LimeLight Facial (520nm visible light - 1100nm infrared technology)
FDA Clearance: LimeLight is cleared for a variety of indications including benign pigmented lesions and vascular lesions.
Novel 3-in-1 Wavelength Light Source for Photorejuvenation
LimeLight - Reds & Browns Begone
*Although this device has not been optimized for hair removal, hair removal may occur as a result of a LimeLight treatment.
Acutip may be combined with a LimeLight facial for the treatment of small facial veins and pigmented lesions.
Use of a Novel Small-Tip IPL Handpiece for
Treatment of Discrete Pigmented and Vascular
Treatment of Facial Telangiectasia with a Small Spot Broadband Pulsed Light Source
Creating an Office ‘Oasis’
Offices that treat pigmented lesions, provide Laser hair reduction or leg vein treatment have a different environment that traditional medical offices. Customers come in for skin care treatment but also look forward to the relaxing atmosphere. Turn your medical office into an "Oasis" for skin tightening, laser hair removal and vascular treatments.
USE OF LASERS/DELEGATION OF MEDICAL FUNCTIONS REGULATION BY STATE
Last Updated: 7/1/2008
Laser vein treatment requires assessment and correct diagnosis before performing the vascular treatment.
Management Strategies for Infantile Hemangiomas
Hemangiomas are benign tumors in which growth of capillary blood vessels occurs through angiogenesis.2 They rarely occur in utero, but instead appear as bluish or red marks within the first 2 weeks of infancy. Following this initial stage, they show rapid growth lasting for up to 12 months, the proliferation phase. In the next phase, the involuting phase, they slowly regress until an average of 5 to 7 years, after which hemangiomas remain unchanged.3 Traditional management of hemangiomas therefore, has been to wait until involution occurs spontaneously. However, complications such as bleeding, infection, ulceration, obstruction of orifices or psychosocial distress may be cues for intervention.
Source: Skin and Aging
VOLUME: 17 PUBLICATION DATE: Jan 09 2009
Issue Number:
1 Jan 09
author: Maya Barsky, BS, and Robert Buka, MD, JD
Skin Rejuvenation, Laser Hair Removal, Pigmented Lesions and Vascular Treatment
Laser based technology and treatment has advanced steadily for treatment of many cutaneous conditions, including a host of vascular and pigmented lesions, wrinkles, tattoos, scars and unwanted hair during the past decade. Demand for aesthetic treatments by skin ablation (resurfacing), and more subtle non-ablative treatments, has increased. Safety and ease of using lasers and high-energy flashlamps, has improved to the point that treatment can in some settings be given by non-medical personnel. Unwanted, preventable complications and side-effects are not uncommon. This article briefly reviews theory, clinical applications and potential for further progress of laser surgery in dermatology.
Source: Skin and Aging
Laser based infrared technology may be used to perform a Laser Vein treatment to hemangiomas. Treating hemangiomas is an advanced vascular treatment and should only be attempted if the treatment provider understands the anatomy and physiology of the lesion and has performed a complete assessment.
Management Strategies for Infantile Hemangiomas
Hemangiomas are benign tumors in which growth of capillary blood vessels occurs through angiogenesis.2 They rarely occur in utero, but instead appear as bluish or red marks within the first 2 weeks of infancy. Following this initial stage, they show rapid growth lasting for up to 12 months, the proliferation phase. In the next phase, the involuting phase, they slowly regress until an average of 5 to 7 years, after which hemangiomas remain unchanged.3 Traditional management of hemangiomas therefore, has been to wait until involution occurs spontaneously. However, complications such as bleeding, infection, ulceration, obstruction of orifices or psychosocial distress may be cues for intervention.
Maya Barsky, BS, and Robert Buka, MD, JD
Performing Test Spots serve several different purposes and are an important part of a skin care treatment plan. Infrared technology used in laser-tissue interactions produces thermal effects on the tissue.
The primary reason for performing a test spot is to observe epidermal response and to determine safe treatment parameters when treating tissue because of absorption by the chromophore. Immediate epidermal damage presents as a blanching or graying of the skin (common with the Nd:YAG). Epidermal damage may take up to 72 hours to be visibly evident especially when treating melanin. A burn from an IPL may take 48-72 hours to appear. It is very important to perform a test spot when treating pigmented lesions.
A test spot may be beneficial for skin types IV-VI to evaluate risk for developing post inflammatory hyperpigmentation. However, this test spot must be evaluated 4-8 weeks post procedure as it takes this amount of time for the PIH to develop. Laser based technology on skin types IV-VI may increase the risk of pigmentatary changes.
Port Wine Stains require test spots as the parameters will vary widely due to the different types and involvement of these vascular malformations. Starting parameters for vascular treatments are usually lower then an average vascular treatment. A cluster of veins is a better target then a single leg vein so there is a higher risk of a burn.
There are advertisements on the internet offering "Free Test Spots" prior to Laser hair removal in order to determine if the treatment "will work before the client pays for the treatments". This perhaps could be beneficial to help determine proper parameters; however, the time period for evaluating the test spot for efficacy may be 4 to 12 weeks or longer depending on the growth cycle.
Test spots are considered an "Industry Standard of Care" and therefore have Medical/Legal implications. The elements of a malpractice suit are the "Breach of a duty that causes harm".
Informed Consent should be obtained for Test Spots and should include any potential complications that can occur from performing a test spot. It is better for the practitioner see the patient back to observe the test spot rather then allowing to patient to report on the results. This allows the practitioner to learn what the end result is and eliminates uncertainty if there is a complication.
Chronological aging and changes in the skin are part of the natural aging process. Genetic factors and hormones influence the skin quality and durability over time. Thicker, darker skin tends to wrinkle less.
Environmental factors such as sun exposure, prolonged exposure to wind, cold and pollution cause cumulative damage to the skin over time.
Smoking also causes skin damage over time. Nicotine causes constriction of the blood vessels that decreases the blood flow to the skin. Toxic substances from smoking affect the skin through the circulatory system and may damage collagen and elastin fibres.
Degeneration of elastin fibres and collagen fibres causes the skin to lose it's strength with subsequent loosening of the skin. These changes in the skin lead to the appearance of fine lines, wrinkles, deep facial expression lines and skin laxity. Fine lines and wrinkle are caused by the decline in the quantity and quality of the elastin fibres.
Additional changes in the skin is the gradual thinning of all layers of the skin (epidermis, dermis & subcutaneous layers). Loss of subcutaneous fat is seen in areas of the face and hands. The skin becomes drier due to the gradual decline in the activity of the sebacious glands. There are changes in hair growth with thinning of the hair on the body.
Sun exposure is the primary environmental cause of skin damage along with prolonged exposure to cold and wind. Sun exposure degenerates the elastin in the skin leading to the formation of wrinkles and loss of elasticity. Sun exposure also creates uneven pigment, formation of solar lentigines, dilated blood vessels (telangiectases), wrinkles and skin laxity.
Advanced Skin care and skin rejuvention may include skin tightening with Titan to address laxity. Laser Genesis to address texture and diffuse redness. Laser vein treatment for dilated blood vessels. LimeLight facial to address pigmented lesions but may also treat vascular issues. These treatment modalities may be combined with both Pearl and Pearl Fractional Laser treatments to address both epidermal & dermal changes. Cutera Laser based technology has been optimized to address the many issues of aging skin.
Reference: "Handbook of Cosmetic Skin Care"; Avi Shai; Howard I Maibach; Robert Baran
This myth might be the cause.
"8. MYTH: Let winter-ravaged skin hibernate — cut back on pro treatments.
TRUTH: Actually, winter is one of the best times to start in-office laser treatments like laser hair removal, as pre-laser skin shouldn't be at all tanned, and post-laser skin won't tolerate sun exposure."
To expand on this particular myth, many of Cutera's aesthetic laser and light treatments such as Titan, Laser Genesis, CoolGlide Laser Hair Removal and CoolGlide Excel Laser Vein Therapy are color-blind; they can be performed on all six skin types and can be performed year-round, irregardless of tanned or tanning skin.
Let your patients know they don't have to wait for Spring or Summer to start laser or light-based cosmetic treatments. In fact, they will appreciate that they can get a head-start now!
As presented by Antonio Campo Voegeli, MD at the American Society for Laser Medicine and Surgery
Twenty-Fifth Annual Meeting in
Background and Objective:
The 1064 nm Nd:YAG laser has proved to be one of the most useful light sources for the treatment of deep vascular lesions. A deeper penetration and a lower absorption by haemoglobin makes this wavelength more useful for the treatment of deep or thick vascular lesions than the traditionally used shorter wavelengths (KTP, pulsed dye, IPL, diode) (Figure 1). However, problems with previously used Nd:YAG devices such as limited parameter combinations and pulse durations, non-optimal cooling systems, and uneven fluence distribution made them of limited value for the treatment of superficial or facial vascular lesions, as pain or risk of burning were common events. Since adequate absorption of this wavelength is achieved by haemoglobin, a system able to control depth of penetration through appropriate spot selection (Figure 2), with variable pulse duration to adjust to different vessel diameters, high fluences and optimal cooling systems to avoid pain or burning, should theoretically be able to treat any vascular lesion both superficial and deep or thick. An Nd:YAG laser with variable spot sizes (3, 5, 7 and 10 mm), highly-variable pulse duration (0.1-300 ms) and high fluences (up to 300J/cm2) (CoolGlide Vantage, Cutera) was evaluated for the treatment of a wide spectrum of vascular lesions.
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