Laser peeling: seasonal and off-season methods of skin rejuvenation

Denis TIKHORUK, General Director of Medicalaser (Ukraine)

Natalya DOBRYANSKAYA, dermatovenerologist, cosmetologist, specialist in laser and injection technologies, methodologist at Medicalaser (Ukraine)

Today, cosmetologists can carry out a number of modern all-season procedures, which are performed using cosmetology devices and have an effect on the skin characteristic of peelings - they cleanse and rejuvenate the skin. These include carbon peeling procedures and fractional rejuvenation with a neodymium laser, hydropeeling with a cosmetology combine, and a number of other hardware procedures - microcurrents, RF rejuvenation, phonophoresis, cryolifting and aquadiffusion.

With the help of hydropeeling and carbon peeling, you can achieve various cosmetic effects, including pronounced skin rejuvenation - smooth out fine wrinkles, tighten pores, improve skin color, lighten, eliminate hyperpigmentation, pollution, toxins, free radicals, while improving skin elasticity – it takes on the so-called appearance of a poured apple.

SKIN AGING PROCESSES

Skin rejuvenation – a collective concept that is characterized by the elimination of the consequences of chrono- and photoaging.

Chronoaging is caused by the influence of two sets of factors on the skin in the following proportion:

• genetic factors of the body – 25%;
• epigenetic factors (the influence of the environment, taking into account a person’s lifestyle and bad habits) – 75%.

Chronoaging in general leads to the formation of wrinkles, gravitational ptosis, disruption of skin color and texture, and a decrease in its elasticity. The production of collagen and elastin decreases, rosacea and enlarged pores appear due to tissue hypovolemia, exposure to toxins and free radicals. Redermalization processes slow down.

Photoaging of the skin is caused by regular and excessive exposure of the skin to sunlight. Excessive insolation causes heliodermatitis, actinic dermatitis, leads to the formation of wrinkles, as well as other manifestations of photoaging - hyperpigmentation, hyperkeratosis, increased dehydration of the skin - and in advanced stages leads to irreversible atrophic changes in the dermis.

The processes of photo- and chronoaging of the skin are in constant synergy.

LASER PEELING

When a certain level of aging is reached, which becomes noticeable to the patient, it becomes necessary to resort to skin rejuvenation methods. This process also includes the prevention of aging of the skin and the entire body as a whole, while various functional structures of the dermis are stimulated to activate neocollagenogenesis, elastinogenesis, regeneration, repair and redermalization.

Laser peeling eliminates both superficial and deep skin defects - superficial and deep hyperpigmentation, uneven skin texture, fine wrinkles, hyperkeratosis and others. Depending on the degree of ablation or non-ablative effect, laser peeling damages or does not damage the epidermis. The degree of heating of the chromophore gives lasers a direct bactericidal effect, such as neodymium, erbium and CO2 lasers.

Unlike CO2 and erbium lasers, neodymium lasers have a non-ablative effect - they act without damaging the epidermis. The pronounced bactericidal, depigmenting and exfoliating properties of neodymium radiation are due to the high temperature during the interaction of the laser beam with the chromophore (vascular contents, melanin, etc.), and the Q - switch mode, short-pulse mode within nano- and picoseconds, allows you to preserve the tissues that surround chromophore, intact. The energy is absorbed so quickly that living skin cells do not have time to be damaged.

The non-ablative action of the laser and devices that do not damage the papillary layer of the dermis are exactly what allows procedures to be carried out all year round, because the surface of the skin remains intact.

ALL-SEASON PEELINGS

Let's consider all-season methods of skin peeling using cosmetic devices.

Using a neodymium picosecond laser , you can fight age-related skin changes, hyperpigmentation, cleanse the skin of impurities, carry out carbon peeling and some other procedures.

A pronounced effect of rejuvenation and cleansing of the skin can be observed immediately after the procedure, with virtually no recovery period (slight redness of the skin disappears after about 1–2 hours), and there is no side effect in the form of peeling, which is typical for some other peelings.

Exposure to picosecond pulses leads to the formation of new collagen and elastin, which ultimately allows the rejuvenation processes to begin. The result after carbon peeling procedures performed with a Pico-Light neodymium picosecond laser is presented in the photo.

Laser carbon peeling

The procedure combines the action of a laser beam and a carbon nanogel mask, which contains carbon dioxide nanoparticles, which is why the nanogel got its name (from the word carbon - “carbon”). The therapeutic effect of the nanogel is based on its ability to penetrate into the deep layers of the skin, bind epidermal cells, sebum residues, impurities, etc. The method is perfect for the treatment of acne, demodicosis, and normalization of skin lipid metabolism. Laser exposure, in turn, evaporates dead cells, stimulates the production of collagen and elastin, destroys pathogenic microflora, evens out the color and texture of the skin.

PROTOCOL of the laser carbon peeling procedure using a neodymium laser:

• we determine the affected area (the area should be free of any damage - abrasions, inflammation, peeling, integrity damage) and clean it of makeup;
• clean the surface with a neutral cleaner, such as chlorhexidine digluconate, and dry the surface with a paper towel;
• Apply carbon gel at a rate of 0.5 ml using massage movements to the entire face and leave for 15–20 minutes;
• We install the attachment for carbon peeling on the device’s handpiece and set the necessary parameters;
• We apply laser radiation to the treatment area strictly perpendicularly from a distance of approximately 5 cm, while a small amount of smoke will be released;
• at the end of the procedure, we cleanse the surface of the skin with chlorhexidine digluconate or tonic and apply a cream with SPF of 30 or higher.

INDICATIONS for the procedure:

• sebum regulation of facial skin (regulation of increased skin oiliness);
• skin treatment for demodicosis, acne;
• correction of fine wrinkles;
• improving skin permeability (for the introduction of therapeutic serums, etc.);
• stimulation of fibroblasts for the formation of young collagen and elastin;
• improvement of skin texture;
• anti-inflammatory effect on the skin;
• planned course of peelings;
• steaming the skin before manual cleaning;
• even out skin color;
• cleansing and reducing pores.

Fractional skin rejuvenation

The method is based on the ability of a laser beam to stimulate the formation of new collagen fibers. The neodymium laser beam penetrates through the top layer of skin directly into the dermis and warms it up, while the collagen fibers heat up and thicken, and the skin, accordingly, tightens and a primary lifting effect occurs.

PROTOCOL for the procedure of fractional skin rejuvenation with a neodymium laser:

• we determine the area of influence (the area must be free of any damage - abrasions, inflammation, peeling, damage to integrity) and carry out makeup removal;
• treat the surface of the skin with a neutral cleaner (chlorhexidine digluconate) and dry it with a paper towel;
• turn on the device, install the 755 nm attachment on the handpiece and set the necessary parameters;
• We apply the manipulator strictly perpendicularly to the treatment area from a distance of 3–4 cm;
• We complete the procedure by applying panthenol spray, let it absorb (5–10 minutes), remove the residue with a dry cloth;
• We give the patient recommendations for home care.

INDICATIONS for the fractional skin rejuvenation procedure are:

• thinning and loss of skin elasticity;
• sagging of individual areas of the skin;
• pigmentation and color unevenness;
• appearance of superficial vascular mesh on the skin;
• the appearance of irregularities on the surface of the skin - a violation of the relief;
• post-acne.

Hydropeeling

The procedure is a new non-traumatic technology for gentle and thorough skin cleansing. It can be considered as an alternative to diamond microdermabrasion, as it allows you to clean and exfoliate dead particles of the epidermis without redness, swelling, pain and increased sensitivity of the skin, which is an inevitable side effect of microdermabrasion.

The stratum corneum of the epidermis consists of 5–15 layers of keratinizing epithelium - keratinocyte cells. As the number of layers of dead cells increases, the skin takes on a dull, gray appearance. After exfoliation of dead particles of the epithelium, the skin returns its radiance and shine, but when using diamond microdermabrasion, healthy keratinocytes up to the papillary dermis are also damaged, and this increases the risk of post-traumatic hyperpigmentation and absolutely excludes the use of diamond microdermabrasion in the summer. And hydropeeling is an all-season procedure.

Hydropeeling is intended for vacuum exfoliation of dead particles of the stratum corneum of the skin, extraction of comedones, excess sebum, any skin impurities and simultaneous deep hydration and nutrition of all layers of the skin, improving metabolic processes in the skin. Serums based on salicylic and hyaluronic acids destroy pathogenic microflora of the sebaceous glands, relieve inflammation, moisturize and soothe the skin. Thus, hydropeeling can be successfully combined with chemical superficial peels.

With the help of hydropeeling, you can exfoliate dead epidermis, extract comedones, lifting, lymphatic drainage, use it in an acne treatment complex, restore trophism and microcirculation of the skin, and introduce any liquid medium into the upper layers of the skin (non-injection mesotherapy). The procedure is suitable for any skin type and any time of year, takes place with minimal costs and at the same time gives maximum results.

In addition, a cumulative effect is formed during the course of procedures. Pleasant sensations and high efficiency make hydropeeling a desirable procedure that you want to resort to as quickly as possible. The procedure becomes an option for express help when you urgently need to restore and refresh the appearance of your facial skin on the eve of any event, when you need a radiant, fresh, toned look.

PROTOCOL for the hydropeeling procedure:

• We interview the patient to determine possible contraindications;
• We select all the necessary inputs depending on the desired result;
• We clean the client’s skin of makeup or any other cosmetic products;
• We adjust the vacuum strength and the amount of liquid supplied to the handpiece depending on the thickness, tone of the skin and the desired result. To carry out the procedure, you can use distilled water or the solution with which you plan to carry out the procedure;
• We apply a product to the cleansed skin to soften its top layer, so that the stratum corneum is easily and painlessly separated, the process of mechanical cleaning becomes easier, the outdated cells should soften, and the bonds between them should weaken. Similar products are available in many brands of professional cosmetics. They are quickly absorbed, as a result of which the cells are filled with moisture, swell, and intercellular connections are weakened;
• For the treatment handpiece, we select a disposable attachment according to the patient’s skin type, treatment site and desired effect. The denser, thicker and more contaminated the patient’s skin, the more abrasive the nozzle should be chosen for the procedure;
• We regulate the vacuum strength and the amount of liquid supplied and use massage lines to exfoliate dead cells from the surface of the skin.
• After the procedure, we apply an alginate mask to consolidate the effect or a serum according to your skin type.

CONTRAINDICATIONS

Contraindications for hardware procedures are the same as for other cosmetic procedures. They need to be taken into account in order to avoid errors when performing:

• pregnancy, lactation period;
• acute and chronic diseases during exacerbation;
• skin damage and tattoos in the affected area;
• herpetic rashes;
• systemic connective tissue diseases;
• diseases of the blood system;
• keloid scars, etc.

Post-procedure care must be very thoughtful and clearly coordinated. Be sure to regularly use panthenol, a moisturizing cream that will relieve possible slight flaking of the skin and a feeling of tightness. It is mandatory to use a sunscreen that prevents the occurrence of post-traumatic hyperpigmentation when using ablative methods. For several days you should refrain from visiting the bathhouse, sauna, swimming pool and other sources of exposure to the skin, including massage.