Advance for Healthy Aging has an interesting article on aesthetic marketing.  It's not enough to do what you did in the past (run a yellow pages ad) and wait for the phone to ring.  You have to be creative and advertise more.

Having an effective call to action is vital - as you can see in the article:

"Your offer. In today's world, you cannot expect much of a response if you don't give your audience a compelling reason to respond and a deadline in which to do it. So many physicians pay for "Name Recognition" promotional efforts that are all about them. That's fine if you're not expecting anything more than a few patients telling you they saw your ad. But if you want new patients to come through your doors, it won't work. A well thought-out call to action will prompt the aesthetic patient to do just that-take action.

Consider adding a special offer if they respond by a certain day. This doesn't have to be a discount off your procedures. It can be a value-added benefit, such as a free skin care product, with the purchase of a service. The reality is everyone likes a good deal, and your aesthetic patients are no different." 

A time-sensitive offer works wonders - creates a sense of urgency.  So if you are having a special on skin tightening packages or procedures, then ensure your offer indicates that if the package is purchased by a specific date, then another benefit (say Laser Genesis treatments or microdermabrasion) will be included gratis.  Action-Benefit offers work very well!

Happy Holidays to all of you from Cutera!

Skincare Regimens to Optimize Laser Success

Advanced Skin Care and skin rejuvenation starts with careful assessment of the client and tailoring the treatment plan to address the client's concerns.

Dr. Gold emphasizes that routines be customized to each patient’s needs. “You need to look at the patient as an individual. And you need to look at what’s bothering them and what they are there for, and then come up with a treatment regimen that is useful for them before, during and after your procedures,” Dr. Gold says.

Tailoring your treatment regimens to each patient before and after laser resurfacing can be as important as the technology you choose in striving to help patients recapture the more youthful appearance they seek.

After laser treatment, skincare routines promote rapid healing, and enhance and reduce the risk of complications such as infection, pigmentary changes and scarring.

Skin changes that progress with age

Advanced Skin Care starts with basic skin care on a daily basis. Daily skin care is necessary In order the achieve optimal results from chemical peels and Light Based Technology for skin rejuvenation.

It's not just your face that can show your age. Skin changes are also noticeable on your neck, shoulders and hands. These areas are frequently exposed to the sun, wind, changing temperatures and pollution, so they need to be moisturized and protected as well, especially from the sun's harmful UV rays.

Aging Skin

Advanced Skin Care with Laser based technology may require methods of pain managament and control.

 

Examples of Pain Control for Ablative Procedures

 

 

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

 

A topical anesthetic is recommended for most ablative procedures. Prior to treatment, a topical anesthetic such as 7% lidocaine and 7% tetracaine is generally used. CAUTION: Toxicity may result with the overuse of topical anesthesia. Consult the manufacturer’s labeling.

 

Example: Some practices are using a BLT which is a compounded anesthetic.

It is usually 10-20% Benzocaine, 6% Lidocaine and 4% Tetracaine.

It is best to leave the anesthetic on for at least 45 min to an hour.

 

Additional forms of pain management are often used to assist in patient comfort, examples include but are not limited to the following:

 

A Zimmer skin cooling system or small fan blowing

 

Anxiolytics for relaxation and further pain control

 

Nerve blocks

 

Acetaminophen

 

Nonsteroidal anti-inflammatory drugs (NSAIDs)

 

Opioids

 

For more detailed information for assessment and management of acute pain:

 

Institute for Clinical Systems Improvement; Sixth Edition March 2008;

Health Care Guideline: Assessment and Management of Acute Pain

 

http://www.icsi.org/guidelines_and_more/gl_os_prot/musculo-skeletal/pain_acute/pain__acute__assessment_and_management_of__2.html

A very inportant part of a skin care treatment plan is client teaching about the importance of sun block to prevent further damage.

FDA CRITICIZED: A new study reports that 85% of sunscreen products don't live up to their SPF promises or contain potentially dangerous chemicals.

The amount of melanin in the skin can influence the skin care treatment plan.
Accurate skin typing is very important to the success of the Laser treatment and helps to identify the client's risk of adverse events related to pigment (hyper or hypo pigmentation) .  Skin color is influenced by genetics and exposure to ultraviolet radiation.

Fitzpatrick Skin Type Chart


Certain melanin makes skin more vulnerable to sunburn

Causes of Hyperpigmentation

Topical agents used in the management of hyperpigmentation

Postinflammatory Hyperpigmentation

Perform a physical exam and ask questions

Treating Acne in Skin of Color

Aesthetic Procedures in Skin of Color

Laser based technology is regulated by the FDA based on ANSI standards.  Cutera is committed to safe use of  Lasers in Dermatology.  Links have been provided to help educate our clients on the Rules and Regulations associated with the use of aesthetic systems.  Some information may be directed toward Laser Surgery and may appear to not be related to advanced skin care, however, the principles of safety are the same.

USE OF LASERS/DELEGATION OF MEDICAL FUNCTIONS REGULATION BY STATE

Laws and Regulations

Current Legislation Pending by State

Directory of State Medical Boards


Laser Regulatory Agencies and Professional Organizations

Food and Drug Administration

American National Standards Institute (ANSI Z136.3)

Joint Commission on Accreditation of Health Organizations (JCAHO)

JCAHO

OSHA (Occupational Safety & Health Administration)

Association of Operating Room Nurses

American Society for Laser Medicine and Surgery (ASLMS)

Clients seek advice for advanced skin care for Acne, Melasma and skin rejuvenation. It is important to identify the root cause of the condition in order to recommend an appropriate and effective treatment.

Three main factors contribute to the formation of acne: androgenic hormones, plugging of the hair follicle, and bacteria.   7 Acne Myths

Melasma is hyperpigmentation in sun exposed areas. The skin care treatment plan for melasma may include topical medications, chemical peels and Laser based technology.

Laser Genesis has been found to be helpful as a part of skin care treatment plan for treating Melasma. However, it should be noted that anything you use to treat Melasma may make it worse. A treatment protocol that is very effective for one client will not work on a different client and may even make their symptoms worse.
R. Lierly, RN

Advanced skin care and Laser based technology has become increasingly popular and growing field of study for many health care professionals. Clients are requesting a number of diverse procedures when they seek our assistance. It is not uncommon to have a client who requests "Skin Rejuvenation". The skin care treatment plan may consist of skin tightening, Laser Genesis and a Limelight facial for a vascular treatment or pigmented lesions. It is quite possible that this same client may later request a chemical peel, Botox or fillers and even Laser hair removal. The diversity of the procedures requires the treatment provider to have a wide range of knowledge in order to adequately meet the client's needs. Some resources I have found to be easy to read and a very valuable resource are listed below. Of course, there are many specialized books that are available and can be found at the links listed below.

Cosmetic Laser Books

Laser and Lights Volume 2

Cosmetic Laser Surgery

R. Lierly, RN

Skin of Color can present with unique conditions that must be taken into consideration when developing a skin care treatment plan.
Skin of Color is highly susceptible to Post-Inflammatory Hyperpigmentation and requires special care whether performing a chemical peel or using Laser based technology to treat pigmented lesions, performing Laser hair removal, Skin Rejuvenation or a Vascular Treatment.
The Fitzpatrick Skin Type Test is very important to help determine skin type. The FitzpatrickSkin Type Test takes into consideration an individual's genetic predisposition that may not be reflected in the color of the skin but can highly influence the individual's ability to form hyperpigmentation in response to trauma or the use of an Aesthetic Laser System.

--Renee Lierly, RN

Laser based technology is both safe and effective for permanent hair reduction, skin rejuvenation, skin tightening, laser vein treatment and treatment of pigmented lesions. The use of an aesthetic laser system for advanced skin care requires the operator to be familiar standards of care and laser safety in order to be in compliance with Laser regulatory agencies such as JCAHO, OSHA, ASNI standards and state regulations.

The Laser Training Institute offers Aesthetic Laser Training and National Laser Certification. The laser course offers a foundation in aesthetic office procedures and safety.

Renee Lierly, RN

Allied Health Association offers medical malpractice insurance for physicians working in the spa environment. This insurance was developed in response to an expanding need for liability insurance for the growing medspa industry. This insurance covers advanced skin care procedures and Laser based technology. The skin care treatments covered are skin rejuvenation procedures such as resurfacing, vascular treatment, chemical peel, Botox, fillers and much more.

Source: Modern Medicine Publish date: Jul 1, 2008

Renee Lierly, RN

A skin care treatment plan to manage the symptoms of Rosacea may include topical and oral medication, Laser based technology, avoiding agravating factors, skin care products and may even include camoflage makeup. Many treatment providers combine Cutera's Infrared Technology of Laser Genesis and the visible to infrared technology of a LimeLight facial (LimeLight 520nm-1100nm) to address the vascular treatment needs of flushing, diffuse redness and telangiectasia.
It is important to educate the client that a treatment plan for Rosacea only helps to control the active signs and symptoms. Rosacea is a chronic condition.

Treating Your Skin with "Intense Pulsed Light"

By Kevin C. Smith MD FACP FRCPC

About the author:
Dr. Kevin Smith is a dermatologist in Niagara Falls, Ontario with a particular interest in protecting the skin and in correcting skin problems resulting from aging, rosacea and sun damage. He is an expert in the use of Botox®, fillers, lasers and intense pulsed light to maintain and enhance the appearance of the skin, and have lectured on those subjects across North America, and in Europe, Asia and Mexico. Read more at www.smithlaser.com

--Renee Lierly, RN

---

How Skin Thickness Affects Wrinkling 
Fighting Wrinkles
Tips for Healthy Skin and Beauty and other Skin Care Resources  
Content Developed By SkinCareGuide Dermatologists.   

Skin care treatment and skin rejuvenation plans may include chemical peels, microdermabrasion and Laser resurfacing in order to reduce pigmented lesions and produce skin tightening. Post operative care is imperative to successful results and favorable client experiences. biO2 Cosmeceuticals is a product line that has demonstrated the ability to reduce client discomfort, reduce post operative erthema and reduce healing time which improves patient perception of the procedure. This post operative skin care regime can be used after Laser resurfacing, microdermabrasion, chemical peels or burn wound care.

Renee Lierly, RN

Skin care treatment plans start with washing the face. Skin rejuvenation and improvement in the overall texture and quality of the skin can be achieved by combining Laser based technology and cosmeceuticals together in an advanced skin care program. It is important to wash the face with something clean in order to prevent introducing bacteria into the skin. One simple way to achieve this is by the use of disposable daily cleansing pads, such as Aveeno Positively Radiant Daily Cleansing Pads  These dual-textured cleansing pads are smooth on one side to lift away dirt, oil and makeup and textured on the other side to gently exfoliate and smooth away dry patches. Gentle enough for everyday use and even for sensitive skin. Additional Product Benefits Include: soap-free, oil-free, hypoallergenic, noncomedogenic.

Travel tip: Count out the number of pads needed for your trip, add a small amount of your favorite facial wash, place in zip lock bag. They do not count as a liquid or a gel. You can always wash your face with a clean, soft pad or use the textured side for a mild exfoliation.
 
How to wash your face 

Renee Lierly, RN

Many aesthetic practices retail up to several lines of skin care products.  Some also include makeup products.  Mineral-based makeup offers many advantages to patients who are investing in aesthetic procedures to their skin.

• Mineral makeup is non-comedogenic
• Mineral makeup usually includes some form of SPF
• Minerals complement all skin types
• Mineral makeup is great for covering up conditions you are in the process of treating (pigmented lesions, vascular treatments)
• Mineral makeup is HOT - lots of buzz

So, which line should be your mineral makeup line?  You have many options!  I've listed some of the companies who allow resale of their products in alphabetic order.

• Colorscience
• GloMinerals
• Jane Iredale
• True Cosmetics
• Youngblood

BareEscentuals is another mineral makeup manufacturer well-known to consumers because they are resold in large cosmetic stores such as Ulta and Sephora, on QVC as well as in BareEscentuals retail stores.  I was not able to source a web site for reselling their mineral makeup but I have seen their line carried in some day spas.

Another option is pursue private label mineral makeup with your own name and brand.  An article with Skin, Inc. magazine indicates that sales of private label brands is on the rise.

From personal experience - I have been a big fan of mineral makeup since I discovered BareEscentuals in 2001.  I have purchased products or tried samples from Colorescience, GloMinerals and Youngblood and I've been very pleased with them.  I've heard great things about Jane Iredale but the one product I purchased did not agree with my skin (possibly a fluke).  I have not tried True Cosmetics makeup which carries the anti-aging ingredient Idebenone but a Cutera customer recently raved to me about how much she loves this line.

Do your research. Talk to your sales reps from the different lines and speak to your colleagues about which lines they carry (and why).  Then you can choose the right mineral makeup partner for your practice.

I had a chance to visit with some skin care reps at ASAPS and I'm very excited about their product lines. 

First of all - physicians should have retail cosmeceuticals in their practice and should strongly consider prescription-based products as well.  After treating and improving your patient's skin, it's a natural fit to offer sun protection, serums, moisturizers, cleansers and eye creams.

There are a number of vendors who offer a complete line of skin care products while other vendors may focus on one or two specialty products.  I won't list them all but I did speak to reps at these three companies at ASAPS.

I had a chance to talk to Marina Youngdale at TOPIX Pharmaceuticals, Inc. who introduced me to their Topix Replenix CF line which contains green tea polyphenols and caffeine USP to deliver enhanced antioxidant benefits.  Topix has a private label program so physicians can offer Topix products with labels reflecting their name, logo and brand.  Details may be found on their web site www.topixpharm.com.

I also met Arely Cruz at Remergent (AGIDermatics) who told me about their product line and provided me with some interesting clinical studies about the improvement of collagen through their serums.  You can access those studies on their web site www.remergentskin.com.

Lastly, physicians should consider a prescription-based skin care line such as Obagi which is not sold outside of physician offices so it's a fairly exclusive but well-known product line.  One of my colleague is on an Obagi regimen and her skin looks great now.

There are also cosmetic product lines, primarily mineral-based, which are appropriate for aesthetic practices and I'll cover some different brands in another post.  Always do your research and meet with vendor reps to help you decide which lines are best for your practice to carry and resell.

The brilliant folks at Laser Skin Solutions came up with a great promotion for Mother's Day.

Teaming up with the number one station in Palm Beach County (with whom they advertise), Karen Lederman and her team are offering an aesthetic treatment package valued at over $5,000.

The station, in conjunction with this contest, is also giving away a $200 laser facial at Laser Skin Solutions during a popular day segment where they promote the contest.  They are asking listeners to nominate a mother in need of a makeover for this contest and directing them to their web site where the contest is featured.  The contest was also part of an eblast to a 30,000 opt-in email list of listeners.  

This is great exposure for Laser Skin Solutions!  Lots of station listeners are hearing their clinic name and learning what types of aesthetic services they offer (BOTOX, fillers, laser hair removal, skin rejuvenation, microdermabrasion, advanced skin care such as Obagi, etc.).

In the first five days of the promotion, the station received over 40 submissions (photos plus a 50 word story on why that mother needs a makeover).  

Think about contests you could create yourself with the support of a local media outlet (radio, TV, newspaper).  Ideas might include Mother's Day, Father's Day, Valentine's Day or the seasons (Spring, Weddings, Swimsuit season, Summer vacation, Back-to-School...).   

Bravo on a very clever promotion - highlighting an important day for women, donating services to help a mommy-in-need and successfully promoting your practice.  This is a win-win idea.



 

Cutera announced our new fractional laser using the YSGG wavelength - a fractional version of Pearl at ASLMS.  We are very excited about the future applications of this ablative skin resurfacing technology as both a stand alone product and also combined with Pearl.  Fractional Pearl will complement our other aesthetic solutions nicely.

While working in the Cutera booth at ASLMS this past weekend, I took some time to walk around the exhibit floor with Karen Lederman, of Laser Skin Solutions, to learn about some new products for advanced skin care.

We stopped by PuriGenex where Dr. Suzanne Bennett applied a refreshing collagen mask to our faces. It minimized my fine lines and was an overall pleasant treatment.  PuriGenex is based in Santa Monica, CA.  Their collagen products are kept refrigerated to prevent them from denaturing.  They offer masks and serums for purchase.   

I also spoke with Laurie Walkenhorst of Carrollton, TX based Swiss-American, makers of the Elta MD Skincare line.  I've been a personal fan of their sun protection moisturizers and creams for the past few years.  Elta MD has a new Hydrovase Gel.  Their new skin care treatment seems well-suited to reduce redness and inflammation after laser treatments.

Another new and intriguing product on the show floor was the Ice Mask.  This mask looks like it has great potential for application post-laser procedures to cool the face and provide greater patient comfort.  Several Cutera customers are looking into adding this to their immediate post-Pearl protocol and I will follow up with them to see how effective the Ice Mask is for post-procedure cooling/comfort.


I found this video on the Ice Mask on YouTube; in Italian but I think you will see how it works.

More news soon!