Lasers and aesthetic procedures
Aesthetic procedures are getting more and more popular as technology advances and more people search for less invasive ways to look youthful and pretty. Aesthetic procedures like Botox injections, chemical peels, dermal fillers and micro-dermabrasion will be described after laser treatments below.
Extrinsic environmental factors e.g. sun exposure may accelerate the ageing of skin and cause skin pigmentations, benign vascular lesions (erythema, cherry angiomas, and telangiectasia), wrinkles and laxity of skin.
Laser stands for Light Amplification Stimulated Emission Radiation. Laser photo rejuvenation targets the affected lesions and leaving the normal skin unharmed. It targets the melanin chromophore found in thepigmented lesions and the oxyhemoglobin chromophore in vascular lesions. A few sessions need to be conducted before results can be seen.
Laser treatment is generally safe and must be done by a well-trained physician. Eye shields should be worn by the clinician and patient. Inflammable materials should not be placed in the room. The room should not be accessible to outsiders when procedure is in progress.
Adverse effects of laser treatment include temporary reddening, blistering, bruising and burning of the skin involved, pigmentation changes (brown or white) which maybe permanent, infections (very low chance), scars(rarely).
There are several lasers used in aesthetic dermatologic procedures. The different types of laser treatments with different wavelengths which are as follows:
Carbon Dioxide Laser
-It consists of wavelength 10600 nm
-It can be used on recalcitrant warts, syringomas (benign sweat duct tumors), sebaceous hyperplasia (enlarged sweat glands), angiofibromas (benign fibrous tissues papules), trichoepitheliomas (small benign tumor arising from hair follicle), epidermal nevus (discolored congenital birthmark), melanocytic nevi (congenital pigmented birthmark), large keloids (fibrous scar tissue post trauma/injury), scars and wrinkles.
Q switched Nd YAG laser
-It consists of wavelength 532 nm and 1064 nm
-It can be used for solar lentigines (brown pigment because of ageing), freckles, tattoos and nevus of Ota (congenial pigmented birthmark).
Pulsed dye laser
-It consists of wavelength 59 nm
-It can be used for hemangioma of infancy (benign blood vessels tumor), portwine stain (ruby red birthmark), face and leg telangiectasia (dilatation of small blood vessels), Poikiloderma (mottling pigmentation disorder), keloids (fibrous scar tissue) and striae (stretch marks).
Long pulsed Nd YAG laser
-It consists of 1064 nm
-It can be used for hair removal.
Non ablative diode laser
-It consists of 1540nm wavelength
-It can be used for superficial scars, wrinkles
Intense Pulse Light
-It consists of 400-1200 nm wavelengths
-It can be used for freckles, facial telangiectasia (dilatation of small blood vessels) and hair removal.
Fractional ablative carbon dioxide laser
-It consists of 10600 nm wavelength
-It can be used for wrinkles, acne scars and photo-damaged skin.
-The radiofrequency penetrates to deeper skin layers and bounce off to the subcutaneous layer as heat resulting in skin tightening. It is more for skin rejuvenation.
Botulinum toxin is a potent neurotoxin from the bacteria clostridium Botulinum. The neurotoxin inhibits acetylcholine release at the neuromuscular junction which causes temporary denervation.
Botox injections are purified forms of the neurotoxin. Botox injections into specific facial muscles will result in relaxation of these muscles with overall smoothening of skin and wrinkle reductions.
Botox injections are also used for other medical conditions likehyperhidrosis, strabismus, cervical dystonia, muscle spasticity and blepharospasm.
Now Botox injections are used commonly to smooth out frown lines, crow feet, forehead furrows and skin bands on neck. Treatment can be done every 3-4 months. It is a very fast procedure.
Chemical peel is a form of chemical exfoliation of the skin. The agents used are alpha hydroxy acids (e.g., glycolic and lactic acids) and beta hydroxy acids (e.g., salicylic acid). By wounding and removing the superficial skin layers with the chemicals, it stimulates skin to renew, increase skin hydration and regenerate new healthier epidermis and dermis.
Chemical peels are used mainly on the face to improve age spots, acne scars, wrinkles, freckles, rough skin patches, sun-damaged skin and irregular skin pigmentation.
Chemical peels may be done up to 6 times per month and thereafter monthly for maintenance. The results only last for a short term. Side effects are skin peeling post procedure, risks of hyper-pigmentation/ hypo-pigmentation and scarring with deeper peels.
Dermal fillers are injectable substances used for facelift by adding volume to sagged areas on the face. In 1980s Bovine collagens are the first injectable fillers used; it can only last for 3-4 months. The newer fillers that contain Hyaluronic acid now can last from 6 to 12 months.
Dermal fillers injections’ results are dependent on the physician skills. It can be used to plump up lips and smooth out wrinkles and folds over the lower 2/3 of the face. The interval between the injections depends on how long the effects last. Side effects include post-procedure bruising and swelling.
Micro-dermabrasion is a form of mechanical exfoliation of the skin with a refined abrasive element/instrument to sand the skin and remove the superficial skin layer. This will thicken your collagen and also stimulate renewal and regenerate new skin layers.
It can be used to treat superficial scars, wrinkles, large pores, acne, acnescars and age spots. Few sessions can be conducted every 2 to 4 weeks and with subsequent monthly maintenance. The results are short term like chemical peels. A single session may not produce satisfactory effect. The side effects include redness post procedure and worsening of telangiectasia (dilatation of small blood vessels).