2012 Laser and Light Therapy in the Beauty Industry Figure 1: (Academy of Dermatology, 2012) Svetlana Cooper Wellington Institute of Technology June 15, 2012 Laser and Light Therapy in the Beauty Industry June 15, 2012 Table of Contents Introduction .................................................................................................................................................. 3 Brief History of Lasers and Light ................................................................................................................... 4 Laser.............................................................................................................................................................. 5 Laser Light Creation .................................................................................................................................. 5 Characteristic of Laser Light ..................................................................................................................... 6 Laser Properties ........................................................................................................................................ 7 Selective Photothermolysis ...................................................................................................................... 9 Types of Cosmetic Lasers ............................................................................................................................ 10 Intense Pulsed Light .................................................................................................................................... 13 Facial Laser and Light Rejuvenation ........................................................................................................... 14 Hair Removal............................................................................................................................................... 17 Types of Laser for Hair Removal ............................................................................................................. 18 Other Hair Removal Light Devices .......................................................................................................... 20 Tattoo Removal .......................................................................................................................................... 21 Consultation................................................................................................................................................ 22 Laser and Light Safety ................................................................................................................................. 25 Indication, Contraindications, Side effects, Pre and Post-Care .................................................................. 26 Indications .............................................................................................................................................. 26 Contraindications for Laser and Light Therapy ....................................................................................... 27 Side effects of Laser and Light Treatment .............................................................................................. 28 Pre and Post Laser and IPL care .............................................................................................................. 29 Survey of Cosmetic Procedures .................................................................................................................. 29 My Personal Experience ............................................................................................................................. 30 My Dairy.................................................................................................................................................. 31 Conclusion .................................................................................................................................................. 33 Works Cited ................................................................................................................................................ 35 Bibliography ................................................................................................................................................ 41 2 Laser and Light Therapy in the Beauty Industry June 15, 2012 Introduction My interest in laser and Intense Pulsed Light (IPL) Therapy started during my first year of study at Wellington Institute of Technology (WelTec). I found a book on this subject, which stirred my interest, and lead me to do some research about laser and IPL treatment even before I knew that I had to write a project for my Diploma. The choice of topic for my project was an easy decision. The more I read, the more excited I became. I decided to visit beauty salons to get more information about laser and IPL and even experience laser treatment on myself. After I complete my diploma in Beauty Therapy, I intend to do a laser and IPL course so that I can perform the type of treatment on clients that I have been reading and studying about. In my project, I will share my knowledge and experience of laser and Light treatment. I will mainly concentrate on laser treatment throughout this project as I believe this is the future in the Beauty Industry, but I will mention treatments using other forms of Light therapy. I will explain what the acronym “LASER” standards for, the difference between laser and other Light technologies, what types of treatments are available, contraindications, pre-treatment, safety procedure and post treatment care. Welcome to Laser and IPL Treatment in the Beauty Industry. 3 Laser and Light Therapy in the Beauty Industry June 15, 2012 Brief History of Lasers and Light Hill & Owens (2009) suggest research and development of lasers began with Albert Einstein in the early 20th century. They go on to say that in the 1950’s, lasers started to be used in the military, space exploration, and medicine. There are various types of lasers, but the first neodymium-doped glass (Nd: YAG) laser was created in 1961 followed by the argon laser a year later. The Nd: YAG was later redeveloped in 1964 for tattoo and vascular removal. In 1965, the first carbon dioxide (CO2) laser was made. Lasers have now entered the era of the beauty industry. (Hill & Owens, 2009) By the mid 1990’s, lasers were introduced into the aesthetics market. During which early generations of non-ablative lasers and Intense Pulsed Light (IPL) devices were developed for hair removal, skin photo rejuvenation, and cosmetic vein therapies. The original Intense Pulsed Light machine, under the name “PhotoDerm”, was invented in 1991 and arrived into the United States from Europe around 1995. “In the 1990’s, IPL started being used to treat erythema and vascular diseases, permanent hair reduction and non-invasive facial rejuvenation,” said Zani. (Zani, 2008) “It's like a laser, but it's more flexible,” says Hillel Bachrach President of ESC. (Yellin, 1997) Figure 2: Early Nd: YAG Laser System (Hill & Owens, 2009) 4 June 15, 2012 Laser and Light Therapy in the Beauty Industry Laser The word LASER is an acronym that standards for “Light Amplification by the Stimulated Emission of Radiation.” What is a laser and what are the characteristics of the laser light? Figure 3: International Laser Caution Sign Laser Light Creation (Spooky, 2007) Light is defined as a visible radiation that the human eye responds to. The wavelengths of light are measured in nanometres (nm) and are between 400nm to 750nm. For example: The wavelength for the colour blue is 488nm and green is 532nm. The majority of lasers are invisible to the human eye and fall in the infrared spectrum of light. Cosmetic infrared lasers can be near-infrared (720nm to 1200nm) or mid-infrared (1200nm to 3000nm). (Hill & Owens, 2009) Creation of light is when an energy source is applied to a molecule, the energy is absorbed and electrons move to higher orbits. When the electrons return to their normal orbit, energy is released as a photon with a specific wavelength within the Electromagnetic Spectrum of Radiation. If this wavelength falls between 400nm to 750nm, then visible light is seen. (Hill & Owens, 2009) The same principle is used to create laser light except the creation is performed in a laser tube, where the photons are reflected with mirrors - which in turn produces a chain reaction creating more photons when they collide. (Hill & Owens, 2009) Laser systems are made up of six basic components: The active medium (which can be gas, liquid or solid, that when stimulated will create laser light), the laser tube or resonator, the power supply, the cooling system, the delivery, and the software systems. (Hill & Owens, 2009) 5 Laser and Light Therapy in the Beauty Industry June 15, 2012 Characteristic of Laser Light Light from a light bulb, for example, generates a polychromatic or multiple wavelength array of light. When this light is projected through a prism it can be seen as the colours of a rainbow. This white light quickly disperses in space within a very short distance. (Hill & Owens, 2009) Laser light is different from normal light, where it is essentially a high-powered flashlight of one wavelength (or colour), that has been controlled to form a narrow, directional beam of light. This makes the light easily harnessed for treatments. (Hill & Owens, 2009) Figure 4: Characteristic of Light (Pegasus Therapy Laser, ND) According to Hill and Owens (2009) laser light has the following six characteristics: Coherent Energy Laser light is coherent because the laser protons travel in one straight line direction. Monochromatic Energy Laser is composed of one wavelength (one colour), whether it is visible or invisible. 6 Laser and Light Therapy in the Beauty Industry June 15, 2012 Parallel or Collimated Energy Collimated energy is defined as harnessing the energy (light beam) to produce a focused spot by the use of a lens. This allows the light beam to travel over long distances. High Energy High Optical Energy is the ability to deliver a lot of energy each second onto a small area. A common unit of energy that is used with lasers is called Joules. Pulse Duration Pulse duration is the amount of time the skin is exposed to laser energy with each pulse. It is usually between 3-10 milliseconds to minimise laser energy absorption to epidermis and prevent damage on the skin surface. Pulse duration can also be referred to as ‘pulse width’. Spot Size The size of the treatment beam that goes onto the skin, measured in millimetres. Reducing the spot size by half will mean the power density will increase by a factor of four. Laser Properties Information about Laser Properties came from (Hill & Owens, 2009), unless otherwise stated. Laser light must be converted into different forms of energy to produce therapeutic outcomes. The distinctive properties can cause four different light-tissue effects: Absorption, Reflection, Transmission, and Scatter. Absorption Laser light is absorbed by the skin or by the material in the tissue which is called a chromophore. Light energy is converted either into heat or a chemical reaction. A chromophore is the target of the laser’s 7 Laser and Light Therapy in the Beauty Industry June 15, 2012 energy, where the laser's light causes cutting or destruction of the chromophores. Common chromophores in the body are water, blood, haemoglobin, collagen, and melanin. Particular wavelengths are absorbed by particular chromophores. For example: Hair removal laser light is absorbed by dark pigment or melanin Vascular lasers target blood or oxyhemoglobin as the chromophore Tattoo lasers target specific dyes or tattoo pigments Figure 5: Laser Light Absorption verses Wavelength (Laser and Health Academy, ND) Reflection Between 4% and 6% of natural light is reflected by the epidermis. A laser beam also reflects off the skin or any shiny surfaces such as a mirror, jewellery, or instruments. The flatter or smoother is the surface, the greater the reflection percentage. Transmission The amount of transmission depends on the wavelength of the light. Transmission is when a material doesn’t interact with the light, thus light passes through and nothing happens. Shorter wavelengths (300nm to 400nm) penetrate only superficially into the epidermis. Visible laser light and some lasers near the infrared zone, easily pass through the epidermis and the dermis, and can penetrate deeper. 8 Laser and Light Therapy in the Beauty Industry June 15, 2012 Scatter Laser light travels in one direction and does not scatter (or spread into many directions). The ability not to scatter is very important because it can reduce the treatments’ effects. Figure 6: The Four Properties of Laser Light (Hill & Owens, 2009) Selective Photothermolysis Selective photothermolysis refers to the precise targeting of a structure or tissue using a specific wavelength of light with the intention of absorbing light into the target area only. (Kita, 2008) 9 Laser and Light Therapy in the Beauty Industry June 15, 2012 Types of Cosmetic Lasers Skin laser therapy has been around for a long time and it has rapidly changed over the last few years. Sometimes it is difficult to understand the difference between types of cosmetic lasers, what each one does, and what differs from one type to another. (Copus, 2011). There are varieties of laser machines and most of them are non-ablative, which means that these lasers don’t destroy or peel the skin. The rest are ablative, which are more severe and can cause epidermal burning, skin peeling or removal. (Copus, 2011). The ablative laser is used to treat mild scarring, wrinkles, hyperpigmentation, and help to “plane down wrinkles” – this process is sometimes called by its trademark name “Fraxel”, where the laser is split into thousands of columns, carrying the name fractional. Types of ablative lasers currently used on the market today are: Carbon Dioxide (CO2) and Erbium / YAG that removes the entire epidermis and part of the dermis. The healing period with these lasers are about 1-2 weeks, during which time there is swelling, oozing, crusting and a lot of discomfort. (Lees, 2012) Recent studies show greater results after a series of treatments for photo damaged and scarred skin using “Fraxel”. 99% percent of the patients had at least Figure 7: Fraxel Laser Machine 25% – 50% improvement after a single treatment and 87% of patients receiving 3 (China Manufacturers treatments demonstrated 51% – 75% scar improvement. (Lees, 2012) Directory ManyNet Technology, ND) 10 June 15, 2012 Laser and Light Therapy in the Beauty Industry Laser clinics reported double digit growth in 2007 compared to 2006. The laser procedure market could grow by well over 100% over the next 3 years. Skincare and cellulite treatments will allow clinics and med spas to increase their sales. Laser hair removal procedures have probably peaked. (Diagonal Report Limited, 2008) I visited two beauty salons in Wellington and after talking to their beauty therapists I have found that the most popular laser or light treatments are: Skin rejuvenation Hair removal Tattoo removal Below is a table that summaries the different types of lasers, what it treats, side-effects and the brand of laser used. Hill and Owens provided the tables which have the lasers divided in two groups. (Hill & Owens, 2009) Ablative Lasers Type of Laser What it Treats Side Effects Brands Carbon Dioxide Deep set wrinkles, acne Long healing time with Fraxel (Fractional CO2) Laser (CO2) scars, birthmarks, saggy skin high risk of scarring. (encourages collagen High risk of pigmentation production), and sun for Asian people. damage. 11 June 15, 2012 Laser and Light Therapy in the Beauty Industry Type of Laser What it Treats Side Effects Brands Erbium Laser Fine to moderate wrinkles, Swelling, bruising, and Harmony Pixel Laser skin pigmentation, acne redness for 1 – 2 weeks. scars, moles, and sun Darker skin can use this damage. laser. Non – Ablative Lasers Type of Laser What it Treats Side Effects Brands Pulsed Dye Vascular lesion, spider vein, Bruising and temporary VBeam Laser (PDL) rosacea, birthmarks, broken pigmentation. capillaries, fine lines around eyes, and stretch marks. Nd: YAG Hair removal, spider vein, Bruising and erythema. CoolTouch skin pigmentation, tattoo GentleYAG removal, and skin Laser Genesis rejuvenation. Alexandrite 12 Hair, tattoo, and leg vein Itching, redness, swelling, GentleLASE removal. and pigmentation. EplTouch Plus Laser and Light Therapy in the Beauty Industry June 15, 2012 Intense Pulsed Light Intense Pulsed Light, or its common abbreviation IPL, is not quite the same as laser, but very similar. IPL systems work on the same principles as laser: Light energy is absorbed by specific target cells (chromospheres) in the skin. The light energy is converted to heat, which causes damage to the specific target area. The main difference between laser and IPL is IPL’s light is polychromatic, non-coherent, and non-collimated. Laser produces one specific wavelength, whereas IPL can contain the full spectrum of light including infra-red, delivering wavelengths between 500nm and 1200nm. (Pitsilis, 2011) IPL devices don’t have a laser generating mechanism but use a flash lamp. When using IPL, the range of wavelengths required for the type of treatment is selected by adding filters. (Pitsilis, 2011) According to Ngan, IPL therapy is considered a non-ablative resurfacing technique, which means that it targets the lower layers of skin (dermis) without affecting the top layers of skin (epidermis). The result is not as dramatic as ablative resurfacing where both the dermis and epidermis are injured to produce a much more noticeable overall outcome. The advantage of IPL therapy is its minimal downtime – a client can often have the procedure done in their lunch break and return to work immediately afterwards. (Ngan, ND) Figure 8: IPL Machine (Health and Beauty, 2010) 13 June 15, 2012 Laser and Light Therapy in the Beauty Industry Hill and Owens (2009) also define types of non-laser machines currently used today. Non-Lasers Machines Type of Machine What it Treats Side Effects Brands Intense Pulsed Light Rosacea Redness, swelling, Lumenis bruising, and Quantrum pigmentation. PhotoDerm Not recommended for dark skins. Radiofrequency Skin Tightening Contracts underlying Facial Rejuvenation fat, therefore some Theramge people experience permanent fat loss in their face. Ultrasound Skin Tightening Minimal downtime, no Ulthera risk of fat loss. Facial Laser and Light Rejuvenation “Rejuvenate means to stimulate and renew so that the skin is at an optimal level of health and vitality.” (Zani, Advanced Skin Rejuvenation, 2008) 14 June 15, 2012 Laser and Light Therapy in the Beauty Industry Zachary suggest that the demand for effective correction of lines, wrinkles, pigments, and scars are always increasing. Over years, facial rejuvenation has become more attractive for clients to enhance the tone, texture and overall appearance of their skin. Concerns about lines on the face, wrinkles, acne scarring and pigmentation can be addressed and treated with excellent results using laser. (Zachary, 2011) There are a variety of devices in the market that use different energies to rejuvenate skin: Fractional Lasers, Radio Frequency (RF), Intense Pulsed Light (IPL), and that’s just to name a few! (Zachary, 2011) Figure 9: Laser Rejuvenation - Before and After “In the world of cosmetic lasers, technology has finally caught Treatment (Balshi, 2011) up with people's expectations creating a potentially new blockbuster market. Laser procedures are meeting consumer demand for fast solutions to some of the most common beauty problems of both men and women. These problems include unwanted hair and ageing skin (wrinkles or lines).” (Balshi, 2011) The key attractions for the cosmetic laser procedure is laser skin rejuvenation treatments which are gentle, pain free and have a long term duration. (Laser Skin Technologies, 2001 - 2012) Facial laser resurfacing works on the underlying layers of skin to improve texture, tone, cell regeneration and collagen formation. This anti-ageing skin rejuvenation treatment will improve skin texture and tone, increase collagen formation to regain skin elasticity. (Laser Skin Technologies, 2001 - 2012) Conditions that can be treated include: Static wrinkles: Wrinkles that are visible at all times and do not change with facial movements 15 Laser and Light Therapy in the Beauty Industry June 15, 2012 Dynamic wrinkles: Expression lines that may appear on the skin when the skin is not moving and deepen with facial movements or expressions Pigmentation: Freckles, sun spots, melasma, or other darkened patches of skin result mainly from sun exposure Scars Vascular conditions Loss of skin tone: The skin is losing collagen and elastin fibres. (Sholar Center for Aesthetic Surgery & Age Rejuvenation, ND) The most popular lasers for facial rejuvenation are the mid-infrared carbon dioxide (CO2) laser, Erbium and Nd: YAG laser machines. (Hill & Owens, 2009) Sun damage The most common type of pigmentation is solar lentigines – large flat brown spots on the face and hands caused by sun damage. Lentigines are due to the increasing number of melanocytes. (Kono, 2007) Ablative laser resurfacing is considered to be the most effective option for skin rejuvenation, but has more side effects which include: Excessive erythema, infection, scarring, and pigmentation. IPL systems offer less traumatic skin rejuvenation treatment with less down time and better results. (Kono, 2007) According to studies, light-skinned clients have better results after treatment and fewer complications than dark-skinned clients. (Kono, 2007) Figure 10: Sun Damage - Before and After Laser Treatment (Aphrodite, 2011) 16 Laser and Light Therapy in the Beauty Industry June 15, 2012 The most common types of lasers for sun damaged skin are the Q-switched Alexandrite, Q-switched Ruby, KTP, and Diode Laser. Carbon dioxide, Erbium: YAG, and fractional lasers, may also be effective. (Kono, 2007) Recent studies show: “The use of IPL for removing lentigines in Asian clients, confirmed the effectiveness with a low risk of hyperpigmentation.” (Kono, 2007) According to a comparison study of Intense Pulsed Light versus a Long – Pulsed Dye Laser for the treatment of facial skin rejuvenation, found the improvements of lentigines was 62.3% for IPL and 81.1% for the Long – Pulsed Laser. But there was no significant difference between IPL and Long – Pulsed Laser in wrinkle reduction. (Kono, 2007) Figure 11: Sun Damage - Before and After Laser Treatment (Dr. Mark's Medical Aesthetic Beauty Clinic, 2012) Hair Removal There are various types of laser and IPL devices used for hair removal and all of them are based on the theory of the selective photothermolysis. (Hill & Owens, 2009) The procedure of removing hair is to target the follicle and then direct the laser beam at its root. During the hair removal process the laser beam finds the hair follicle that it is targeting by first finding the melanin. (Hair Lasers, 1996 - 2009) 17 Laser and Light Therapy in the Beauty Industry June 15, 2012 Different types of hair absorb different types of wavelength. Clients with blond or red hair have only 10%-15% reduction with multiple treatments. (Hill & Owens, 2009) Longer pulse durations are needed for darker skin types and coarse hair due to their longer Thermal Relaxation Time (TRT). TRT is the amount of time it takes a substance to return to its normal temperature. (Hill & Owens, 2009) Hill and Owens (2009) recommend before considering hair removal you need to assess the colour of the hair and the texture of the hair. Brown, dark brown and black hairs are the best targets with the highest efficiency of clearance. White, blond, red, and grey hair have limited amount of melanin in their hair follicle, thus reduced efficiency of clearance. According to Clinical Professor of Dermatology at Weill Cornell Medical School, New York, Harvey Jay said: “While complications from laser or light pulsed hair removal have been documented in the literature, our study date reinforces the safe claim of IPL hair removal procedure. Using therapeutic levels of treatments on a significant number of patents with all skin types, we have achieved patient satisfaction and keep side effects minimal and transient.” (Yellin, 1997) Types of Laser for Hair Removal In New Zealand the first laser hair removal machine was the Ruby laser, after that, the Alexandrite laser became popular. (Pitsilis, 2011) Ruby Laser: 694nm (Hill & Owens, 2009) The oldest type of laser used for hair removal purposes. It works best for light and fine hair types. It cannot be used on dark and tanned skin. Ruby Lasers are preferred for hair removal as they cover a relatively smaller area than other lasers. (Medic8 Ltd, ND) 18 June 15, 2012 Laser and Light Therapy in the Beauty Industry Well known Ruby Laser machines are Palomar E2000 and RubyStar. (Hill & Owens, 2009) Figure 12: Laser Hair Removal - Before and After Figure 13: Ruby Laser Machine (The Beresford Clinic, 2008) (Christopher, ND) Alexandrite Lasers: 755nm Alexandrite Lasers are the most popular laser devices on the market. These lasers are very effective for long term hair removal for all skin types I – IV and the most effective for dark coloured hairs. The Alexandrite laser systems include: GentleLASE, Apogee, and EpiTouch Plus. (Medic8 Ltd, ND) Diode Laser: 800nm The Diode Laser targets and heats water in the skin’s upper dermis, which will enhance new collagen production. (Hill & Owens, 2009) The Diode Laser is an extremely popular non-ablative laser for efficient hair removal on all skin types and can treat acne and acne scars. Diode Laser treatment is not painful and side effects are minimum (temporary redness and swelling). (Hill & Owens, 2009) After one treatment when used for acne scars, the amount of scars decreased by 37%, after two - 58% and 83% after a third treatment. (Acne Laser Treatment, 2012) 19 Laser and Light Therapy in the Beauty Industry June 15, 2012 Figure 13: Acne - Before and After Laser Treatment (Acne Laser Treatment, 2012) Other Hair Removal Light Devices Hill and Owens explained (Hill & Owens, 2009) that the procedure for hair removed using Intense Pulsed Light is different compared to laser light. IPL produces a high intensity flash, where filters are inserted into the applicator head, which narrow the wavelengths making them more specific when placed in contact with the skin. The energy from the light source is absorbed by melanin, which is converted into heat and destroys hair follicles. The pulse duration, spot size, and fluence all determine how much heat is absorbed by the melanin in the hair follicle and how much heat is transmitting into the skin. (Hill & Owens, 2009) Hill and Owens (2009) believe that Intense Pulsed Light Therapy has been used for hair removal since 1998. The energy from the light source is absorbed by melanin, which is the chromophore and gives hair its colour. The light is converted into heat and raises the temperature to 70° or more and destroys hair growth. (Hill & Owens, 2009) 20 Laser and Light Therapy in the Beauty Industry June 15, 2012 “High-tech hair removal using IPL technology is exceptionally safe on all skin types, even among clients with dark skin, according to a clinical study commission by Cornell University and published in the December 2002 issue of Cosmetic Dermatology.” (Laser and Health Academy, 2011) Tattoo Removal Tattoos are prevalent today and 39% of adults have a tattoo. Some estimate that more than 10 million adults have at least one tattoo. Recent research revealed that tattoos are becoming increasingly popular among females with Kiwi women more likely to have a tattoo (22%) compared with men (17%). The survey also discovered that 15% of New Zealanders, who have a tattoo, regret the decision to have it. (Revell, 2009) Tattoo removal using laser is very effective as the laser light targets the different types of tattoo ink, breaking them down where the particles of dye will be released in the blood stream and cleaned by macrophages. The tattoo location, size, colour and age are important to asses during a consultation. Clients with darker skin are at risk of skin pigmentation and scarring. (Hill & Owens, 2009) The first lasers used for tattoo removal were the Argon and the CO2 lasers. They break down the ink, but damage other layers of skin and cause scarring. (Senerth, 2002) Only three types of lasers have been proven effective in breaking down tattoo ink without damaging the surrounding skin; the Q-switched Ruby, Q-switched Alexandrite, and most recently the Q-switched Nd: YAG. They are all referred to as "Q-switched" because of the short, high energy pulses of light used in the procedure. The Q-switched Ruby is the most commonly used laser for tattoo removal. However, the Q-switched Nd: YAG has been recently discovered to be more effective on coloured tattoos and 21 June 15, 2012 Laser and Light Therapy in the Beauty Industry darker pigmented skin. The beam of light penetrates deeper which increases the amount of damage done to the epidermis. (Senerth, 2002) The colour and the wavelength of these lasers vary and are indicated below: Q – Switched Ruby Laser: 694nm, deep red colour Q – Switched Alexandrite Laser: 755nm, near-infrared, possibly visible Q – Switched Nd: YAG Laser: 1064nm, infrared, not visible Figure 14: Tattoo Removal - Before and After Laser Treatment (Hostmonster, 2005 - 2012) Intense Pulsed Light can be also used for tattoo removal. Both methods share similarities, but the procedures are different. Laser treatment is more effective but expensive. (Huson, 2012) Consultation Before any course of treatment, the beauty therapist should start with a consultation. This is the time to advise the client about the importance of skin preparation for the treatment and prescribe products that will work for the client’s skin which will enhance the treatment results. Figure 15: Consultation Card (Sunless Beauty, 2011) 22 Laser and Light Therapy in the Beauty Industry June 15, 2012 During the consultation, the beauty therapist will assess the medical background of the client, set up a realistic expectation of the treatment, explain the procedure, what the client will feel during the treatment, give recommendations about pre and post-care products and regimes, and finally discuss the Fitzpatrick Skin Type Scale with the client. (Hill & Owens, 2009) The Fitzpatrick Skin Type Scale categorises the skin into 6 classifications. The classification depends on the amount of melanin (contributes to our skin colour and protects us again UV exposure) in the skin and will indicate how the skin will react in the sun. Pale or white skin burns easily and tans slowly - it needs more protection against sun exposure. Darker skin burns less, tans easily, and prone to develop pigmentation. (Hill & Owens, 2009) The key to successful laser and IPL treatment is to access hair type and skin according to the Fitzpatrick Skin Type Scale. Failure of the assessment could result in an ineffective treatment, dissatisfaction of the client, and potential injury. (Hill & Owens, 2009) The types of lasers used on darker skin tones (Fitzpatrick Skin Type III-VI) are very different from the types of lasers used on lighter skin. Why? It is because dark skin types have a very high chance of developing hyperpigmetation after the treatment. (Hill & Owens, 2009) Figure 16 Fitzpatrick Skin Type Scale Type I-V (Cacci, ND) 23 June 15, 2012 Laser and Light Therapy in the Beauty Industry Fitzpatrick Skin Type Scale Classifications: (Hill & Owens, 2009) Skin Skin Type Colour Type I White Blond hair and green eyes. Always burns, freckles. English, Scottish Type II White Blond hair and Always burns, freckles, difficult Northern English green/blue eyes. to tan. Blond/Brown hair and Tans after several burns. German Tans more than average, rarely Mediterranean, burns, no freckles. Southern Type III White Hair and Eye Colour Reaction to Sun Common Ethnic Considerations blue/brown eyes. Type IV Brown Brown hair and brown eyes. European, Hispanic Type V Type VI Dark Brown/black hair and Tans with ease, rarely burns, Asian and Indian, Brown brown/black eyes. no freckles. some African Black Black hair and Tans with ease, rarely burns, African brown/black eyes. deeply pigmented, never freckles. 24 June 15, 2012 Laser and Light Therapy in the Beauty Industry Laser and Light Safety Lasers produce an intense, highly directional beam of light. Properties of the laser light can cause harm and therefore, it is critically important to protect yourself and your client against accidental exposure to laser light. There are certain rules which you need to follow to perform safe laser or light treatment, where only a fully trained beauty therapist can perform the treatment. (Hill & Owens, 2009) The laser or light treatment room should have proper ventilation, either no windows or covered to prevent light escaping, no mirrors, and either the door should be locked during the treatment or a permanent sign should be placed outside of the treatment room to advise that the laser or IPL is in operation. Wearing special protective glasses for both the client and the beauty therapist are required during a treatment. (Absten, 2006) Figure 17: Laser Danger Sign (University of Washington, 2012) 25 Figure 18: Safety Glasses for Client Laser and Light Therapy in the Beauty Industry June 15, 2012 Indication, Contraindications, Side effects, Pre and Post-Care Indications According to Pamela Hill and Patricia Owens there are three types of skin clinical indications: Types A, B, and C. Clinical indications are conditions which will advise if a client suits the particular treatment. (Hill & Owens, 2009) Type A includes superficial damage (pigmentation, lentigines, and vascular changes including telangiectasias, rosacea, melasma and erythema). (Hill & Owens, 2009) Type B is not a superficial but includes both the epidermis and the dermis (wrinkling; large pores, skin laxity, and acne scaring). (Hill & Owens, 2009) Type C is more advanced changes (keratosis or early skin cancer). (Hill & Owens, 2009) Below is a list of items which can be treated: Wrinkles Solar damage Rosacea Rough texture Acne scarring 26 June 15, 2012 Laser and Light Therapy in the Beauty Industry Contraindications for Laser and Light Therapy All information about contraindications has been provided by (Hill & Owens, 2009) unless otherwise indicated. Contraindications are conditions which will stop you from performing the treatment. These include: Bacterial infections of the skin (Impetigo, cellulites , folliculities) Fungal infections (ringworm) Yeast infection Viral infection (cold sore, warts) Open cuts, rashes Sunburn Certain type of medication. For example: Accutane (a form of vitamin A) reduces the oil in the sebaceous glands causing the skin to become thinner and it can burn easily. Moles Tattoos (unless removing) Pregnancy and Lactation History of hypo or hyper-pigmentation Atopic Dermatitis History of cancer Immunosuppressive medications Tanning Figure 19: Cold Sore (Heal Blog, 2012) 27 Laser and Light Therapy in the Beauty Industry June 15, 2012 Contraindications for Laser and Light hair removal Contraindications for laser and light hair removal are similar to those listed above, but there is one specific condition that needs to be considered before treatment commences: Endocrine disorders, for example polycystic ovarian disease You need to refer your client to a doctor and treat the type of disorder before hair removal treatment. (Hill & Owens, Lasers and Light Therapy, 2009) Figure 20: Polycystic Ovary Syndrome (Rebar, 2012) Side effects of Laser and Light Treatment Side effects of laser and light treatment may include burns, lost of pigmentation, and folliculates. Figure 21: Hypopigmentation (Skin Sight, 2008) 28 June 15, 2012 Laser and Light Therapy in the Beauty Industry Pre and Post Laser and IPL care Pre-care for laser and IPL treatment is just as important as aftercare, where using specific home care products are essential to achieve the best possible result. (Hill C. , Pre and post IPL care, 2011) The first and the most important is Sun Block. No matter what time of the year, it is essential for a laser or IPL client to protect their skin from the sun. A lot of problems can occur from the sun exposure including hypo and hyper-pigmentation. (Hill C. , Pre and post IPL care, 2011) The second is Vitamin C. Clients should start using a serum with Vitamin C, one or two weeks before the laser or IPL treatment. Vitamin C is a great antioxidant and will help to strengthen and repair the skin. (Hill C. , Pre and post IPL care, 2011) The third product is Flaxseed Oil. The client should take flaxseed oil at least one month before treatment. (Hill C. , Pre and post IPL care, 2011) Figure 22: Flaxseed Oil (Healtheries, ND) Figure 23: Vitamin C (Blackmores, ND) Survey of Cosmetic Procedures The following survey was conducted by Proctor and Gamble, March 2010. The amounts of cosmetic procedures are rapidly rising, according to the survey: “1 in 10 (8%) women admitted to already having work done and 2 in 5 (38%) would consider having a cosmetic procedure. The majority of respondents said they would choose to have cosmetic procedures to ‘stay youthful’ 29 Laser and Light Therapy in the Beauty Industry June 15, 2012 (37%), while others did so to appear more attractive to a current or potential partner (21%). However, two thirds (67%) of those surveyed said they would happily consider using a face cream that offered similar anti-ageing benefits to cosmetic procedures as an alternative.” (Gamble, 2010) For those women who would consider cosmetic procedures the most popular choice was laser and IPL treatment with 45% of those surveyed saying they would give it a try, followed by microdermabrasion, 31% These were the two most popular treatments chosen by women who had already had work done with 49% having used IPL and 31% microdermabrasion. Almost all of the respondents (93%) agreed that cosmetic procedures are more accepted in society today than five years ago and nearly half of the female respondents (43%) said they were concerned about the growing trend to have a cosmetic procedure. (Gamble, 2010) Dr Wong, top Auckland appearance medicine expert says: “Kiwis are following a growing international trend, with an increasing number of both men and women opting for cosmetic procedures to turn back the clock.” He continues to say: “While lasers have been seen as the 'gold standard' for non-surgical revitalization of the skin, anti-ageing creams can help to reduce the appearance of lines and wrinkles.” (Gamble, 2010) To perform safe, effective treatments you need to know of anatomy and physiology of the skin, understand healing processes, the physics of laser and IPL, and also be aware of the tissues’ effects of laser and IPL on the skin. (Gamble, 2010) My Personal Experience To help with my project and to further understand laser treatment, I had one laser session performed on myself and recorded a dairy of my experience and feelings. 30 Laser and Light Therapy in the Beauty Industry June 15, 2012 My Dairy Thursday, 15 March 2012 I visited Courtney Clinic to get some information about laser treatment. After talking to the laser beauty therapist, I considered having one laser treatment to see what it was like and help me understand a little more about lasers in the beauty industry. Monday, 2 April 2012 I finally decided to make the appointment for laser facial skin rejuvenation. I am looking forward for it. Thursday, 12 April 2012 Day of appointment: I am very excited but also rather nervous as never experience this before. During treatment: The beauty therapist first started working on my right cheek. I could see bright flashes of light on my face even though I was wearing protective glasses and had my eyes closed. It was quite painful to start with, not what I expected from the treatment. I could smell something burning (which later happened to be facial hair) and it felt like my face was on fire. The therapist gave me ice packs to apply on the area just treated to rapidly cool it down. She then moved from one area to another. As the treatment progressed, I felt less pain - I must be getting used to it! The treatment took about 15 minutes but I had to leave the ice packs on my face for some time. My face is very red and sore, but the majority of the redness disappeared within 30 minutes. Friday, 13 April 2012 I feel absolutely fine, no evidence that I had laser treatment yesterday. I may consider making another appointment for a laser treatment in one month’s time. 31 June 15, 2012 Laser and Light Therapy in the Beauty Industry Monday, 16 April 2012 Everything was fine over the weekend but applying make-up with a brush this morning, I noticed my skin is a little bit sensitive to the touch. Figure 25: 1 hour before Laser Treatment Figure 26: 1 hour after Laser Treatment The photos do not really show the detail, but there is a slight redness of my skin in the after picture (right). This is better shown in the photo below of my right cheek. Figure 28: GentleLase System Figure 27: Redness on my Cheek The pictures to the right are the GentleLase Laser System and its applicator head that were used during my facial rejuvenation treatment. Figure 29: Applicator Head 32 Laser and Light Therapy in the Beauty Industry June 15, 2012 Conclusion Modern lasers are miracles and one of the most revolutionary medical tools in history. Popularity of modern day procedures such a laser and light treatment will increase dramatically and will get more and more popular, because they are quick, affordable, with minimum side effects and give good results. (Beauty Laser, 2008) According to the Cosmetic Laser Procedure Market Report in America, published on March 12, 2008: “In the world of cosmetic lasers, technology has finally caught up with people's expectations creating a potentially new blockbuster market. Laser procedures are meeting consumer demand for fast solutions to some of the most common beauty problems of both men and women. These problems include unwanted hair and ageing skin (that is wrinkles or lines).” (Wood, 2008) “Laser procedures are taking consumers and their beauty dollars from established (and more traditional) salons and spas. They are also expanding their customer base, as they attract new and younger clients. Indeed, almost a third of cosmetic laser clients could be new to the professional beauty market.” (Wood, 2008) “Laser technology continues to evolve and provide dermatologists with more options to target not only specific signs of aging, but specific cells responsible for age-related changes in our appearance,” said dermatologist Jenny Kim, associate professor of medicine, division of dermatology, University of California, Los Angeles. (Academy of Dermatology, 2012) During my research, I recently found new laser technology for hand rejuvenation that has just been introduced into the beauty market in Los Angles. Doctor Atkin, a dermatologist in San Diego, says she has seen a lot of patients concerned about "aging hand syndrome." The Aging process is often more noticeable in the hands as skin becomes wrinkled over time. Doctor Atkin continues to say her approach to hand rejuvenation has two-parts. Firstly she 33 Laser and Light Therapy in the Beauty Industry June 15, 2012 restores the volume in the hands and hides the appearance of veins and tendons. She then follows with laser hand resurfacing or photo-rejuvenation to address skin pigmentation caused by age spots, sun spots, or other related conditions. "Younger looking hands are usually free of brown sun-damaged spots and have more volume. With aging and thinning of the subcutaneous area, tendons and blood vessels become more apparent. When we add fillers, thus volume, the normal youthful appearance returns.” (Hurst, 2012) I personally experienced laser skin rejuvenation treatment and I can say laser is definitely very efficient and gave quick results. More and more people want to look younger, fell more confident and happy. More beauty clinics are popping up offering modern treatments, such as laser or light therapy, Botox, and microdermabrasion, just to name a few. Talking to a few beauty salons’ employees, popularity of laser and light treatment will increase and will become very popular. I believe laser and light are the future for the beauty industry. 34 Laser and Light Therapy in the Beauty Industry June 15, 2012 Works Cited Absolute Aesthetics. (2008 - 2012). What is IPL (Intense Pulsed Light)? Retrieved from http://www.iplhairremoval.co.uk: http://www.iplhairremoval.co.uk/what_is_IPL.htm Absten, G. (2006, February). Laser Safety Operational Guidelines. Retrieved from http://www.laserTraining.org: http://www.laserTraining.org Academy of Dermatology. (2012, February). New anti-aging treatments help turn back the clock. Retrieved from The Jerusalem Post: http://www.jpost.com/LifeStyle/Article.aspx?id=257380 Acne Laser Treatment. (2012). Diode Laser Treatment for Acne. Retrieved from http://www.acnelasertreatment.net: http://www.acne-lasertreatment.net/diode-laser-treatment-for-acne Advanced Skin Clinic and Surgery. (2011). 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