Application of cryotherapy in dermatocosmetology

Natalya Sachuk – head of the Farmosa restorative medicine clinic, dermatocosmetologist, trichologist, member of the All-Ukrainian Association of Trichologists, the Association of Preventive and Anti-Aging Medicine, the Ukrainian Academy of Dermatovenerology (Ukraine, Vinnitsa);

Marina Erokhina is the chief physician of the Farmosa restorative medicine clinic, a dermatologist, trichologist, member of the Ukrainian Academy of Dermatovenereology, the Ukrainian Society of Aesthetic Medicine, and the All-Ukrainian Association of Psoriasis (Ukraine, Vinnitsa).

The ability of cold to reduce pain and inflammation, relieve swelling and improve tissue trophism has been known for a long time. Hippocrates, Galen and Avicenna also used the properties of cold in their medical activities. With the advent of modern technologies that make it possible to use ultra-low temperature gases, a new direction in medicine has developed - extreme aerocryotherapy.

Its founder is considered to be the Japanese scientist Toshimo Yamauchi, who in the late 70s obtained excellent results in the treatment of rheumatoid arthritis using ultra-low temperatures. And then German and Russian scientists developed experience in the use of extreme cold in various fields, including dermatology and regenerative medicine.

The practical application of cryotherapy in dermatocosmetology involves the use of liquid nitrogen as “dry” cold. Liquid nitrogen is a colorless, odorless, fuming liquid that is stored in special Dewar vessels. This inert gas is completely safe: it does not burn or explode. Cold agents traditionally used in cryotherapy in the form of cold water, ice, salt and gel cryopacks, chloroethyl, carbon dioxide, vapor-liquid cryogenic jets do not provide objective control during the procedure.

Therefore, tightly controlled liquid nitrogen gives the best predictable results.

Depending on the time of exposure, liquid nitrogen can cause tissue death during deep freezing or, conversely, strong regeneration and nutrition of damaged tissue.

Over the past decades, the field of general aerocryotherapy in aesthetic medicine and dermatology has become very relevant and in demand. Firstly, a huge base of positive results has been accumulated. Secondly, patients, receiving procedures in medical institutions and sanatoriums for general health, are ready to continue these procedures in clinics for aesthetic purposes.

Impact at the cellular level

It is important to distinguish between local cryotherapy (cryomassage, cryopiling, cryodestruction, etc.) and general aerocryotherapy (cryosauna, cryopool), which affects the body as a whole.

Cryotherapy, carried out before many cosmetic procedures (masks, peeling, injections), enhances their effect. General aerocryotherapy (ACT) has a beneficial effect on the general condition, exhibiting antidepressant, vasodilating, immunomodulating effects, and, above all, after the procedure, patients lose weight. The effect of extreme aerocryotherapy can be characterized as follows.

The biochemical indicators of metabolic and endocrine processes and the neurovegetative state are significantly improved. But the most convincing is the natural and characteristic dynamics of the immune system. There is not only a simple quantitative regulation of the pools of T-lymphocytes and B-lymphocytes, but also modulation of the functions of immunocompetent cells, humoral and cellular immunity, as well as nonspecific protection at the level of markers and cytokines. During treatment, the high level of circulating immune complexes and specific antigens recorded in patients with autoimmune diseases has a natural tendency to decrease to physiological values. Therefore, extreme aerocryotherapy is especially relevant for patients with atopic dermatitis, psoriasis and alopecia areata to obtain stable remission.

There is also a clear lymphatic drainage effect, that is, an improvement in the outflow of lymph from tissues and, consequently, the elimination of edema of lymphatic origin.

Microcirculation of blood and trophism in tissues is maximally improved, arterial blood flow and, to a large extent, venous outflow are increased, which is important for older patients in anti-age programs.

The fact is that exposure to cold in the form of ACT leads to pronounced phase changes in the activity of peripheral vessels, which is manifested by spasm of small arteries and arterioles, slowing down the speed of blood flow, which is the first protective phase of the vascular response to extreme cooling. Then the second protective phase of the vascular reaction develops - in the form of a pronounced expansion of peripheral arterial vessels, which leads to active arterial hyperemia and is manifested by a sharp reddening of the skin, an increase in skin temperature to +35 ° C (normal average skin temperature is +32.5 ° C) . Visually, the consequences of cryotherapy are manifested by a change in the color of the skin after the procedure - in the form of diffuse, bright and persistent erythema. Systemic expansion of the integumentary vessels stimulates the functioning of the circulatory system, improves nutrition and oxygenation of all tissues of the body, and reduces the hemodynamic load on the heart muscle. Along with changes in arterial and capillary circulation, ACT provides a moderate improvement in venous outflow.

In some cases, a person can spend up to 1,000 kcal to combat extreme cold during the procedure, to warm cooled tissues to normal (+36.6 °C) and to stabilize thermodynamic processes. These clinical effects work wonders in treating cellulite and stabilizing weight in patients.

The essence of the method

Schematically, the cryoprocedure looks like this. The duration of exposure sufficient for the development of a therapeutic effect is 60-180 seconds. A person is completely placed for 30-180 seconds in a vertical procedural cabin with an air environment, the temperature of which ranges from –120 to –180 °C. The head is out of the air flow. Only cotton underwear remains on the body, warm socks are put on, and the hands are clamped in the armpits. The patient, actively moving around his axis, prevents local frostbite. During this time, a large volume of surface tissue is cooled to a temperature of –2 to + 4 °C.

It is necessary to understand that cryotherapy is effective only if the temperature on the surface of the skin drops below 0 ° C.

For the outer layer of the skin, such short-term hypothermia is safe, but cold skin receptors send a signal to the brain of such strength that the above-described cellular reactions are triggered. In order to properly cool the skin, the temperature of the gas should not be higher than -180 ° C, and the contact time with it should not be less than two minutes.

To obtain maximum results, there are a number of principles and rules of cryomedicine:

1. Gradual increase in the intensity of activities.
2. Systematicity. Strict adherence to the methodology (exposure time, temperature, number of sessions). A course of cryotherapy procedures is more effective than rare sessions.
3. During therapy, it is necessary to take into account the individual characteristics of the body.

Contraindications

It is very important to understand that cold is not a panacea for all diseases, and at the same time take into account the importance and seriousness of the cryotherapy technique. Therefore, it should be carried out by a knowledgeable specialist.

The prescription of a course of treatment for general aerocryotherapy is preceded by clinical, laboratory and functional monitoring (history, ECG, blood pressure, blood and urine tests, etc.). Immediately before each procedure, the patient undergoes an examination, pulse diagnostics and blood pressure determination.

A contraindication to cryotherapy is, firstly, complete intolerance to cold (according to statistics, 1-2% of the population suffers from it), as well as some diseases and characteristics of patients. In particular, the use of general cryotherapy is not recommended in the following cases:

• myocardial infarction, rehabilitation period after a heart attack;
• stage II hypertension;
• heart failure;
• severe diseases of the respiratory organs and nervous system;
• some blood diseases;
• pathologies of arterial vessels (vasculitis, arteritis, etc.);
• fever, high temperature;
• pulmonary tuberculosis;
• acute inflammatory processes associated with the respiratory tract;
• oncological diseases;
• individual intolerance to ultra-low temperatures.

Indications in aesthetic medicine and dermatology

Cryotherapy in cosmetology has been used for decades, but currently there are results of fundamental research and clinical trials, and patents have been received for the treatment of certain dermatological diseases. The rejuvenating effect for the skin of the face and body using this method is effective and safe, and has no side effects.

Indications for the use of cryotherapy are related to age-related changes in the body (wrinkles, age spots, impaired blood and lymph flow).

Cryotherapy in dermatocosmetology is used to solve the following problems:

• cellulite;
• overweight;
• stretch marks, postoperative scars and scars;
• general skin aging;
• wrinkles, anemic skin with insufficient blood supply;
• psoriasis, atopic dermatitis, neurodermatitis, eczema;
• alopecia areata, diffuse hair loss;
• acne (acne), demodex;
• viral warts, papillomas;
• seborrhea;
• mycoses.

In addition, cryotherapy is used to prepare for some cosmetic procedures (massage, peelings, mesotherapy, etc.), as well as during rehabilitation after aesthetic procedures - to enhance regeneration.

ACT in the treatment of excess body weight, cellulite

One of the effective means of combating excess weight is general cryotherapy.

Weight loss as a result of this method is due to the normalization of metabolic processes.

To obtain maximum results (up to 5 kg of weight loss), a course of 20 procedures, carried out every other day, at a temperature of –180 °C is recommended. A very important point is to abstain from food two hours before and after the procedure. All of the above cellular processes contribute to maximum skin tightening and have a defibrosing effect for stage 3-4 cellulite.

ACT for psoriasis, atopic dermatitis

General cryotherapy is also successfully used in dermatology.

Neurodermatitis, psoriasis, atopic dermatitis - almost all pathologies associated with skin diseases are direct indications for cryotherapy.

The duration of the intensive course of treatment depends on the form of psoriasis and the severity of atopic dermatitis. On average, the intensive course is about one and a half months and can range from 2 weeks to 3-4 months. Treatment is initially carried out daily for 7-10 days, then the frequency of procedures is selected for each patient individually.

For dermatological diseases, local and general aerocryotherapy is used. Local cryotherapy is associated with exposure to a low-temperature gas flow obtained by evaporating liquid nitrogen and directed directly to the diseased area of the body.

General ACT is aimed mainly at homeostasis modulation. That is, the task of general ACT is to change the nature of the course of the disease. At the first stage - reduce the number of rashes during relapses, lengthen the period of primary remission. At the second stage - to achieve lasting clinical and cosmetic comfort.

Modern equipment for cryotherapy ensures convenient use of the technique for therapeutic and cosmetic purposes with maximum efficiency. Extreme aerocryotherapy is a unique and effective method in dermatology and aesthetic medicine and a promising direction that, in addition to treatment, helps preserve the beauty of the skin, restore its youth and get rid of some cosmetic imperfections.

First published: KOSMETIK international journal, No. 3 (49), 2012, pp. 68-71