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The Role of Estheticians in Medical Trends

By: Steven H. Dayan, MD, and Terri Wojak
Posted: October 26, 2009, from the November 2009 issue of Skin Inc. magazine.
Fractionated CO2 results

These images show a before and after of fractionated CO2 treatment for skin rejuvenation on the face. The patient also used a topical product following the procedure for moisturization and sun protection.

Trends in the cosmetic field are changing rapidly, and the increased popularity of cosmetic medical treatments may cause estheticians to become concerned about losing some of their business.

However, the opposite is true; this is a golden opportunity for increasing your education and broadening your client base. There are many ways that you can assist with cosmetic medical procedures. Patients appreciate the extra attention to detail that can be provided through the expertise of an esthetician, and they often become regular clients of the esthetician who assists them with these treatments.

Skin rejuvenation

Skin rejuvenation is a process that helps decrease the visible signs of aging, including photodamage, fine lines, wrinkles, and loose or sagging skin. There are many methods used to provide skin rejuvenation, including surgery, cosmetic fillers, neurotoxin inhibitors and laser rejuvenation. There are several lasers to choose from for skin rejuvenation, such as intense pulsed light (IPL), visible light lasers and ablative lasers. IPL and visible light lasers are more commonly used for removing discolorations on the skin, such as pigmentation or telangectasia. Ablative laser treatments can be beneficial for all signs of aging, including pigmentation, fine lines, wrinkles and loose skin caused by a reduction of collagen.

Fractionated carbon dioxide (CO2) lasers are becoming the latest trend for skin rejuvenation. These lasers use a long wavelength of energy that is absorbed by water in the skin. CO2 lasers rejuvenate by destroying the outermost—and most photodamaged—layers of the skin.

During CO2 laser treatments, heat travels locally in a controlled manner to the deep dermal reticular layer. The generated heat changes the shape of dermal protein, such as collagen, which causes an immediate tightening. Although the results are great, traditional CO2 lasers remove the entire epidermis and papillary layer of the dermis, leaving the skin requiring six weeks of downtime for healing. The extended recovery needed for this treatment, in addition to the substantial risk for complications, such as hypopigmentation and scarring, have resulted in the development of fractionated lasers.