LASER EQUIPMENT FOR REJUVENATION

Laser devices are used with great success for the spread, rejuvenation, removal, removal of blood vessels, age spots, scars, stretch marks, post-acne, neoplasms, tattoos, for the treatment of vitiligo, psoriasis, acne (acne), nailsgrowing.

Today's review of laser equipment is very specific: we will get to know the reader in detail with the device for skin rejuvenation.

LASER DEVICE

Laser consists of three main elements:

• energy source (or "pumping" mechanism);
• work body (active environment);
• mirror system (optical resonator).

Energy sourcescan be electrical emissions, flashlights, arc lamps, other lasers, chemical reactions, etc. , which activate the working medium with their energy.

Working fluidis ​​a major determinant of the wavelength produced, as well as other laser properties (monochrome, coherent, narrow focus). There are hundreds and even thousands of different work bodies where lasers can be built. However, the following working media are most commonly used: liquids (consisting of organic solvents, such as methanol, ethanol or ethylene glycol, in which chemical dyes are dissolved), gas (gas mixtures, eg carbon dioxide, argon, krypton or mixtures such as neon heliumlaser; these lasers are most often pumped by electric discharge), solids (such as crystals and glass; solids are usually activated by the addition of small amounts of chromium, neodymium, erbium, or titanium ions); semiconductor.

Therefore, according to the type of working medium (active medium), the laser is divided into:

• gas;
• liquid (on inorganic or organic dyes);
• metal vapor laser;
• solid (crystal, glass);
• semiconductor (or diode).

Optical resonators, the simplest form of two parallel mirrors, are located around the laser working medium. The forced radiation of the working medium is reflected between the mirrors and returns to the working medium, accumulating energy. The wave can be reflected many times before exiting. On more complex lasers, four or more mirrors are used, which also form an optical resonator, but the design is more complex.

The quality of the manufacture and installation of these mirrors is one of the most important conditions for the quality of laser systems.

Also in laser systems, additional devices can be installed to obtain various effects, such as rotating mirrors, modulators, filters and absorbers. Its use makes it possible to change the parameters of laser radiation, for example, wavelength, pulse duration, etc.

LASER EQUIPMENT TECHNICAL PARAMETERS

Laser energy parameters:

1. Power, measured in watts (W).
2. Energy, measured in joules (J).
3. Energy density (J / cm2).
4. Pulse duration, measured in miles, nano-, picosecond.
5. Wavelength, measured in micrometers (μm) and nanometers (nm).

Laser radiation, which acts on living organisms, is subject to the phenomena of reflection, absorption, dispersion. The stage of this process depends on the condition of the skin: moisture, pigmentation, blood circulation, swelling of the skin and underlying tissues.

Many lasers target specific chromophores, which are biological structures that have a clear absorption spectrum. The ability of certain chromophores to absorb light at different wavelengths of different intensities is determined by the absorption spectrum. The unit of measurement of the ability of chromophores to absorb laser light is the absorption coefficient

The spectrum of chromophore absorption varies radically. Therefore, it is important that the wavelength of the laser beam coincides with the wavelength at the peak of the very precise chromophore absorption capacity at which the exposure is planned.

Therefore, there is not a single universal wavelength, i. e. a laser, for all indicators (appointments). So, lasers for hair removal can not rejuvenate the skin, and vice versa. Of course, there are often some purposes indicated in the laser instructions, but in fact there will only be one problem to solve the equipment effectively.

The penetration depth of a laser beam is inversely proportional to the absorption coefficient and, consequently, depends on the wavelength. For different skin chromophores (water, melanin, hemoglobin, oxyhemoglobin), the depth of penetration is also different. For example, in the visible area (0, 38-0, 74 microns, or 380-740 nm), the penetration depth will be 3-7 mm, in the infrared region (0, 76-1, 5 microns) - from 0, 5 to 1, 5 mm, and in the ultraviolet area (0, 3-0, 5 microns), laser radiation is highly absorbed by the epidermis and therefore penetrates into the tissue to a shallow depth, from 0, 2 to 0, 4 mm.

METHODS OF PRODUCING LASER RADIATION

There is apulsed laser and cwproduces radiation. Depending on the pump method, continuous and pulsating laser beam production can be obtained. Pulse light is produced as a disturbed wave beam for a specified period of time. Other lasers produce continuous light, and special devices split this light into short segments. As a rule, continuously generated radiation lasers, in addition to physiotherapy lasers, have unwanted heat-generating properties at the site of exposure, which can cause scarring and damage to the tissues around the site of exposure.

LASER POWER LEVEL

The power of medical laser radiation (in particular, cosmetics) varies within a wide range, determined by the purpose of its use. For lasers with a continuous pump, the power can vary from 0, 01 to 100 W. A pulsating laser is characterized by pulse force and pulse duration. The power of a pulsating laser is several sequences of magnitude higher. Thus, neodymium lasers produce pulses with energy E = 75 J, whose duration is t = 3x10-12 s. Pulse power: P = E / t = 2. 5x1013 W (for comparison: hydroelectric power station power is about 109 W).

In cosmetology practice, including for skin rejuvenation procedures, laser radiation is used both with low power values ​​(low intensity laser beam, LLLT) and high (high intensity laser radiation, LILI).

LOW INTENSITY LASER RADIATION (LLLT)

The action of LLLT is to activate cell membrane enzymes and stabilize lipids. It is known that LLLT stimulates cell division and expansion. The effect occurs at the atomic-fine molecular level, where energy is absorbed under the influence of certain frequency laser beams (as a rule, in the red and infrared ranges). Such energy absorption leads to a sharp increase in intracellular concentrations of Ca2 +, i. e. , there is activation of ATP accumulation and release, cell membrane recovery, increased intracellular metabolism and increased regenerative processes due to activation of cell proliferation (fission). Old cells are intensively replaced with new cells, and the biorhythm of this process is restored. This therapy uses a low intensity laser (with an intensity of 0. 1-10 W / cm2). The maximum wavelength of a laser is 1300 nm. In particular, laser diodes are used for skin rejuvenation procedures:

• transmitters with wavelengths of 890 nm and 915 nm (laser rejuvenation);
• Low intensity lasers with wavelengths of 785 to 890 nm (laser biorevitalization and laser mesotherapy - delivery of active ingredients to the skin via LLLT).

Treatment with laser therapy because of its low intensity is painless and comfortable for the patient. In some cases, a slight sensation of warmth may occur. There is no recovery time, however, to get a clear effect (increase skin elasticity and firmness, microrelief, moisturize and lift the skin), supportive procedures and procedures are required.

The basic set of laser therapy includes a device combined with a control panel (sometimes in the form of a touch screen) and a hand-held transmitter. This kit can include several transmitters (for example, with a large working surface area for working the body and with a small area for working the face), as well as additional tools for various procedures. Laser therapy has small dimensions, low power consumption and the ability to install work media directly on hand tools, without using light guide devices to transmit radiation.

HIGH INTENSITY LASER RADIATION (WHEEL)

High-intensity laser radiation (2500 J / cm2) makes it possible to concentrate significant energy in small amounts, resulting in local thermal heating, rapid evaporation, and hydrodynamic explosions in biological environments. In the field of cosmetology, VILI has the widest range of applications, one of which is skin rejuvenation.

Skin rejuvenation using high-intensity laser radiation is a modern method of lifting, removing and / or reducing the depth of wrinkles, and improving skin quality. For high-intensity laser rejuvenation, the devices are used whose radiation is well absorbed by water (because the skin is 77 percent water). The purpose of using the laser is a rapid increase in temperature in the area of ​​laser pulse absorption with momentary tissue evaporation.

Among the various high-intensity laser equipment for skin rejuvenation, experts typically distinguish two main types of devices: fornon-ablativeandablative methods.

Ablation - evaporation of superficial tissue with laser exposure.

Laser ablation deviceis ​​very effective in combating age-related skin changes: decreased collagen and elastin - skin structure proteins that give it firmness and elasticity. Traumatic laser treatment is used to trigger the renewal process. Moreover, it should be noted that the stronger the injury, the stronger the rejuvenating effect, but at the same time, of course, the longer the recovery period and the higher the risk of side effects.

That is why the main trend in the development of modern lasers for skin rejuvenation is to find a compromise, an attempt to find a way to minimize trauma to the skin, but at the same time get a strong response to regenerative reactions.

Modern ablative devices include:

• Fractional CO2 laser (carbon dioxide laser);
• YAG erbium fraction laser (solid yttrium-aluminum-garnet crystal laser with erbium ions).

You need to immediately define the term "functional".

Fractional lasers are different from conventional lasers because laser beams are forcibly divided into many microbes ("fractions"). This can be done in hardware in several ways:

1. with the help of a micro lens mounted on the hand tool (a large number of beams simultaneously hit the skin);
2. in scanner mode, when a laser beam penetrates the skin sequentially;
3. with a roller attachment, which is controlled by a laser pulse and allows the procedure to be performed in motion.

This leads to the fact that the laser effect on one or another area of ​​the skin becomes not total, but zonal: not the entire surface of the skin is exposed to its effects, but thousands of micro areas, where unaffected tissue remains. Fractional lasers are less traumatic: at the time of tissue processing, they do not cover the entire surface of the skin, but from 3 to 70 percent, depending on the laser setting, while triggering recovery mechanisms throughout the area.

In fact, thanks to the advent of fractional lasers, a new era of laser cosmetology began: laser procedures became less painful, safer ("smoother"), the recovery period after the procedure was significantly reduced (from two days to a week). At the same time, clinical effectiveness does not decrease, but, on the contrary, increases.

Modern carbon dioxide lasersoperate on the principle offractional phototrolysis, which consists in the formation of freezing microzones in the form of columns perpendicular to the surface of the skin. The term "phototrolysis" here means the destruction of tissues under the influence of temperature, which arises in the process of transferring laser energy to tissues (photo - light, heat - heating, lysis - destruction). Laser carbon dioxide has a radiation wavelength of 10. 6 microns. During fractional rejuvenation procedures, these lasers practically remove the micro-zone of the skin practically at the entire depth of the epidermis (up to 20 microns), while the thermal damage zone extends to the dermis by 150 microns or more, causing collagen freezing. This leads to the desired effect (reduction of denominated collagen fibers, smoothing the skin).

There are a number of fractional carbon dioxide devices on the market today with adjustable flux density and pulse duration. This allows you to choose the temperature and depth of heating of the dermis. Thanks to new technology, the time for complete post-procedure recovery is reduced to one week. Firms - modern carbon dioxide laser distributors began to advertise the procedure carried out with their help as a procedure to rejuvenate the "weekend", because when performing fractional laser phototrolysis, the "acute" recovery period (intense edema and erythema) passes in two days off and onMonday patients can go to work.

Erbium lasers have a wavelength of 2. 94 microns and a higher absorption coefficient for water than carbon dioxide lasers. Erbium laser radiation penetrates to a depth of about 1 micron, causing rapid evaporation of the thin layer of the epidermis with almost no damage to the surrounding tissue.

"Erbium laser (Er: YAG) is a special ablative laser. The effect of ablation is so significant that the top layer of the epidermis evaporates without leaving a trace. This laser is ideal for re-surfacing, smoothing scars, removing pigmentation. "

Today, erbium lasers are actively used when working with the most sensitive areas: neck and décolleté, paraorbital and periorbital areas. With this laser, each point can be processed several times, while the doctor has the ability to control the whole process of "milling". This is an erbium laser that is actively used intraoperatively by plastic surgeons. In addition, erbium lasers are preferred when patients are not prepared for long-term recovery.

Non-ablative high-intensity lasersdo not work on the principle of evaporation, but on the principle of water heating and freezing with the formation of new collagen in the affected area.

To apply the non-ablative method, as a rule, lasers with a large penetration depth into the network are selected. In this category, for rejuvenation, the laserneodymium (Nd: YAG)(yttrium-aluminum-garnet crystal doped with neodymium), which has a wavelength of 1064 nm, which corresponds to the near infrared spectrum, is mainly used.

Such laser beams can penetrate into the dermis to a depth of 5 mm. For skin rejuvenation purposes, these lasers are typically used at millisecond and nanodetic pulses, which makes it possible to stimulate collagen synthesis (in almost all cases) without damaging the surrounding tissue, that is, in a non-ablative mode. But when focused in small places, it can also be used for ablation.

In modern cosmetology, neodymium lasers are used primarily to remove unwanted vessels, such as spider veins, but also for photo rejuvenation. This technique has a separate name -ablative skin remodeling. In this case, the object of influence is hemoglobin. The purpose of these actions is to stimulate collagen growth. Heat is produced where the laser beam is absorbed the most, such as the upper papillary layer, and spreads to nearby tissues. The result is a predictable inflammatory response that causes changes in skin collagen synthesis with a corresponding skin renewal effect. Thus, due to partial freezing of the microvascular bed and partial denaturation of collagen structure, lasers trigger the formation of young fibroblasts.

I would like to see the latest developments in the field of laser technology for skin rejuvenation - the advent of picosecond lasers.

"In 2015, the main theme of all major international conferences on laser medicine was the use of picosecond lasers for rejuvenation. This is a completely new and promising technology that emerged in 2014 and was approved by the FDA. Principles of operationpicosecond laser transcends selective phototrolysis theory, because it affects tissues not through heating (thermolysis), but through the momentary fatigue of the target with energy ”.

Laser picosecond produces pulses, whose duration is measured in trillions of seconds. Such a short pulse does not have time to cause thermal damage to the tissue, but so much energy is concentrated in it that its target is immediately destroyed into microparticles, forming a vacuole. This principle of exposure is called photomechanical exposure. In response to the formation of vacuoles in the dermis layer, a reaction begins that triggers new collagen synthesis.

Leading experts in the field of laser medicine, who provide independent reports on picosecond fractional technology, argue that these lasers provide a comparable effect to traditional ablative fractional lasers, completely painless for patients. But the most important argument to support this technology for the modern metropolitan population is ultra-short recovery, which takes from three to twenty-four hours. It should also be noted that there is no need to spend time for anesthesia before the procedure, and the process itself, due to the very high pulse rate, does not require more than thirty minutes. "

Lasers for skin rejuvenation can be divided into laser profiles and complex multifunction laser systems ("combining").Each type of equipment has its advantages and disadvantages, fans and opponents. Many cosmetologists see more benefits in so-called laser harvesters.

"Modular platforms make it possible to gradually expand the capabilities of beauticians by purchasing other accessories. Each nozzle has its own type of transmitter, and buying a nozzle is always cheaper than buying a separate device. Keep in mind that such modular systemsallows doctors to have all types of lasers to solve specific problems, and not use a single laser for hair removal and rejuvenation, as selective principles indicate that each wavelength will do one thing, and all other indications are secondary. So modular devices with attachments are madeso that the clinic does not buy 5-6 separate devices, but has one modular platform with different laser devices, and this is always cheaper in terms of money and more rational in terms of patient loading than six separate lasers, each filling the space and full of most patientseither two or three daysa week. "

Some people think that multifunctional devices are not suitable for large clinics where doctors work "quickly".

"Multifunctional machines have one important drawback: such a combination breakdown means the breakdown of all functions at once, and merging is not always a good choice for situations when there are several specialists in the cabin" in the flow "in different offices.

However, the choice depends on the buyer and depends on many factors: company size, profile, number and specialization of doctors, financing, in the end.

"Debating the advantages and disadvantages of both versions is like debating the advantages of a smartphone with a camera over a DSLR. If you want to take pictures, call and surf the Internet at the same time, the choice is clear. But if you are aprofessional photographers, the possibility of a phone camera will not be enough for you. "

To make the right choice of laser rejuvenation machine, experts recommend focusing on the following very important aspects:

1. You need to request the results of the clinical trial of this model from the distributor.
2. You should talk to specialists from different salons and clinics who use attractive equipment, get their feedback.
3. As a rule, serious companies give customers the opportunity to test this device by salon experts, so that employees and administrators can evaluate the effectiveness and advantages of the equipment offered.
4. All laser devices must have a registration certificate from the Ministry of Health and a Gosstandart compliance statement.
5. You should note that the terms of use of manipulation in some models are limited, this implies additional costs. Therefore, you should ask the supplier to provide a document confirming the guaranteed amount of impulse, and not be guided by the words of the manager selling the device.
6. Make sure you meet the distributor of disposable items on the device (other than manipulation), how often they need to be purchased, how much it costs and whether the stock is always available.
7. Find out how post-warranty maintenance of the device will take place, provided what and in what period.
8. Find out who and how the training specialist works on this device, how many specialists can be trained when buying, under what circumstances, the training will be repeated if the specialist staff at your salon changes, and under what circumstances.

In conclusion, we would like to remind you that the use of laser techniques for rejuvenation requires beauty salons and clinics have medical licenses and specialists who are entitled to provide services using this class equipment - doctors who have undergone special training under "laser treatment ".