Laser cosmetology: possibilities and scope, main types of lasers, absolute and relative contraindications



Laser exposure is widely used in dermatological practice and aesthetic medicine.

Such hardware techniques are shown not only for the treatment of a variety of benign skin pathologies, inflammatory external lesions. They are very effective for eliminating the main signs of aging, getting rid of unwanted vegetation and other skin defects.

Currently, laser cosmetology is used everywhere thanks to the pronounced and long-lasting result and the simplicity of most procedures.



All medical lasers used in medicine generate radiation in:

• the visible part of the spectrum, with a wavelength (Latin designation λ) from 360 to 760 nm, and in modern devices and more;
• ultraviolet part of the spectrum, with a wavelength less than 360 nm;
• X-ray part of the spectrum, with a wavelength less than 1 nm.

The basis for the operation of any laser device is its active medium. Materials for it can serve as solid substances (various crystals, alloys, semiconductors), gases (usually CO2, less often halogens, inert gases, and various mixtures of gases).

The composite ingredients of the laser active medium determine the wavelength, power and a number of other radiation parameters generated by the device. With the help of electromagnetic waves or light flux, the molecules of the active medium come into functional excitation, which is accompanied by the exit from each light photon. Its collision with other molecules provokes the appearance of additional quanta radiation. As a result of repetitive processes, an avalanche-like generation of photons with the same energy occurs.

In the device forming the laser pulse, the active medium is located in the so-called resonator, where several mirrors are located. Reflecting from each other, the light beams come together and leave the resonator in the form of a precisely directed laser beam.

The therapeutic and cosmetic effect of using this technique is due to the unique properties of this type of radiation. It:

• coherence - the oscillations of the waves completely coincide in time and spatially;
• monochrome - all emitted waves have the same length, which is determined by the active medium used;
• collimation - waves are transferred parallel to each other, not diverging to the sides, which minimizes energy consumption.

The basis of the interaction of laser radiation with skin cells are the optical properties of the epidermal cover and the beam itself, this is the wavelength and the energy flux density. When choosing the parameters suitable for any procedure, the specialist first of all takes into account the localization features of the target cells. However, attention is also paid to the heterogeneity of absorption, for example, hemoglobin has several peaks of "response" to laser radiation, and the level of melanin interaction is inversely proportional to the wavelength.



The distribution of light on the skin depends on several parameters:

• Reflection. As a rule, about 5-7% of laser radiation is reflected at the level of the stratum corneum, of course, it does not affect the underlying cells of the epidermal layer in any way.
• Takeovers The main “targets”, or, to put it scientifically, the chromophores for laser radiation are: hemoglobin contained in blood and, accordingly, blood vessels, melanin (the main coloring pigment of skin, hair, birthmarks, etc.), water, collagen. Each of these structural units has its own characteristics with respect to active laser radiation.



• Scattering This effect is usually caused by collagen, which quickly decreases the energy flux density and, as a result, affects tissue and skin cells. That is why, laser radiation with a long wavelength is used to combat unwanted vegetation on the body and face.
• Penetration. This factor is determined by the wavelength and is monitored by a doctor or cosmetologist depending on the set therapeutic or cosmetological tasks.

The most common classification used by modern clinics and centers of laser therapy devices based on the properties of the active medium.

So, lasers are divided into:

• Gas. The mixture of neon and helium, nitrogen, carbon dioxide, argon, etc. act as a “working” medium. The advantage of such devices is a wide range of wavelengths. The most powerful today is the CO2 laser , which causes its widespread use in various branches of medicine.
• Excimer. This is one of the varieties of gas lasers, however, they function at the expense of halogens and inert gases. They have a narrow specialization and are used in ophthalmology for the treatment of various diseases and vision correction.
• Solid State. They consist of a special glass (sometimes it is replaced with an yttrium aluminum garnet - AIG) and particles of rare-earth metals (neodymium, erbium, etc.). Directly the source of laser radiation are metal ions, and glass or AIG only ensure their correct spatial location.
• On dyes. The active medium is liquid solutions of special dyes. However, in medicine and cosmetology, such technologies are not used; such lasers are used for research purposes.
• Semiconductor (or diode). They are characterized by a combination of high efficiency, small size and relatively low energy consumption.
• On metal vapors. Usually they function with gold or copper particles.

Also, laser devices are divided on the basis of the characteristics of the generated radiation at the visible, ultraviolet and infrared. In addition, they can be low- or high-intensity. The former are intended exclusively for dermatology and cosmetology, the latter are used in modern surgical technologies.

For therapeutic purposes, laser therapy is used very widely. But such manipulations are carried out in the clinic after a comprehensive examination of the patient. And if there are certain contraindications, the ratios of benefits from the use of laser treatment and the possible risk are assessed, and only then a decision is made. In cosmetology, laser technology is more used to rejuvenate the face and body, eliminate scars , remove excess hair, etc.

Naturally, such conditions cannot be called threatening for life and health; therefore, if there are any contraindications, it is recommended to refuse the procedure and find another way to solve aesthetic and cosmetic defects.

Thus, the strict limitations for conducting manipulations using laser technology are:

• oncological diseases;

• age up to 18 years;
• varicose veins, thrombophlebitis, especially if the area of ​​laser radiation covers the area of ​​large blood vessels;
• diabetes;
• some hormonal disorders;
• psoriasis, seborrhea;

• autoimmune diseases, according to doctors, the skin is one of the main organs of immunity, therefore, excessive exposure to it can cause an exacerbation of the pathology;
• bleeding disorders;
• increased photosensitivity;
• psycho-emotional instability;
• neurological disorders;
• severe hypertension and cardiovascular lesions, including angina and heart rhythm disorders;
• active course of tuberculosis infection;
• violations of the endocrine function of the thyroid gland.

Postponing the procedure of skin treatment with a laser is better with:

• exacerbations of chronic dermatitis, herpes virus;
• acute infectious or bacterial diseases;
• the period of rehabilitation after long illness, operations, long medication;
• the use of tetracycline antibiotics and other drugs that increase the susceptibility of the skin to light radiation;
• unhealed epidermal damage in the area of ​​exposure to laser radiation.

With the influence of laser energy on the epidermal covers, the following processes occur:

• photostimulation, in other words, the acceleration of metabolism at the cellular level, which leads to the rapid healing of wounds and the resorption of scars and small scars;
• photodynamic effect, which normalizes cell activity, due to this effect, laser devices are used to treat a variety of infectious, atypical skin diseases (lichen, acne, etc.), pigmentation disorders;
• selective photothermolysis, laser radiation selectively affects certain skin structures - hemoglobin, melanin, etc., this effect is used to remove tattoos, unwanted hair, correct developmental defects of the subcutaneous tissue, etc .;
• photomechanical action, which involves the complete or partial removal of pathological tissues with or without damage to the healthy epidermis.

According to the level of influence on the skin tissue, laser radiation is divided into high- and low-intensity.

The use of low-intensity laser devices provides the following spectrum of action:

• Anti-inflammatory. Thanks to radiation, blood vessels are dilated, microcirculation parameters are improved, the synthesis of a number of enzymes is stimulated. As a result, the rate of synthesis of inflammatory mediators decreases, edema and redness disappear.
• Antimicrobial. High temperature creates unfavorable conditions for the further development of pathogenic flora, regardless of its type (fungal or bacterial) and causes instantaneous death of microbial cells.

• Analgesic. A similar effect is provided by the effect on reflex nerve endings. As a result of their blockage, it is possible to eliminate the itching and pain, which is the most common symptom of most dermatoses.
• Immunomodulatory. Due to the active influence of radiation, the functioning of cellular immunity is normalized, the physiological balance of immunoglobulins is restored. This is true for the treatment of autoimmune skin diseases.

Such a trend in aesthetic and therapeutic dermatology provides a quick and safe solution to a number of problems.

The wide variability of tunable laser parameters allows the use of a similar technique for:

• facial and body skin rejuvenation;
• elimination of small scars, scars, traces after severe acne, stretch marks;
• treatment of allergic, psoriasis, vitiligo, seborrhea;
• eliminate unwanted vegetation on the body;
• removal of warts, papillomas, benign neoplasms, birthmarks, etc .;
• tattoo information ;
• elimination of vascular pathologies of the skin (hemangiomas, telangiectasias), including venous diseases of the lower extremities;
• skin tightening and facial contouring;
• hair growth stimulation for baldness;
• treatment of superficial pigment skin lesions, including the removal of freckles .

Clinical trials demonstrating long-term results of laser therapy demonstrate a positive effect and the absence of adverse reactions.

Almost the only drawback of this method of treatment is the high price of the services of a specialist of this profile. Therefore, laser cosmetology is still quite limited. However, every year there are new, cheaper devices, which eventually gradually reduces the cost of procedures.

• Laser removal of spider veins
• Laser removal of facial vessels
• Treatment of varicose veins with laser
• EVLK
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• Rosacea Laser Treatment

Laser cosmetology of the face: various methods of rejuvenation, the use of fractional laser, technology Palomar, acne treatment

All methods of laser irradiation used in dermatology can be divided into two large groups. The first involves deep damage to the treated skin area, including the epidermis. In this case, laser radiation is uniformly and equally absorbed by all cells. This technology is called ablation.

Another method of exposure is characterized by a selective effect on various structures without damaging the integrity of the epidermis. In this case, the laser radiation is absorbed by certain cells. Today, facial laser cosmetology is most often used to rejuvenate the skin and eliminate the signs of aging of the epidermal integument.

Age-related changes are manifested in the form of mimic and senile wrinkles, the appearance of age spots, sagging and violation of the shape of the face oval, the formation of body fat, changes in the contours of the lips, eyes. An alternative to plastic surgery can be various procedures performed using laser equipment.

Unlike conventional laser exposure, fractional provides a selective effect on certain areas of the skin, while the areas between them remain intact. This technique repeatedly stimulates the synthesis of collagen, helps to normalize the work of the sebaceous and sweat glands, activates microcirculation, delivery of nutrients. As a result, wrinkles are smoothed, due to moisture retention, the skin becomes healthy, its turgor increases, the color evens out.

At present, Palomar equipment is used to conduct fractional laser skin rejuvenation. The manipulator device is equipped with a diffuser, which distributes the laser beam in three directions. As a result of exposure to a multitude of microscopic points, a pronounced rejuvenating effect arises, and at the same time, the skin regeneration period is significantly shortened.

If for classical peeling it is 7-10 days, then regeneration of the epidermal cover after the procedure of fractional rejuvenation is no more than 2-3 days. According to experts, this technique allows you to avoid other complications: burns, edema, severe redness.

Another type of laser skin rejuvenation is thermal lifting. Collagenogenesis is stimulated by active cell heating. Depending on the indications, the temperature in the cells can reach 45-50º and more. Under the influence of this type of laser radiation occurs not only the activation of metabolism, but also the splitting of fat cells.

Therefore, thermolifting is used to correct a second chin, to eliminate lipid deposits in the face, abdomen, buttocks and other problem areas.

Laser exposure effectively helps to cope with acne. According to dermatologists, more than half of boys and girls in puberty suffer from acne.

This kind of rash is one of the few indications for laser therapy in juveniles. Radiation exposure allows you to eliminate pathogenic flora, causing an inflammatory reaction and suppuration, suspend the pathological process, remove redness, eliminate traces of acne and prevent the emergence of new ones. A more benign option to remove cosmetic defects is photorejuvenation .

Indications for its conduct are:

• small mimic and senile wrinkles;
• avitaminosis, skin hypoxia;
• excessive dryness, loss of elasticity and color;
• hypersecretory activity of the sebaceous and sweat glands;
• rash on the skin of an inflammatory nature;
• dark spots.

The course of photorejuvenation includes up to 5-7 sessions, it is recommended to carry out after peeling, to remove small scars and scars after plastic surgery. A detailed scheme for the correction of aesthetic defects prompts cosmetologist at the preliminary consultation.

Laser procedures in cosmetology: removal of unwanted hair and benign neoplasms

In recent years, photo and laser hair removal has become particularly popular. And if the first method has a more limited range of indications, the second method of removing unwanted vegetation is suitable for almost all women.

Recent developments allow you to choose the parameters of laser radiation in such a way as to remove not only the hair, regardless of their color and skin tone. At the same time, the ideal condition for laser exposure would be the possibility of selective absorption of hair only by melanin and the absence of influence on other epidermal cells.

This result can be achieved by an optimal combination of wavelength and pulse generation frequency. This ensures that certain areas are heated without overheating surrounding tissues.

But in practice, the "optical window" of the melanin pigment is in the range of 500-1100 nm, so damage to the surrounding skin is inevitable to one degree or another. However, modern technologies can reduce this side effect to a minimum.

In addition to melanin, the targets for laser radiation during the epilation process are growth-promoting cells in the hair follicle and blood vessels that supply the bulb. Обычно для устранения нежелательной растительности применяют полупроводниковые, александритовые, неодимовые, реже, рубиновые лазеры с длиной волны от 694 до 1064 нм и мощностью потока 20-60 Дж/см2.

Лазерные процедуры в косметологии позволяют избавиться от нежелательных волос на любом участке тела: области половых органов, ногах, груди, спине, лице, в подмышечных впадинах. Кроме того, подобная методика с одинаковым успехом применяется как у женщин, так и у мужчин.

Сделать эпиляцию более безопасной позволяет аппараты серии Vectus компании Palomar. Отличительной чертой подобного устройства является считывающий сканер Skintel, распознающий тип кожи пациента, зоны концентрации меланина и автоматически подбирающий параметры лазерного излучения. Кроме того, аппарат оснащен картой памяти, куда вносят индивидуальные настройки для каждого пациента, историю проведения сеансов эпиляции.

Таким образом, сводится к минимуму риск ожогов, нарушений пигментации и других побочных реакций. Подобные параметры также повышают эффективность процедуры.

• ВЛОК
• Лазерное очищение крови

Одним из наиболее распространенных показаний к проведению лазерной терапии являются доброкачественные новообразования. Это вызванные вирусом папилломы человека бородавки и кондиломы, липомы, родинки и т.д. В некоторых случаях при помощи высокоинтенсивного лазера возможно удаление злокачественного новообразования, однако манипуляция проводится после гистологического обследования и определения границ опухоли.

Суть процедуры заключается в воздействии направленного луча на новообразование, при этом патологические клетки разрушаются и «выпариваются» с поверхности кожи.

Одновременно происходит свертывание крови, что обеспечивает отсутствие кровотечения и вероятности вторичной бактериальной инфекции. Манипуляция не оставляет шрамов, рубцов и других видимых следов на коже. Период заживления и восстановления эпидермального покрова занимает порядка 7-10 дней, иногда — дольше. Обычно с этой целью используют СО2 лазеры. Процедура достаточно болезненна, поэтому в некоторых случаях показана местная анестезия.

Лазерная эстетическая косметология: удаление сосудистых патологий, рубцов, стрий

Попытки применения лазера для лечения варикозного расширения вен проводятся уже несколько десятков лет. Трудность подобной терапии состояла в различной глубине расположения кровеносных сосудов. Однако с изобретением неодимовых лазеров с длиной волны до 1024 нм, удаление патологических очагов сосудистой сети стало возможным.

Излучение прицельно действует на основной компонент красных кровяных телец — гемоглобин. Таким образом достигается коагуляция кровеносного сосуда и исчезновение внешних проявлений варикоза — гематом, отеков, сосудистого рисунка на поверхности кожи и т.д. По такому же принципу происходит удаление сосудистых «звездочек» на лице и теле — телеангиэктазий.

Under the influence of radiation, pigment spots are removed . The fact is that the concentration of melanin in these zones is much higher than in the rest of the skin. During the course of the procedures, the pigment gradually breaks down and peels off along with the upper layer of the epidermal cover.

After several sessions, the pigment spots become less noticeable, and then the skin color completely flattens. When deep wounds "turn on" the protective mechanisms of our body. The fact is that epithelium regeneration occurs rather slowly, therefore, for the speedy healing of skin lesions, connective tissue is “used”.

In structure, it differs significantly from the epidermis, is not so abundantly supplied with blood, contains collagen and elastin in a lower concentration. However, under the influence of laser radiation, the generation of collagen molecules is activated, a capillary network is branched. As a result, connective tissue is gradually replaced by normal epidermal. Outwardly, this is manifested by the disappearance of the scar and the leveling of the skin surface.

Laser aesthetic cosmetology can not completely replace plastic surgery. However, the effect of such procedures lasts a long time, a positive point is the wide range of indications. In modern cosmetology centers, new equipment has been installed that allows to cope with a complex of aesthetic and medical problems. Despite the fact that the cost of services is quite high, it is justified by the result.