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Fundamentals of Laser Science
By: Zoe D. Draelos, MD, and Peter T. Pugliese, MD
Posted: March 28, 2011
A basic understanding of the physics of lasers and how laser light interacts with skin is essential information for any esthetician who plans to move ahead in this industry. Estheticians need to understand the basics of laser science and to appreciate the wide range of its applications to skin care.
Lasers can be used to destroy or physically remove unwanted tissue. The old methods as well as the more recently used resurfacing laser treatments fall into this category. With resurfacing, skin actually is removed either superficially or more deeply. Resurfacing causes tissue loss; laser stimulation doesn’t destroy tissue. The problem with this is that skin repairs itself perfectly at the time of injury only if enough of the cells that regenerate skin remain; that is, if the basal layer of the epidermis is left intact. The deeper the removal of the dermis, the less perfect is the subsequent repair. For example, the new skin can be left whiter and thinner than normal. Furthermore, only skin on the face can be treated this way as the dermis on the body is much thinner and mechanical removal of even slight depth could cause scarring.
The alternative way of using laser light is to use it to stimulate the patient’s body to produce the desired repair without any mechanical destruction. This requires meticulous attention to the technique of application, which also has to be very gentle. It is slower than resurfacing, but the benefits far outweigh the investment of time. The skin repairs itself perfectly, provided it is not accidentally or purposefully interfered with during the healing process. The genetic code in the basal cells and fibroblasts acts as the master plan that the body uses as the method by which to heal itself. Extensive destruction of regenerative epidermal cells removes this data from the master plan. When laser light is used in these very gentle modes, it simply acts as a trigger to start this re-healing process, just as any gentle rejuvenation process.
Actually all lasers can be used in this gentle fashion. The laser chosen will depend on where in the skin the repair needs to occur. As you now know, different colors of laser light will penetrate to different depths. The carbon dioxide laser is capable of the deepest penetration, able to reach collagen and beyond. It is used to stimulate dermal collagen repair resulting in rejuvenating skin, or repairing scars and stretch marks. It takes gentle stimulation requiring a special care so that the temperature delivered to the tissue remains specific. See The Effects of Temperature on Tissue.
Laser technology is fast developing, but the training and associated skills still are lacking. Recommending one of your clients for laser treatment imposes considerable responsibility on the esthetician. Having a laser and knowing how use it are not the same things. A pilot skilled in flying a single engine airplane would not dream of trying to fly a multi-engine airplane without adequate training by an experienced pilot. A few days training, or even a month of training with a laser is not adequate to qualify a physician as an expert. The esthetician should get a good background on the physician’s training and experience with lasers before referring a client.
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