Laser and Intense Pulsed Light devices are adding new dimensions to skin care

High-touch skincare services have won clients' hearts. Spas focusing on cutting-edge wellness, though, have also found there's wisdom in using high-tech tools like lasers and Intense Pulsed Light (IPL devices) to improve their clients' complexions. Intrigued by these modern instruments, and turned off by the prolonged healing times required with most medical resurfacing procedures, many spa clients are now viewing these less invasive services as a way to improve their appearance without having to take time off from work and family activities.

This whole process is called Selective Photo Thermolysis. In simple terms, this means picking the right wavelength to produce the desired results." Here are some of the newer laser and laser-Iike tools available.

CoolTouch Laser. Following the theory that less is often more, the new CoolTouch-an Nd:YAG laser with a cooling cryogen spray to prevent external burning of the skin-has captured the interest of many women considering laser resurfacing because procedures using this device can be done in the doctor's office and require no down time. Often referred to as a laser facial, this service treats aging, sun-damaged skin from the inside out. Treatment series are recomrnended-a minimum of two to improve collagen production and at least six to treat wrinkles--with each treatment costing anywhere from $300 to $750. Follow-up treatments are necessary every few months to maintain results.

Cold Lasers. The cold laser-a device that emits no heat and has an extremely short wavelength-is the newest tool for estheticians; it is not classified as a medical laser. Total Rejuvenation and EuroPro are both producing cold lasers. Neither of these devices requires medical supervision, but both types are expensive, costing just under $20,000!

Lorrie Klein, M.D., diplomate of the American Board of Dermatology, uses the Total Rejuvenation cold laser in her Euro Day Spa and the CoolTouch laser in her dermatology practice in Laguna Niguel, California. "I became sold on the benefits of the cold laser after having a service myself," she says. "While I'm not aware of any scientific studies that actually prove that it enhances elasticity, I did notice that my skin felt tighter after the treatment. Whether this was due to increased collagen production or muscle stimulation, I don't know. I can say, however, that as a skincare client, I was pleased with the results."

Intense Pulsed Light Devices.
Rejuvalight, distributed by Cosmopro, is being used by some spa therapists to achieve results similar to those produced by lasers. "IPL units use incandescent light and all the wavelengths are contained in that light source," says Greif. "To some extent, IPL devices are capable of filtering certain ranges of wavelengths to get a laser-like effect." IPL is further adjustable through computer-controlled energy delivery.

The noninvasive approach offered by IPL is especially effective for treating signs of photoaging without the inflammatory response and other complications of laser resurfacing. Researchers at Tokyo Women's Medical University recently treated 97 patients using IPL at 550 and 570 nanometers to determine the effectiveness of IPL photorejuvenation. Each patient received three to six treatments at intervals of two to three weeks. The study reported in Dermatologic Surgery (Vol. 27, No.7, 627- 632) relied on the perceptions of both the doctors and patients to assess effectiveness. More than 90% of both rated pigmentation changes as "good" or "excellent"; more than 83% gave the same rating for improvement in dilated capillaries; and 65% noted the same level of improvement for overall skin texture.

Mona Sappenfield, CIDESCO diplomate and owner of the Mona Spa of Well Being in Memphis, Tennessee, began using two different IPL systems three years ago. She became interested in this modality after two physicians began treating some of her clients at her spa with the Epilight by Lumenis-an IPL medical device that's used for photorejuvenation and hair removal. She has since begun doing these treatments herself under the supervision of a medical director. "We use the Epilight as well as the Rejuvalight systems," she says. "The results are the closest thing to a facelift that I've been able to achieve since becoming an esthetician in 1980. This is particularly true when we do a series of treatments involving both of these devices."

Sappenfield became even more passionate about these two IPL machines after incurring significant sun damage during a recent trip to Mexico. "This happened even though I slathered my skin with SPF30 sunscreen and wore broad-brimmed hats," says Sappenfield. She began a series of Epilight photo facials, followed by a maintenance program using her Rejuvalight machine. "Within a few days of starting this program, the sun damage on my face surfaced and sloughed off in brown, crumbly particles," she says. "We've since taken ultraviolet photos of several of our clients who have undergone this same program and found that the improvement in their sun-damaged skin has been dramatic. "

Hair removal is also a viable service with some IPL machines. Amy Kamin, president of Phases Skin Care Corp. in New York City, is doing this with AcuLight-an IPL photo-epilation device by AcuLight Corp. Fees for this service range from $475 for a series of four upper-lip treatments to $665 for a series of four bikini treatments. "I really believe that devices like AcuLight are the way of the future," says Kamin. "They're far less invasive than medical lasers and more accurate when it comes to treating all colors of hair and skin. Because AcuLight only targets hair follicles, hairs are destroyed selectively without disturbing the surrounding skin tissue." The cost of devices like AcuLight varies, with some companies offsetting large buy-in costs by offering leasing programs that often involve splitting gross profits.

MEDICAL ALLIANCES
Even day spas that have no interest in becoming medical spas are getting more involved in cosmetic medical services. A perfect example is Essentiels Spa in Boulder, Colorado. During a recent expansion of her facility, owner Susan Macinko built a small medical suite consisting of three rooms--two treatment rooms and one for consultations, videos and booking calls. "I was approached by a few physicians in our area to become involved in laser hair removal," says Macinko. "At first I thought it would be great to cross-train some of our staff to do this service, but that idea changed quickly after we officially opened our facility."

Along with a group of investors, Macinko purchased an $80,000 Candela GentleLase, a long-pulse, alexandrite medical laser that's approved by the FDA for permanent hair reduction. Soon she discovered that her massage therapists had no interest in learning laser hair removal, and her estheticians were too busy with skincare services to handle the additional business. Macinko decided to hire qualified personnel from the medical field instead. "We now have one registered nurse and another person from the medical field who do our laser hair-removal services on a full-time basis," says Macinko. "This has worked out better for us because our medical staff is completely focused on this aspect of our business and can directly confer with our physicians."

Ceanne Mayo, general manager of Essentiels Spa, says that timing and testimonials are everything when it comes to introducing laser hair removal services; "Clients have to protect their treated areas from any sun exposure for several weeks prior to and following a laser hair removal treatment," says Mayo. "This can really restrict their activities in the summer when clothing is so brief. We learned through trial and error that the fall and winter months are the best times to introduce this service. We've also found that there's nothing better than word of mouth when it comes to marketing this system. We did this by encouraging our staff members to have a series of these treatments and then to talk about the results with their clients."

Kamin stresses the importance of never promoting your IPL or laser services at the expense of other services on your menu" "Our sales of AcuLight hair removal treatments have been high because we drive those numbers," she says. “But we're still sensitive to the fact that not everyone wants to have a laser or IPL treatment. A perfect example is myself. I'm a waxing person. I've waxed all my life and I like the instant results I get from this service. Someone else might hate waxing or not believe in the theory behind the AcuLight hair removal system. There’s plenty of room in your business to support all the different ways to control unwanted hair growth.”

Macinko has also worked carefully on her marketing program by creating a trifold brochure that describes expectations, costs and what it’s like to receive one of these services. This brochure is inserted in retail bags, placed on tables and posted on bulletin boards within her facility. “I do this with all new services because it gives me the room I need to tweak the information whether it’s cost, description or intention-before it’s permanently added to our menu,” says Macinko. “So far we’re extremely pleased with sales of this service, which are doubling each month!"

Essentiels Spa sells laser hair removal in a series of three treatments. Each treatment costs $75 for the lip or chin; $125 for the underarms, neck area and sides of the face; $!75 for bikini line and forearm; and $225 for the upper back, extended bikini and lower leg. Although physicians often charge more than twice as much, "our goal is to make these services affordable but still profitable for our spa," says Macinko. "At the moment, these prices appear to be accomplishing both of these goals."

CAUTIONS
Beauty and medical professionals involved in IPL and laser treatments also advise that you should thoroughly investigate all aspects of the equipment-from usage to customer surveys to all rules and regulations--before committing to buy any piece of equipment or to any lease program. "From a legal point of view, the FDA clearly states that all Class II medical devices must be used by licensed professionals," says Greif. "Determining what a licensed professional really is, though, is left to each state." Some states have restricted these devices to medically trained personnel and others are still in the process of developing regulations.

So far, IPLs and cold lasers have fallen outside of most of these FDA guidelines because they aren't true lasers. This doesn't mean, however, that there aren't some local or state restrictions on the use of these machines. "The only way to know what is legal in your state is to contact your state board," says Sappenfield. "While you're investigating these services, also talk to your insurance provider about the specific types of machines and how you want to use them in your business. If you don't do this, you could find out too late that you aren't insured for providing IPL services, or even for something as gentle as cold laser treatments."

Whether laser and laser-like devices will continue to proliferate and dominate spas of the future is yet to be determined, but they are among the most cutting-edge devices now available to day spas and deserve a close look from business owners who want to stay ahead of the trends.