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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.
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Mature skin that is characterized by fine lines, wrinkles or increased laxity benefit most from ablative laser treatments. One of the most popular and effective treatments available today is the fractionated carbon dioxide (CO2) laser. Care for the patient’s skin after treatment with the CO2 laser is critical, because it can affect the healing process and the results. Patients should be prepped with pigment-lighteners before and after these treatments in order to prevent the possibility of adverse reactions, such as hypopigmentation and hyperpigmentation. The patient must also be taught the importance of keeping the skin occluded with an ointment recommended by the treating physician. Along with a gentle cleanser, this ointment is the only product that should be used for the first four to five days following a deep ablative laser treatment.
The main purpose of these treatments is to create a wound response in the skin so more collagen will be produced. If the skin doesn’t have a healthy environment to generate this collagen, patients may not achieve optimal results and it can increase the likelihood of complications. The skin heals best in a moist environment; therefore, after the initial healing period, hydrating agents including hyaluronic acid and emollient moisturizers should be used. Peptide-rich products may also be applied to aid in the rebuilding process.
Fractional nonablative lasers are considered to be a more progressive treatment, meaning they will need multiple treatments to attain results similar to the CO2 laser. They are ideal for those who desire a shorter and less extreme healing period than that associated with CO2 lasers. The esthetician’s role in this treatment is similar to ablative laser treatments, although the care is much less intense. The patient will generally use an occlusive agent for one to two days, as opposed to the four to five days that are recommended with CO2 laser.
Lasers may also be used in the treatment of acne, which occurs because oil glands are stimulated to produce more sebum. In addition to this overproduction of sebum, dead skin cells accumulate in the excess oil. This excess buildup of skin cells and oil acts as a breeding ground for Propionibacterium acnes, which is the bacterium that causes acne. Laser light in the red to blue spectrum may be effective at killing this bacteria and decreasing the inflammation associated with it.1 The laser works not by heat, but by activating a protein to destroy P. acnes and the surrounding inflamed acne lesions. Lasers alone or photodynamic therapy, a process where lasers are used in conjunction with a topically applied solution, have proven highly successful. Photodynamic therapy utilizes a topical drug called aminolevulinic acid to photosensitize the P. acnes, making them more susceptible to laser light. Proper product use during this treatment is essential. Gentle cleansers, sunscreens containing zinc oxide and hydrating agents, such as hyaluronic acid and vitamin B-5, should be used.
Erbium laser treatments are also successful for patients experiencing acne grades I and II, consisting of only blackheads and whiteheads with no inflammation. The erbium laser is used to remove superficial dead skin cells and un-roof, or open, lesions. A series of these treatments at a low setting is recommended for quick results with little downtime. In addition, a salicylic acid-based lotion will boost these results; it causes the outer layer of the skin to slough off extra dead skin cells. Recommending proper products for home care can make a significant difference in a patient’s outcome.