Marta Moidlova, M.D., Clinic for laser and esthetic dermatology and plastic surgery, Old Town Square, Prague, CZ

Premysl Fryda, MediCom a.s. Laser

E-mail: moidlova@moidlova.cz

Abstract

Cosmetics is a well established and independent branch, apparently different from plastic surgery, esthetic dermatology and similar medical specialties, yet complementing them very effectively. However, is there any difference between individual beauty parlors? Definitely there is, but where? Enthusiasm, knowledge, experience, talents, good eyes and clever fingers - this is an absolute minimum in terms of a cosmetician`s "software". Speaking about "hardware", a good cosmetician needs a suitable place for the business, a chair, a table, a mirror ... all the same. Then cosmetic milks, creams, masks, agents, all the beatiful jars, sprays and cups come ... they all have them, too. So where is the difference, if any at all? The difference lies in modern technical equipment, in technical devices helping a cosmetician be more efficient, more successful, more up-to-date, and, first of all, more attractive for the clients. And here, undoubtedly, laser dominates.

Technical gadgets

Speaking about technical equipment, what options can a cosmetician have? Not many, really:

• Electrolytic epilator, though it is a bit an obsolete technique, a time consuming one, painful, unprecise, with imperfect results, and in case of electrocauter successive scarring may appear. 
• Vacuum lymphodreinage unit, though this technique comes much more under medical specialists, especially as one of the means of consecutive treatment after oncological surgeries.
• Solarium - only a supplement from the point of view of cosmetics.
• Microdermabrasion seems an ideal option. It is capable of scraping off superficial layers of dead skin cells from the face, décolté, hands etc. with a flow of tiny crystals. Microdermabrasion is a great tool in hands of an experienced cosmetician, eliminating fine wrinkles, acne scarring, minor pigmented lesions, rough skin and the like. The skin gets regenerated, smoothened and cleansed, not only the skin looks better, but is also able to take in cosmetic preparations much better in the course of successive treatment.
• Polarized biolamps are also a possibility how to improve cosmetic treatments and care. However, we should avoid using monochromatic devices using different color filters or sources, for those only deprive us of the synergic effect of polychromatic light devices enabling the light to penetrate in different depths in tissue. A separate article on the use of biolamps in cosmetics was published in Laser Partner Clinixperience No. 45/2002.
• Laser is the real king of cosmetics. Surgical laser is able to ablate wrinkles, repair scars, remove pigmented lesions and age or sun spots, rid of unwanted tattoos and hairs. Some of the applications do not even have a non-laser alternative, such as permanent hair removal or elimination of  naevi flamei. All the above mentioned applications, and many others, can only be performed with a surgical laser and by physitians. However, apart from those, there is another group of lasers, called soft lasers (a name very appropriate for cosmetics), or therapeutic, biostimulation, low-level lasers (low-level laser therapy - LLLT), and those will be the subject of this article.   

Mechanisms of soft lasers 

Laser is nothing else but light with specific features, and it is generally known that for every living cell light is of fundamental and unsubstitutable importance. This phenomenon can be noticeable best in plants assimilating light to be able to grow, however similar dependency applies to animal organisms, too. Lack of light causes growth disorders and can also result in psychic defects, depressions, or even in a specific disease called seasonal light deficiency.

Laser energy is absorbed in tissue through cytochrome cells, mitochondrial apparatus of individual cells transforming light energy into cellular energy. At the same time, passage of light improves permeability of cellular membranes, leading to their better nutrition, improved function and quicker cell division. These processes in tissue activate macrophages (responsible for absorption of  noxious agents and support of healing processes), improve activity of fibroblasts (mast cells supporting collagen synthesis in tissue), and support improved production of specific enzymes. Apart from stimulation of growth and wound healing medicine can also make use of other characteristics of laser beam, such as ability to decrease pain through influencing neural peripheries, anfi-inflammatory effect, or stimulation of acupuncture points or physiological trigger points.

In cosmetics it is very important to choose a suitable laser device. The first decission to make is an appropriate wavelength of emitted light, i.e. its color. The rule is that red color (632 - 670 nanometers - nm) is convenient for superficial applications, not penetrating deep in tissue and thus all energy being absorbed in the skin and subcutis. On the other hand, infrared (IR) lasers with higher penetration depths are quite useless in cosmetics, whilst they come in very useful in massage and physiotherapy facilities . The second important value is the power output of a laser, which should be for cosmetics within the range of 10 to 40 miliwatt (mW). Lower output leads to excessive prolongation of application times necessary to irradiate recommended dosages of energy, and, on the other hand, suitable red lasers with higher output are usually very expensive. The third important issue to decide on is the construction of lasing device. You can buy a laser with a hand-held pinpoint laser probe, which will be suitable especially when treating little lesions (See Fig 1). On the other hand, when working on larger areas (whole face, décolté etc.), you might prefer a laser scanner automatically distributing light on required area and freeing your hands for another client (See Fig. 2). A laser with automatically adjusted parameters of therapy is recommended.

 Soft laser in cosmetics

LLLT has many possible applications in cosmetics and laser can even lay the foundations of a specialized beauty salon. The following list has originated on the basis of years of experience, and can provide readers with a general overview of potentials of this useful and profitable method.

1)    Healing of inflammatory and other pathologies

• Acne - one of the most frequent cosmetic problems, due to civilization impacts shifting more and more into middle age. Laser helps effective healing of papuli and pustuli even after a few applications, in most cases skin responding to laser treatment spontaneously and very quickly.
• Alopecia – supportive treatment of alopecias, hair growth stimulation and improvement of quality.
• Dermatitis - LLLT helps to improve inflammatory and other conditions on the skin.
• Eczema - laser can improve quality of life of the patients by diminishing some of the superficial manifestations of the disease.
• Herpes - one of the most effective applications. A herpes usually does not even appear if the painful spot is irradiated before eruption, or has a relatively mild symptoms. In other cases a scab can be expected to create on the herpes within a few hours after irradiation, avoiding unpleasant long lasting suppurative manifestations. LLLT shortens healing by more than fifty per cent, and is also suitable to treat post-herpetic neuralgia.

2)    Post-procedure applications

• Healing of nail matrices - successful treatment also after nail design applications.
• Post cleansing treatment - quicker regeneration of skin suffering from red spots, minor edemas and haematomas, open and widened pores.
• Post epilation treatment - application of LLLT after wax or electric epilation significantly soothes irritated skin, healing up punctures in rather a short time. It is recommended to stimulate the area to be treated not only after the application, but also before the initial hair removal, due to analgetic effect of laser light, as well as due to more effective start up of healing processes. 

• Permanent make-up - after mechanical penetration of pigments under the skin LLLT regenerates microscars, soothing irritated skin.

3)    Scars management

• Post acne scarring - a long term treatment helps to improve the final condition.
• Scars - LLLT contributes to decolorization, smoothening and softening scars.
• Striae - regeneration of unwanted microscars and rhagadae in skin.

4)    Improving the beauty of your clients

• Biostimulation of skin - overall soothing of the skin, improvement of its look, LLLT smothens and stretches the skin removing its minor defects.
• Cellulitis - laser should be understood as one of the components of comprehensive treatment, LLLT improving microcirculation of lymph and blood, locally decreasing the feeling of pressure and pain, releasing collagen threads.
• Dandruff - LLLT can help in combination with special anti-dandruff shampoos.
• Laser Mask (Le Masque de Laser) - application of a face mask, the performance of which is activated by irradiation with a laser beam, a combination of deep cleansing of tissue with biostimulation.
• Rejuvenation - improving the looks, smoothening and tightening of the skin.

• Wrinkles - soft laser is not able to rid of the wrinkles mechanically, however by improving the condition of the skin it contributes to its increased flexibility and elasticity.

5)    Other cosmetic-related applications

• Chronic Fatigue Syndrome - thanks to its stimulative effects LLLT may become a part of comprehensive treament.
• Seasonal Light Defficiency (SLD) - application on epiphysis has been described as a means of suitable psychostimulation.
• Migraine - relief of negative manifestations of similar diseases may sometimes also be required.
• Myorelaxation - beauty parlors are sometimes associated with massage or fitness facilities where LLLT can be used to decrease muscle spasms prior to initial massages, or to release tension in case of neck and lower back pain.

 

Hygienic conditions for soft laser in cosmetics

It is generally believed that soft laser can be operated only by physicians, however this is not a correct opinion. Soft lasers can be commonly operating in, and their advantages can be made use of by, beauty parlors, haidressers salons, massage and regeneration facilities and the like, provided their users observing specific hygienic and safety regulations.    

The first prerequisite is a proper training, familiarizing the staff with performance and mechanism of laser in living organism, with possibilities of indications and applications, with initial laser techniques, as well as with contra-indications and labor safety. A laser workplace must be adapted in such a way that an unwanted laser beam cannot hit anybody, all windows and mirrors must be covered by jalousie or curtains not transmitting laser light during laser operation. Corresponding laser safety eyewear is also required. Every laser workplace is subject to hygienic control classification.

Current medical legislation imposes a certain limitations on cosmeticians regardless to whether they work with laser or not. They must not break integrity of the skin, must not perform procedures on sick skin or mucosa, and must not manipulate scars and birthmarks. In fact most of beauty centers either co-laborate with doctors or work under direct supervision of medical specialists who can guarantee expert skin care in full extent. However, even within the frameworks of limited number of procedures, soft laser represents a reliable, effective, and attractive skin care.

Related articles

• Laser Partner No. 23/2001: P. Petrovska: Laser in dermatology
• Laser Partner No. 25/2001: T. Trobonjaca, Zlatko Simunovic: Aesthetic treatments with low level laser therapy
• Laser Partner No. 33/2001: R. Smucler et al.: Laser Mask increasing the potential of laser biostimulation in cosmetology and dermatology
• Laser Partner No. 45/2002: Bozena Apetaurova: Biolamp in cosmetic practice

 

Literature

• Jan Javurek: Fototerapie biolaserem - lecebna metoda budoucnosti, Grada Publishing, Praha 1995
• Zlatko Simunovic a kol.: Lasers in Medicine and Dentistry, Vitagraf Rijeka, 2000
• Jan Tunér, Lars Hode: Laser Therapy - Clinical Practice and Scientific Background, Prima Books, Grangersberg 2002