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Skin Care Before and After Cosmetic Laser Treatments

By: Terri Wojak
Posted: February 28, 2011, from the March 2011 issue of Skin Inc. magazine.
medical spa client

Author’s note: Please refer to “Combining Laser Treatments and Esthetics” in the June 2010 issue of Skin Inc. magazine for more detailed information about the particular lasers and what esthetic treatments can be incorporated with them.

Lasers are an important component of a cosmetic medical practice. They treat many skin conditions, such as hyperpigmentation, acne, telangiectasias, aging skin and many other conditions that are not easily treated by typical facial treatments. Patient education on pre- and post-laser care will optimize results and increase retail sales. These tips are designed to assist the esthetician in properly caring for patients’ skin. It is important to note that in this article the word “patient” is used because a medical professional is performing the actual treatments. The esthetician in this scenario is assisting the treating physician and educating the patient about skin care.

Pigmentation disorders

Patients with pigmentation disorders, such as solar keratosis, photodamage, post-inflammatory hyperpigmentation and melasma, can achieve significantly better results if they take care of their skin at home. Most pigment disorders can be treated easily with visible light laser or intense pulsed light (IPL), except in the case of melasma. There has been success treating melasma with fractionated erbium laser treatments and other modalities, although several treatments are typically needed.

When treating patients with pigment disorders, home care is critical. Topical agents containing pigment-lighteners should be used at home for four to six weeks before treatment with continued use until the desired outcome is reached. Some popular pigment-lightening ingredients include hydroquinone, which many professionals consider to be the most effective pigment-lightener on the market; however, sensitivities may occur when using it. If a patient develops sensitivity or is looking for alternative treatments, the ingredients kojic acid, azelaic acid, licorice root and arbutin, as well as many others, can be used with good results. These ingredients work by suppressing the activity of the melanocytes, which are the cells in the skin that produce pigmentation to protect it from irritation, inflammation, acne, hormonal conditions and photodamage. Those with darker skin have more active melanocytes; therefore it is an absolute necessity to pretreat Fitzpatrick Skin Types IV–VI so the risk of complications is decreased. Along with pigment-lighteners, sunscreen is an absolute must. If the proper sunscreen is not used before and after treatments, patients increase their chances of undoing the results they have obtained or increasing their existing pigmentation.

Rosacea or vascular issues

For patients with rosacea or vascular issues, IPL or visible light lasers are the most effective treatments. Light therapies are attracted to color and cannot differentiate between tanned skin and target colors; therefore, patients must use a topical broad-spectrum sunscreen before and after treatments. Zinc oxide is often preferred because it is a physical sunscreen with anti-inflammatory properties. Topical vitamin C and vitamin K could also be used to achieve favorable results. Vitamin K decreases the pooling of blood under the skin commonly associated with telangiectasias, and vitamin C has been shown to strengthen capillary walls, therefore decreasing the chances of further damage. Care for these patients is simple compared to other skin conditions that are treated with lasers. Always remember, less is more with these skin types. It is imperative to educate the patient about the importance of wearing sunscreen on a daily basis and about ways to avoid further damage. The patient should also be aware of triggers that will cause breakouts.

Mature skin

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