Equipment for Aging Skin

With all the constant advancements in our industry, estheticians have never been in a better position to achieve the best anti-aging results for our clients’ skin. There are endless choices of products and modalities available that promise to improve our bottom line, attract and retain new clientele, and gain a competitive edge over other skin care professionals in our area.

Having a results-oriented product line is one part of the equation, the other is purchasing the right tools and equipment. In selecting the right equipment for your esthetics practice, take into consideration your budget, the space in your treatment room, and your clientele demographic. Will this device increase your profits, and how long will it take to recuperate the cost of the device?

In addition to the factors above, you may only operate devices that are listed within your scope of practice as an esthetician. Although all of the equipment in this article is intended for anti-aging and rejuvenating purposes, not all of it is accessible to estheticians. For example, IPL and laser devices are designed with different wavelength settings. In a medical esthetics practice, physicians, nurses, physician assistants, and estheticians will operate these devices. In most states, only a physician or registered nurse is allowed to operate IPL and laser machines. You have to check with your own state. 

In the U.S., there are four classes of medical devices. The class is a FDA classification that refers to how aggressive the device is and whether it requires a physician or nurse under the supervision of a doctor to operate it. I will discuss several types of lights in this article, they are all different, and are classified as Class I- Class IV. LED lights are (most likely) Class I - Class II, IPL and laser are Class III or IV medical devices found in medical offices and medical spas.

Because IPL and lasers are medical devices, they are not included within our scope of practice. The light device you can buy as an esthetician is an LED light therapy tool, which is the most gentle type of light treatment, with no contraindications.

Laser

Laser is an acronym. It stands for Light Amplification Stimulated Emission Radiation. 

An IPL laser (Intense pulsed light) usually gives good results for diminishing redness, fresh hyperpigmentation, and stimulating mild collagen growth. A series of 6 is recommended, and the cost is usually around $500.

Photorejuvenation laser treatments are most commonly used for lightening and removing hyperpigmentation on the face, neck, chest, hands and other areas of the body, as well as reducing redness and rosacea. It has a lesser effect of improving skin texture through collagen stimulation and improves pore size minimally by temporarily reducing oiliness. Like all laser treatments, it’s best to do this treatment in the winter time, and the client will need maintenance treatments when brown spots reappear, usually once or twice a year. This treatment can be administered by a doctor, PA-C (certified physician assistant), ARNPs, RNs, or MAs.

During the treatment, the IPL device sends short, concentrated pulsating beams of light at irregular skin. The light bypasses the epidermis and gently heats the cells in the dermis. The fibroblasts start to produce more collagen, which improves texture and fine wrinkles. The new skin that forms is smoother and firmer. The client has a sensation of light sunburn immediately after the treatment, and may experience a prolonged redness, swelling, oozing, delayed wound healing, scarring, crusting or scabbing, pigmentary changes, and acne flare-ups. 

Fractional lasers are newer and also treat wrinkles and post-acne scars. The non-ablative fractional lasers, like the Fraxel, may cost as much as $5000 for 6 treatments, and have a two day down-time.  This laser will take two to six months to give the best results.

Ablative fractional lasers, like the Active FX, have a four to eight day down-time day downtime and give a better result for the crinkly areas on the neck. The cost of this procedure is usually $1,000-$2,000 per treatment, and a series of four is recommended over a six month time span.

LHE (Light Heat Energy)

LHE Skin Rejuvenation uses the combination of light and heat energy at low fluencies to target the dermis. This process is completely safe for the client and requires little downtime. The natural fusion of light and heat energy increases overall effectiveness of the procedure and speeds up the healing process compared to other skin rejuvenation techniques that only use light or heat. Skin rejuvenation also accelerates blood circulation, allowing better absorption of anti-aging serums and creams.

LHE Skin Rejuvenation can be separated into several treatments used to treat skin concerns that most clients experience in older age: 

• Collagen Renewal
• Wrinkles Reduction
• Rosacea Treatment
• Pigmented Lesion Treatment
• Vascular Lesion Treatment

Using LHE technology, skin rejuvenation works by applying short pulses of light and heat energy into the dermal-epidermal joining area deep in the skin. The procedure affects the skin just enough to trigger a wound-healing response which produces new collagen under the undamaged layer, thereby replacing the old collagen. Fibroblast stimulation then occurs to help further build collagen and elastic fiber cells in the connective tissue of the inner layer of the skin. The effect of the LHE method gives the skin the elasticity it needs to look firm and plump. 

The skin rejuvenation process can occur over a few weeks or up to a few months. During this time, the wound-healing response will significantly improve the skin tone and texture of the skin. The healing process will also fade away fine lines and wrinkles. Depending on the type of treatment you get, a full treatment course ranges from six to eight sessions spaced one to three weeks apart to get maximum results.

LED

After the age of 30, we lose approximately 1% of collagen per year. To rejuvenate the skin, and stimulate collagen and elastin production, one of the best modalities is LED – light emitting diode - a tiny computer chip encased in glass. Red/Amber anti-aging LED therapy is non-invasive, painless and requires no recovery time. It is safe for all skin types and tones, and a full treatment requires only 20 minutes. 

Each LED wavelength (color) of light provides unique therapeutic benefits. Blue kills germs and bacteria, amber stimulates collagen and elastin, red stimulates circulation and calms down inflammation, and infrared heals and calms the skin and also improves product absorption. The best combination of lights for anti-aging and skin rejuvenation is red, infrared and amber together. This type of light synergistically minimizes the appearance of large pores, increases moisture retention, prevents environmental damage, renews the skin, and encourages new collagen production. Such lights are available for home use in a handheld, as well as panels for faster and more convenient treatment room services. LED lights are in our scope of practice, and can be used by estheticians in all states with no physician supervision.

Panel LED lights are the most convenient type of phototherapy equipment, since they don’t require direct hands-on supervision, and cover a larger treatment area than a handheld for a full 20 minutes. This type of treatment can be added as an a-la-carte to your service menu, and is also beautifully incorporated into the facial with clear serums, crèmes and masks. Clear products work best, because they allow the light to shine through, uninterrupted.  Using the LED panel with peptide serums, crèmes, and masks increases the efficacy of the light, and promotes instant and cumulative skin tightening and reduction of wrinkles.

Galvanic

Galvanic current is a constant and direct current (DC) that uses a positive and negative pole to produce the chemical reactions when it passes through tissues and fluids in the body. The two main reactions of the galvanic machine are

ionic iontophoresis and chemical desincrustation.

For the best anti-aging results, both desincrustation and ionic iontophoresis are advised. In the beginning of the treatment, we use desincrustation. Desincrustation is a deep cleansing treatment that softens and emulsifies sebum, and is the ideal in preparing the skin for extractions. It should be done after cleansing the skin, using desincrustation fluid - a type of alkaline solution made from sodium chloride (table salt) that causes an alkaline reaction to soften the follicles for deep cleansing.

At the end of the facial, we can use the galvanic machine to penetrate products. Starting with desincrustation reduces the barrier properties of the skin by assisting with exfoliation, making it easier for ions to move across the skin during iontophoresis. 

Although this is a very commonly used machine in our scope of practice, don’t forget to make sure the client fills out the consultation form, and is not contraindicated to receive a galvanic treatment. Contraindications for using a galvanic device are: pregnancy, metal implants/pins in the face or body, epilepsy, pacemaker, and high blood pressure.

Along with the galvanic machine, some of the most popular modalities among estheticians in skin tightening and firming are microcurrent and radio frequency. The ideal client for a microcurrent or radio frequency (RF) procedure is anyone over the age of 21, who may be concerned with wrinkles, loss of skin tone, muscle tone and elasticity, as well as clients complaining of an overall droopy appearance - sagging jowls, flat cheekbones, and pronounced nasolabial folds. 

Microcurrent

As far as this modality is concerned, it’s less about improving the skin’s texture, but about tightening the muscles. Microcurrent mimics the body's own natural bio electrical field and sends tiny electrical currents to our muscles. Two ball probes, negative and positive, with current running between them stimulate the muscle, causing tightening. Microcurrent devices lift and re-educate muscles, creating a lifted and convex appearance. Combining ultra low frequencies with a modified waveform enables the microcurrent to recharge the electrical potential of the muscle by stimulating the spindle cell fibers that run the length of the muscle.

Originally developed for treating facial palsy, microcurrent devices as used in our scope of esthetic practice: 

• Re-educate muscles
• Increase blood and lymph circulation
• Enhance the penetration of the active ingredients of skin care formulations
• Increase the production of collagen and elastin
• Increase protein synthesis, gluconeogenesis and cell membrane transport 

Additionally, research has shown that microcurrent may help with anti-aging at an even deeper level – in studies, it has increased levels of adenosine triphosphate (ATP) in lab-rat skin cells by 500%. These devices come in a variety of sizes and intensities ranging from free-standing units, to table tops and handhelds.

Radio Frequency

Radio frequency (RF) is a procedure commonly used for the treatment of skin laxity from an increase in tissue temperature. This is an anti-aging modality that produces a selective and controlled rise in tissue temperature from a high frequency alternating current (0.3 to 10 MHz). The rising of temperature and the depth of heating depend on the level of energy used and on the impedance of biological tissues. The goal is to induce thermal damage to thus stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue. After a series of treatments, the facial skin in the treated areas appears more firm and tight. 

The most popular form of radio frequency skin rejuvenation is Thermage.

Thermage treatments are all about energy – focusing radio frequency energy to kick start the body’s own natural renewal process. Like most smart technologies, the process is relatively simple – it’s a combination of heat energy to treat deep tissue, and cooling effects, to protect the skin surface and deliver better patient comfort. Thermage treatments are typically 45 minutes for eyes or face and up to 90 minutes for larger body areas.

Treatment begins with a cooling effect on the skin for comfort and safety of surface layers. A specially designed treatment tip is placed against the skin in targeted areas, then radio frequency energy penetrates deep into the skin’s tissue, heating the treatment areas and remodeling the collagen. At the end of the process, there is a final delivery of cryogen to cool the epidermis.

Benefits include:

• Smoothing of wrinkly or uneven skin
• Better definition of facial features around the eyes, jaw and neckline
• Smoothing and toning of unsightly bulges, dimples and wrinkles on the face and body

Most patients begin to see benefits from this treatment after the first session, and typically three to six treatments are necessary to achieve optimal results. Production and strengthening of collagen in the skin, called collagenesis, is a gradual process, so smoothing and tightening changes become more apparent as time goes on, with full results achieved after three to six months and lasting one year or longer. Single maintenance treatments are recommended every nine to twelve months.

As with the microcurrents, RF devices come in a variety of sizes and intensities ranging from free-standing units, to table tops and handhelds.

Take your time to select the best modalities for your treatment room. Consider the devices that are within your scope of practice, as well as within your budget. Don’t blindly follow the trends, but do your research and make the most educated purchase for your client demographic and budget. When used correctly and in combination with the right products, these devices are sure to increase your bottom line, and provide the best non-surgical face-lift results your clients are looking for.