Smoothing of skin texture can be achieved by 2 types of procedures:
1. collagen renewal
2. skin peels or resurfacing
collagen renewal is stimulated by creating mild thermal insult to the dermal/epidermal junction. The thermal trauma triggers a wound-heal response and new collagen remodels under the undamaged layer.
The resulting mild thermal insult to the papillary and upper reticular dermis leads to fibroblast activation. Fibroblasts are the cells of connective tissue responsible for making the collagen and elastin fiber cells found in the connective tissue of the dermis.
The creation of new collagen and connective material caused by the thermal insult and subsequent fibroblast activation occurs over a period of a few weeks to a few months. This wound healing response leads to improvement in skin texture and the smoothing of fine lines.
Resurfacing, skin tissue removal, can be acheived in different ways. All achieve results in basically the same way.
Parts of your skin are injured and removes, as the healing process progresses; a new, healthier-looking skin emerges.
What differentiates the various resurfacing methods is the way in which the skin's layers are injured. Chemical peels involve the application of a caustic solution, dermabrasion utilizes high-speed rotary wheel, and laser resurfacing uses a laser beam.
The different types of chemical peels vary according to their specific ingredients and their strength. The depth of their peeling action may also be determined by factors such as how long they remain on the skin and whether they are applied lightly or rubbed more vigorously onto the skin.
Glycolic (AHA) Peel: Alpha hydroxy acids (AHAs) are naturally occurring carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. No anesthesia or sedation is needed, and one will only feel a tingling or mild stinging sensation when the solution is applied to one's face. AHAs have a profound effect on keratinization; which is clinically detectable by the formation of a new stratum corneum. It appears that AHAs modulate this formation through diminished cellular cohesion between corneocytes at the lowest levels of the stratum corneum. AHAs with greater bioavailability appear to have deeper dermal effects. Glycolic acid, lactic acid and citric acid, on topical application to photodamaged skin, have been shown to produce increased amounts of mucopolysaccharides and collagen and increased skin thickness without detectable inflammation, as monitored by skin biopsies.
TCA Peel: A trichloracetic acid (TCA) peel is often used for the treatment of wrinkles, pigmentary changes and skin blemishes. Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.
Phenol Peel: Phenol is the strongest of the chemical solutions and produces a deep skin peel. phenol peel is sometimes recommended for treating particularly rough and sun-damaged facial skin. Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic. A single treatment usually achieves the desired result.
Dermabrasion creates an injury similar to skinning your knee. It uses a small, rapidly spinning wheel with a roughened surface similar to fine-grained sandpaper to abrade the skin, removing its upper layers.
Dermabrasion will require some form of anesthesia. Small areas may require only local anesthesia, but larger areas may benefit from sedation, as well. Post-dermabrasion treatment is similar to treating a burn.
This resurfacing procedure sometimes is selected for the treatment of facial scars such as those caused by acne and often is performed on the cheeks or the entire face. Dermabrasion, like the deeper chemical peels, is very effective in reducing the appearance of vertical wrinkles around the mouth that often cause lipstick "bleed". It can be used on a small area of skin and on patients with somewhat darker complexions. The treated area usually will blend with the surrounding skin so that there is little if any noticeable difference in the pigmentation.
There are two forms of laser resurfacing:
ultrapulse or continuos wave (fractional and non fractional) Includes 4 laser options: ActiveFX, DeepFX, Total FX(combined superficial and deep fractional ablation), SCAAR FX (synergistic Coagulation and Ablation for Advanced Resurfacing).
pixel pro is an Erbium YAG handpiece that can be attached to the Harmony platform. this handpiece has three differeent tips for ablation and fractional ablation; 4mm Erbium, 1x7 fractional rolling and 7x7 fractional stamping tips.
10,600nm laser with the ability to preform fractional and non fractional treatments. 3 pixel arrays: 7x7, 9x9 and 1x7 (optional), 50-mm and 100-mm surgical handpieces
The CO2RE system provides a total of seven different treatment modes including four fractional ablative treatment modes and pattern shapes, a traditional resurfacing mode, and two excision modes including defined shape and freehand modes for minor dermal excisions.
CO2 fractional laser
Depth of Penetration - Up to 1.6 mm
Wavelength - 10,600 nm
Energy - Up to 70 mJ (per MTZ)
Handpiece Technology - 135 microns (deep treatments) and 600 microns (superficial treatments).
Fraxel 1550 indications for use include skin resurfacing procedures and the treatment of periorbital wrinkles, acne scars, surgical scars, dyschromia and cutaneous lesions, such as age spots, sun spots, actinic keratosis and melasma. Fraxel 1927 is indicated for the treatment of actinic keratosis.
AcuPulse™ is a safe, simple and cost-effective CO2 laser that delivers outstanding results. AcuPulse™ can be used for 34 aesthetic indications, more than any other CO2 laser. AcuPulse™ combines treatment versatility with reproducible results.
A full-featured CO2 laser, Smartskin+ provides highly customizable, cost-effective skin resurfacing treatments for more even tone, smoother texture, and markedly reduced wrinkles.