Fractional laser skin resurfacing aficionados will be hearing more and more about the Starlux 1540, Starlux 2940, Fraxel Repair, ActiveFX, DeepFX, and Fractional Skin Rejuvenation in the future.

To grasp the significance of these new laser skin resurfacing devices some minor understanding of the technologies of cosmetic laser skin rejuvenation treatments as well as older cosmetic laser skin treatments is a good start.

Cosmetic Fractional Laser Skin Resurfacing’s History

Fraxel was the first non ablative fractional laser for the cosmetic medical market. From the beginning it’s been upgraded and has been improved on by a number of other competing fractional laser skin resurfacing technologies including the DeepFX and ActiveFX from Lumenis, the Starlux 1540, and Starlux 2940 from Palomar Medical.

Fractional laser skin resurfacing is new area of medicine that intersects cosmetic dermatology and traditional plastic surgery. Rapid advancements and new breakthroughs in these types of cosmetic medical technologies are occurring frequently and are fueled by an aging population of patients. The benefit for these patients is a rapid increase in the effectiveness of fractional laser treatments and less down time and potential side effects.

Fractional laser technologies new applications are expanding into associated cosmetic areas like skin tightening where fractional treatments compete with radio frequency treatments like Thermage, and eventually into fat and cellulite treatments and removal.

What was a revolutionary advance in 1995, full face CO2 Laser Resurfacing for wrinkle removal using the Ultra pulse CO2 laser, fairs poorly when compared to new fractional laser treatments and although the wrinkle removal results were fantastic, the CO2 laser resurfacing created a very real “burn wound” that took many months of recovery and the need for general anesthesia. After a year, the skin would turn white or show hypo pigmentation. Because of the side effects, few patients today choose to have this very effective wrinkle removing procedure.

The Newest Fractional Skin Resurfacing & Rejuvenation Technologies

Now, cosmetic Fractional Skin Rejuvenation or Fractional Laser Skin Resurfacing has evolved and eliminated many of the previous technologies shortcomings. The new erbium lasers are ‘fractionated’ into tiny micro-lasers, treating only a small portion of the skin (think tiny pin pricks) and leaving surrounding skin completely intact, greatly improving healing times.

The ‘fractionated’ treatment areas called micro-treatment zones, cause enough injury to the skin to trigger new collagen production and is used to replace collagen damaged by aging and sun exposure. The new collagen that is produced ‘fills in’ or ‘plumps up’ the underlying tissue and smoothes out skin wrinkles. The untreated skin between the micro treatment zones speeds the healing process to a mere 3-4 days and leaves most of the pigment cells intact, preventing hypo pigmentation.

Starlux 1540: Palomars New Fractional Non-Ablative Laser Resurfacing Technology

The Fraxel and Starlux1540 are non ablative lasers (ablate means to “surgically remove) which means that the skin is not removed by the laser, rather the laser beam instantly heats the skin, causing inflammation and new collagen growth.

With these new treatments, skin laxity and wrinkle smoothing results are less dramatic than with ablative lasers, but the benefit of reduced recovery time and reduced side effects mean that non ablative laser treatments are often the first choice.

Starlux Fractional Ablative Laser Resurfacing In The Near Future

New fractional ablative lasers have recently been developed that provide the benefits of fractional treatments (less down time and reduced complications) as well as the benefits of ablative skin resurfacing (better wrinkle removal and facial rejuvenation).

These Starlux 2940 fractional ablative lasers remove tissue in the micro treatment zone instead of just heating the dermis like the old Fraxel or Starlux 1540.

The benefit of Starlux 2940 fractional ablative laser treatments is that a greater amount of wrinkled and sun damaged skin can be removed than with the older laser technologies, and with a better medical result. There is some minor increase in recovery time with redness for around 5-6 days. Still, the Starlux 2940 fractional ablative lasers require much less recovery time than the old non fractional erbium and CO2 ablative lasers.

Competing Fractional Laser Technologies

Reliant: CO2 fractional laser called Repair

Lumenis: CO2 fractional ablative lasers called ActiveFX & DeepFx

Palomar now has the Starlux 2940 Erbium fractional ablative skin resurfacing laser.

Medical Spa MD is a community of Plastic Surgeons, Cosmetic Dermatologists, and Aesthetic Physicians with more than 3,500 members. Medical Spa MD offers Medical Esthetician Training and provides information on non-surgical cosmetic medical technologies and treatments.

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Electrolysis was the only form of long-term hair removal available before Intense Pulse Light (IPL) and laser devices entered the market. Electrolysis is still used today even though it is painful to the patient. It can also be invasive to the skin which allows for risk of infection. During the electrolysis procedure, a fine needle is inserted into the hair follicle, delivering a galvanic current to destruct the stem cells in the follicle. Unfortunately, this painstaking process is performed one hair follicle at a time. Maintenance procedures are often needed for years after the first treatment.

With laser and pulsed light technology, hundreds of hair follicles are treated at a time and vary upon the spot size (the size of the tip of the device delivering energy). These non-invasive laser hair removal procedures only take minutes to perform instead of the hours required with electrolysis.

What is Melanin?

A patient’s skin type and hair color can be the most important consideration prior to laser hair removal treatment. Laser hair removal is based on selective photothermolysis (using light and heat for destruction of a hair follicle) with melanin being the target chromophore (chemical grouping that produces color). The difference between the absorption of laser or light energy by melanin in the hair follicle and melanin in the epidermis determines the amount of energy that can be safely used without harming the skin.

A patient with very dark skin and gray or white hair, would have little if any response, while light-skinned patients with dark hair are considered to be the ideal patients for hair removal Since melanin in the hair shaft and follicle are the target source for laser and IPL hair removal procedures, patients should be advised during their initial consultation not to tweeze, wax or use any depilatory device prior to hair removal. Hair which is protruding from the skin can singe during a laser or light treatment which causes an unpleasant smell and possible flares. The patient can shave the area to be treated or can use hair removal creams, which preserves the chromophore in the follicle

Treatment Day

Most devices technically operate the same way when performing a laser hair removal procedure. The parameters on the device (joules, milliseconds, pulse, etc.) should be set according to the skin analysis and history performed on the patient. It is important to for patients not to wear dark clothing near the area to be treated as the pigment in the clothing could potentially be absorbed by the laser or light and can result in a burn. The patient should be instructed to refrain from using any body washes, lotions, cosmetics, or any skin medications the day of treatment. Some patients may prefer to have a topical anesthetic applied prior to the procedure. If any residue of the anesthetic remains, it should be wiped clean from the skin. A spot test, or patch test, should be performed on the intended treatment area. Several treatments are required at monthly intervals for an optimal outcome and a yearly maintenance procedure is recommended.

Medical Spa MD is a medspa community of Plastic Surgeons, Cosmetic Dermatologists, and Aesthetic Physicians with more than 3,500 medical spa members world-wide. Medical Spa MD offers medical esthetician training manuals and provides information on nonsurgical cosmetic medical technologies and treatments.

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The advent of aesthetic laser treatments in cosmetic medicine has led to many advancements in cosmetic medical device industries. In the cosmetic laser arena, new and improved cosmetic lasers are entering the cosmetic medical market every few months. This development curve is leaving the classification criterion of aesthetic lasers to continually be redefined. Therefore, the following information is to be used as a guideline and is not considered to be a current and thorough description.

Lasers in use by medical practitioners typically have low outputs of energy and power, and are thus placed in ANSI (American National Standards Institute) Class 2 category. Another important 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 are classified by the FDA (Food and Drug administration) as Class II or Class III medical devices.

Class 1 Lasers

Class 1 lasers are not considered to pose any hazards when operated according to normal conditions and includes lasers which are completely enclosed such as CD players, fiber-optics devices, and printers. These devices cannot have emissions exceeding the maximum permitted exposure (MPE) under any conditions are considered to be class 1 systems.

Still, problems can occur if the laser is outside of the enclosure.

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

Class 2a

Lasers in this class do not pose a threat unless the laser is directly viewed for more than 16 minutes or so and encompasses visible light lasers with a total output power less than 1 milliwatt, but greater than a few microwatts.

Class 2

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

Class of lasers that includes those 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 that are readily available are class 3a laser devices.

Class 3b

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

Class 4

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.

As an aesthetician, you are now crossing the line from treating clients to treating patients. All the components of aesthetic care play an even more important role when designing a post-procedure treatment plan for the patient who just underwent a deep chemical peel for acne scarring. Or, the Rosacea patient who just completed her first intense pulse light treatment. It’s important to remember that you are the skin care expert in your recommendations of skin care products and regimens to your clients. However, you are also a critical adjunct to the physician who has planned an aggressive therapy treatment for his patient.

Medical Spa MD is a cosmetic medical community of Plastic Surgeons & Cosmetic Dermatologists with more than 3,500 medical spa members world wide. Medical Spa MD offers medical esthetician training manuals and provides information on nonsurgical cosmetic medical technologies and treatments.

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Technorati Tags: Cosmetic Dermatology, cosmetic surgery, health, laser clinics, laser hair removal, Laser Medicine, Laser Treatments, Med Spas, Medical Spas, medicine, plastic surgery, technology, womens issues