  fibroblasts  and   suppresses  MMPs  (Matrix  Metalloproteinase  enzymes  that  break  down  collagen).         Red  600-­660nm   Red  LED  has  undergone  studies  by  NASA  on  wound  healing,  but  currently  the  FDA   has  not  approved  it  for  skin  rejuvenation.    This  light  improves  vasodilation  and   oxygenation.     Both  Amber  and  Red  LED  have  been  approved  by  the  FDA  to  provide  topical  heating   to  promote  increased  blood  flow  for  the  temporary  relaxation  of  muscles  and  relief   of  pain.           Radio  Frequency  Technology   Radio  Frequency  (RF)  is  neither  a  laser  nor  an  IPL.    Rather,  it  is  a  form  of   electromagnetic  energy  very  similar  to  microwaves.    It  is  considered  a  non-­‐ablative   resurfacing  treatment.    The  treatment  passes  Radio  Frequency  electricity  through   the  skin  to  heat  up  the  tissues.    This  is  supposed  to  make  the  tissues  contract  and,  as  


is true  with  any  injury  to  the  skin,  it  begins  collagen  production.    The  most  popular   device  associated  with  RF  is  Thermage.         As  with  lasers  and  IPL,  the  goal  is  to  target  tissues  that  will  selectively  absorb   energy  to  produce  thermal  changes  without  injury  to  the  surrounding  tissues.    But   there  are  challenges  when  directing  light  to  the  skin  surface.    Photons  must  first   penetrate  the  epidermis  where  they  are  scattered  or  absorbed  by  melanin,  which   reduces  the  number  that  will  reach  the  target  and  increases  the  potential  for   epidermal  complications  such  as  crusting  and  dyschromia  (discoloration  of  the   skin).    In  addition,  the  correct  wavelength  for  a  particular  target  may  not  penetrate   deeply  enough  to  produce  sufficient  dermal  heating.         The  main  goals  of  Radio  Frequency  are  to  tighten  and  firm  skin,  which  in  turn  can   help  to  reduce  wrinkles.    

Purchasing Equipment  

When purchasing  any  piece  of  equipment,  it  is  important  to  know  what  you  are   buying.    When  searching  for  a  device,  it  is  best  to:       • Look  for  a  company  that  has  been  in  business  for  at  least  three  years,  and   ask  for  studies  that  back  up  their  claims.   • Be  cautious  of  claims  that  products  penetrate  to  the  dermis.   • Always  ask  for  a  demonstration  first.     Protocols  for  each  device  will  depend  on  the  type  of  machine  purchased,  and  each   manufacturer  will  have  a  specific  procedure  to  follow.    

Healing the  Skin  Pre  and  Post  Treatment  

When the  skin  has  undergone  trauma  of  any  kind,  a  treatment  protocol  that   addresses  redness,  irritation,  inflammation  and  sun  protection  is  key.    If  the  client   has  undergone  an  invasive  surgery  and/or  re-­‐epithelialization,  skin  healing  must  be   apparent  and  the  physician  must  first  give  the  go  ahead  for  the  client  to  receive   treatments.    If  the  treatment  was  non-­‐invasive  or  non-­‐ablative,  the  skin  therapist   can  focus  on  hydrating  and  regenerating  the  skin.    Just  remember:  the  more  invasive   the  procedure,  the  more  soothing  and  anti-­‐inflammatory  the  protocol.    Treat  the   skin  as  you  would  a  sensitized  skin.       While  we  may  not  be  permitted  to  utilize  some  of  these  pieces  of  equipment   ourselves,  we  can  still  ensure  our  clients  see  the  results  they  want  by  incorporating   pre  and  post  treatments  to  compliment  the  procedure  they  are  undergoing.    If  you   are  permitted  to  utilize  these  amazing  electrical  modalities,  consider  incorporating   them  into  your  treatments  to  ensure  your  clients  get  the  optimum  results  they   desire.          

Emerging Technology and Advanced Treatments  

Emerging Technology and Advanced Treatments Article

Emerging Technology and Advanced Treatments  

Emerging Technology and Advanced Treatments Article

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