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LASER SHOW

Laser Show
BY LEDA KOPACH
“RENEW” Nov/Dec 2004 pages 38-39

What's new in medispas? "Everything!" declares Norman Leaf, M.D., board certified dermatologist and owner of Solutions Skincare Medical Clinic in Beverly Hills California. "That's because medispas are new," he adds. "Consumers are extremely interested in this aspect of skin care."

As a result, new technology emerges constantly in the medispa and aesthetic skin care arenas. Currently, skin resurfacing treatments and fillers like Botox, Restylane and Hylaform top the list of most requested medispa services. But, says Leaf, look out for lasers and laser-type equipment. New technology and new applications indicate that these types of treatments are quickly edging into the medispa spotlight.

Acne Advances
According to Bruce Katz, M.D., board-certified dermatologist and owner of Juva Skin and Laser Center and Medispa in New York City, one of the newest treatments in laser technology is photodynamic therapy, which is very effective in treating acne. "The laser was originally developed to treat pre-cancerous skin lesions of the face or scalp called actinic keratoses," he says. "But by coincidence, it was discovered that it's also very beneficial for treating acneic skin."

To treat acne, the doctor swabs the area with a Levulan Kerastick, a topical formula which contains the active ingredient aminolevulinic acid. The Levulan is then activated by the Blue Light Photodynamic Therapy Illuminator.

Research has demonstrated that when activated by the visible light, the Levulan destroys acne-causing bacteria. According to Katz, M.D.’s and patients have also noticed a welcome side effect to this treatment: In addition to ridding the skin of acne, there seems to be a reduction in oil production in many instances.

Busy, active patients like the fact that there is no down- time from the procedure. Although some people may experience a bit of redness and swelling immediately afterward, it generally subsides within a few days. It's important to remember, however, that the treated lesions are sensitive to light. So when working with clients who are undergoing this type of treatment, be sure to advise them to avoid sunlight and other sources of bright light for at least 40 hours after each doctor's appointment.

Most people tolerate these treatments well, with the exception of patients with extreme sensitivity to light and patients who suffer from porphyria, a metabolic disorder that causes sensitivity to light.

While the benefits of the treatment are substantial, so is the cost. Nationally, a Levulan session ranges from $500-$800, and doctors recommend four to six treatments in order to attain the desired results. But the high price tag may be worth paying when considering the alternatives.

"Levulan is just as effective on acne as Accutane and antibiotic usage without the horrible side effects that have recently surfaced," says Katz. "There has been a lot of media attention about the fact that Accutane can cause extreme side effects like depression and suicide. JAMA [The Journal of the American Medical Association} has also reported that women who have been on antibiotics for acne may be at a higher risk for breast cancer."

Cellulite Reconsidered
Until now, cellulite treatments have usually involved either endermologie or topical treatments. Recently, however, several new machines designed to help combat the appearance of cellulite and tighten skin overall have received FDA approval.
Among them is VelaSmooth, recently launched by a manufacturer called Syneron. It's not technically a laser, but this laser-like medical device combines various energy technologies-bi-polar radio frequency and infrared light plus tissue mobilization combined with suction work- to re-contour the skin surface.

"Other cellulite treatments have not been very effective," says Teri Villardi, esthetics director of Dr. Neil Sadick Aesthetic Surgery and Dermatology Center in New York City. "A lot of clients were really troubled by cellulite, but we couldn't do a lot for their condition. The new VelaSmooth treatment combines light and radio frequency and a vacuum to penetrate the skin and dissolve fat. The body eliminates the fat through urination."

In response to numerous requests, Katz has also introduced a new cellulite treatment. "The Triactive Laser is a low-energy diode laser that's actually quite effective for firming skin," says Katz. The triple-action device combines the action of six diode lasers to enhance microcirculation, mechanical massage to stimulate subcutaneous tissues and localized cooling to smooth the appearance of the skin. "In my medical spa, estheticians perform the service," notes Katz. "We usually recommend weekly sessions for about 10-12 treatments to see the desired results. We're really pleased with it."

New Combinations
Doctors also report that they are working with new combinations of modalities, and achieving excellent results. For example, Villardi notes that when combined with radio frequency, laser treatments are more effective. "Radio frequency allows the lasers to go deeper," she says. "We are using radio frequency not only with non-ablative services like IPL (Intense Pulsed Light) but also with LED (Light Emitting Diodes.) With IPL and radio frequency, we find that skin is smoother, less red, and it really helps rosacea. Used alone, LED is effective for reducing red- ness and hyperpigmentation, and for evening out skin tone. When used with radio frequency, LED also helps tighten skin and promotes collagen production. Plus, wrinkles are diminished." .