Laser Treatments MD

Laser treatments are typically performed by a doctor-supervised esthetician. While devices used for skin tightening do vary in method, they all expect to achieve similar results. These procedures usually are performed in monthly treatments and results can be seen gradually over several months. Since the improvement is gradual, it is recommended that a patient takes “before” photos of the targeted treatment area(s) before the procedure, and each month thereafter with a final results photo taken one month after the last treatment. This photo journal can help show the patient their improvements.

Devices Used for Skin Tightening

The source of energy used to produce thermal damage can be either radio waves, infrared light, lower wavelength laser or any combination of the three. The intention is to stimulate increased collagen production.

Light wavelengths, specifically in the infrared spectrum, are successfully used to promote tightening of the skin by heating the dermis. This in turn initiates the body’s natural healing response. This type of treatment is called “selective thermal damage”. When the dermis becomes “damaged”, the body will begin to heal itself by encouraging additional collagen production and the rebuilding of the collagen that already exists in the tissue. As the layer of collagen builds upon itself, the underlying tissues of the skin contract, resulting in a tighter appearance to the skin. Most infrared devices deliver their light source in a single grid. This results in a large area of controlled thermal damage. The Palomar LuxDeepIR Fractional is one device on the market that delivers light in an array of columns into the target area of tissue and leaves the surrounding areas untouched. The company says that this type of technology reduces patients’ pain and also promotes quicker healing time as the new developing areas of collagen can attach to and build upon the untouched areas. When using the radio frequency devices, there also is a variance from one source of energy to bipolar devices constituting two wavelengths.

Why is collagen important to Skin Tightening?

Collagen is an important protein and structural component of skin. Large amounts of collagen are contained in the dermis. Collagen fibers build a strong mesh responsible for maintaining the texture, strength and resilience of skin. As we get older, our collagen fibers start to break down and the epidermal layer thins. The results are visible sagging, wrinkles and folds. Even though fibroblasts can produce more collagen fibers, the human body’s ability to do so decreases as we age.

Expected Results

The most dramatic results of laser skin tightening therapies can be seen in the neck and jaw line where the skin is thinner. Results vary according to the differences in skin texture, thickness and each patient’s individual lifestyle. Many of the procedures do not require any downtime after the procedure; but side effects may include edema, erythema, or skin blanching immediately following treatment, with rarer side effects including risk of blistering, skin depression and possible pigment changes.

Aesthetic lasers commonly in use by cosmetic dermatologists typically have low outputs of energy and power, and are usually placed in ANSI (American National Standards Institute) Class 2 category. Another organization is the LIA (Laser Institute of America). The majority of medical lasers fall into the ANSI Class 3 or 4 categories with most surgical lasers being in ANSI Class 4. Most medical and/or surgical lasers that are used to perform aesthetic laser treatments are classified by the FDA as Class II or Class III medical devices.

Class 1 Laser Treatments

Lasers with this classification don’t pose hazards when operated under normal conditions and includes lasers which are completely enclosed; CD players, fiber-optics devices, and printers. Lasers with emissions that don’t exceed the maximum permitted exposure (MPE) under any conditions are class 1 systems.

Potential dangers can occur during the repair of such devices since the laser is outside of the enclosure.

Warning labels are required for this class inside the unit or underneath the cover.

Class 2a Laser Treatments

Few lasers qualify for this class of low-power, visible light lasers. Lasers in this class do not pose a threat if the beam of light is directly viewed for periods of time less than 16 minutes or so. Visible light lasers with a total output power less than 1 milliwatt, but greater than a few microwatts.

Class 2 Laser Treatments

This class of lasers includes visible light lasers that are intense enough that viewing the beam into a human eye can cause the normal “aversion response”. An aversion response is when the eyelids close, or the head moves in order to avoid the light. It can occur within 0.25 seconds and includes the blink reflex time.

Class 3a Laser Treatments

This includes those lasers emitting ultraviolet or infrared light as well as visible light. All devices within the Class 1 AEL (Allowed Exposure Level) with laser output between .18μm and 1mm fall in this class. (Common Laser pointers are class 3a laser devices.)

Class 3b Laser Treatments

This class includes the same spectrum as class 3a, but increases the output level to that of Class 2 AEL.

Class 4 Laser Treatments

This class of lasers includes any that exceeds the Class 2 AEL. Most every laser that produces an excess of 0.5 watts is in this class.

Laser clinics and medical spas that are performing cosmetic laser treatments (laser hair removal, etc) are now considered to be treating medical patients. All of the components of regular medical care play an important role when designing a post-procedure treatment plan for the patient who just underwent a cosmetic laser treatment or the Rosacea or acne patient who just underwent an IPL (intense pulse light) treatment. When performing medical treatments in a med spa or laser clinic, you’re the ‘medical’ skin care expert and your recommendations of skin care products and cosmetic laser treatments will carry weight with your clients. You’re also a critical support to the plastic surgeons who have planned an aggressive therapy treatment for their patients. It’s incumbent upon you to understand all aspects of the care you’re providing.