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Combining Laser Treatments and Esthetics

By: Terri Wojak
Posted: May 26, 2010, from the June 2010 issue of Skin Inc. magazine.

Cosmetic laser treatments can address various conditions commonly associated with aging and photodamaged skin, such as pigmentation, vascular disorders, fine lines, wrinkles and loose skin.

The growth of nonsurgical procedures continues to rise, despite the recession. According to the American Society of Aesthetic Plastic Surgery, in 2008 alone, Americans spent $4.6 billion on nonsurgical cosmetic procedures, and laser skin resurfacing has grown more than 270% from 1997–2008. This shows that there is room for even more growth in this industry, and estheticians can play a role in making this business a success. One of the biggest concerns for new and seasoned estheticians is that medical skin care treatments are taking the place of esthetic skin care services, such as superficial peels, microdermabrasion and facials. If the esthetician and the practice position it correctly, adding esthetic services to complement medical services can be beneficial to everyone involved, including the patient.

How do lasers work?

In order to offer esthetic services to clients effectively before and after laser treatments, you must have a good understanding of lasers and how they work. Light that is able to be seen is called visible light, and this is a combination of multiple colors that are blended together. Visible light is most evident when you shine light through a prism or when you look at a rainbow. In these instances, the light is broken up and each component of the visible light is seen as an individual color. The primary colors in the spectrum are red, orange, yellow, green, blue, indigo and violet, and each color in the visible light spectrum has a corresponding wavelength measured in nanometers (nm). The wavelength helps determine the characteristics of light. In laser therapy, the longer the wavelength, the deeper the light penetrates the skin. Therefore, red will travel deeper into the skin than violet. Laser therapy manipulates the light so that it is directed specifically at the chromophore (target). When the laser light hits its target, it is absorbed and then heated. The goal in laser therapy is to destroy the target before the heat can spread to, and potentially damage, the surrounding tissues.

VLL and IPL devices

Nonablative, or “cold,” lasers have become a great option for skin tightening, as well as treating brown spots and telangiectasias. Visible light lasers (VLL)—lasers that target a specific wavelength between 400 nm and 1064 nm—and intense pulsed light (IPL)—a light therapy device that targets several wavelengths throughout the electromagnetic spectrum—can be used to eradicate brown spots and red blood vessels, and subsequently improve the appearance of the skin in a relatively short time with no downtime. When the darkly pigmented cells of the skin absorb the laser light, energy is released in the form of heat, which causes the destruction of the cell. In the case of spider veins or broken capillaries, the energy is absorbed by the red blood cells, and the heat is transferred to the wall of the blood vessel, which is then destroyed. In both of these methods, little energy is dissipated to the surrounding tissue, and therefore it is not injured, and the skin surface remains unharmed. Also, depositing heat into the dermal layers of skin can cause collagen stimulation, which can result in skin tightening. This is why these treatments are usually marketed as offering skin rejuvenation benefits.

The esthetician’s role. Following laser treatments for pigmentation, the spots often darken before they lighten or disappear. An esthetician can provide peeling services at two-week intervals between the series of VLL or IPL treatments. This will improve the results, as well as speed up the removal of any darkened lesions on the skin. Jessner’s peels have been shown to be very effective for lightening pigmentation and work great in conjunction with these treatments. If the client is more on the sensitive side with red undertones to her skin, a lactic acid peel would be a better option. Microdermabrasion is also effective if the only concern is lifting darkened or crusted pigment. It is also the responsibility of the esthetician to recommend products to maintain the results of these procedures. For pigmentation, products containing pigment-lighteners should be used. For vascular problems, products containing vitamin K can help strengthen capillaries in order to prevent additional damage, and with every treatment, the use of sunscreen is of the utmost importance.

Ablative and fractionated ablative lasers