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Chapter 3 - Adept Beauty
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How the Procedure Works

 

Young, elastic skin depends on the number of structural proteins such as collagen and elastin. These proteins help the skin resist temporary changes such as stretching, folding, or wrinkling. As we age, one’s body produces less of these structural proteins, making the skin more prone to show signs of aging, such as fine lines and wrinkles. 

A mild superficial controlled burn by using voltaic/plasma arcs or Lasers induces a skin tightening effect which helps the skin restore more of its natural elasticity. This occurs because a localized excitation, stimulates the skin's regeneration response, resulting in firmer, tighter skin between the wrinkles and hence the reduction in the appearance of wrinkles and fine lines. Similar results are also possible by using other skin rejuvenation methods, like AHAs (alpha hydroxy acid) based cosmetic peels, however the use of voltaic arc or cosmetic lasers are generally more selective because it can be applied exactly where required, therefore inducing the skin tightening exactly where the client needs it, with a higher degree of precision. We refer to this type of skin tightening as "localized skin tightening" or "targeted skin tightening".

There are two types of plasma arcing. Electrofulguration and Electrodessication

Plasma Fibroblast Therapy works by way of electrofulguration. Skin tightening using voltaic arcing also referred to as PLASMA, produce mild appreciable cumulative improvements in the appearance of fine lines and reduces the appearance of sagging skin. 

In Fulguration Configuration above, the electrode does not touch the skin or tissue and once the spark occurs the current flows from the tip of the electrode down to earth following the path of least resistance.

When the equipment is set up in electrofulguration mode the electricity flows from the tip of the electrode through the body (which at medium/high frequency reacts as a Faraday cage) down to earth, and a return pad is not usually needed. Because the current flows superficially to earth, the result is a very superficial carbonization of the superficial part of the skin (epidermis), lesion or benign mole.

Because of its higher degree of precision in tissue carbonization, electrofulguration is used in aesthetics for:

→ Benign moles and benign skin lesions removal in general.

→ Tattoo removal.

→ Permanent Makeup removal.

→ Brown spot removal.

→ Skin tightening … and more 

 

The Uses of Electrodessication (when the Equipment configured with a return pad) are usually:

→ Permanent epilation.

→ Red vein coagulation for aesthetic reasons.

→ Benign skin lesions removal in General.

 

3.02

Pre-Procedure Consultations

Contraindications & Managing Expectations

 

 

Confidentiality is an important part of the therapeutic relationship between a client and a therapist. Whilst carrying out a consultation it is important for you to stress that all personal information relating to the client will remain completely confidential, and that information will not be disclosed to a third party without the client’s written consent. 

Contraindications are conditions that may be present on a client and are such that you would not be allowed to proceed with the treatment, unless they have written confirmation from their General Practitioner that it is safe to do so. 

It is essential that you not only look for these problems, but you should have already asked your client if they were aware of any issues when you did your consultation. 

It is vital that you check for contraindications - should you ignore them so that you can do the treatment and get paid, you could find that the treatment makes the problem worse. If you are at all unsure, you should suggest that the client visits his/her General Practitioner to have the matter checked before you provide the treatment.

The client must be in good health at the time of the treatment, with no underlining chronic health conditions. If the client displays signs of cold or flu the treatment must be postponed. 

The client must not display any tanning at the time of the treatment. This is especially important for tattoo removal or permanent makeup removal. 

  • Contraindications are conditions that may be present on a client and are such that you would not be allowed to proceed with the treatment, unless they have written confirmation from their General Practitioner that it is safe to do so. 

  • It is essential that you not only look for these problems, but you should have already asked your client if they were aware of any issues when you did your consultation. 

  • It is vital that you check for contraindications - should you ignore them so that you can do the treatment and get paid, you could find that the treatment makes the problem worse. If you are at all unsure, you should suggest that the client visits his/her General Practitioner to have the matter checked before you provide the treatment 

  • The client must be in good health at the time of the treatment, with no underlining chronic health conditions. If the client displays signs of cold or flu the treatment must be postponed. 

  • The client must not display any tanning at the time of the treatment. This is especially important for tattoo removal or permanent makeup removal. 

  • If the client wears a pacemaker, avoid treatment with electrical arcing.  

  • Current or history of cancer, especially malignant melanoma or recurrent non-melanoma skin cancer, or pre-cancerous lesions or after recovery from cancer till off medication for 6 months and have General Practitioner approval prior to commencing treatment 

  • Any active infection 

  • Diseases such as a history of recurrent Herpes Simplex, Systemic Lupus Erythematous or Porphyria The client must not display herpes simplex and not have had herpes simplex in the past even if dormant at the time of the treatment. In case of clients with herpes simplex, a full antiviral course should be completed before starting the aesthetic treatment. 

  • Use of photosensitive medication, and/or herbs that may cause sensitivity to such as, tetracycline or St. John’s Wart 

  • Immunosuppressive diseases including AIDS and HIV infection or use of immunosuppressive medications 

  • Diabetes unless under control 

  • History of bleeding coagulopathies or use of anticoagulants 

  • History of keloid scarring 

  • A history of heart disease (Angina, heart pacemaker, taking anti-coagulant drugs) 

  • Use of oral or topical Roaccutane or Retin A, vitamin A or other such products in the previous 3 months for the treatment of acne or other dermatological conditions 

  • Surgery in the past 6 months

 

3.03(a)

Anatomy and Physiology

 

In our basic course we gave you all the information on the anatomy, fibroblasts, and additional structures and functions of the skin. This section is to continue to familiarize your knowledge of elements of the skin.  

Appendages of the skin 

 

Hair: hairs are dead structures that are made of a hardened protein called keratin and grow out from follicles. Most of the body is covered with hairs, with the exception of the palms of the hands and the soles of the feet. They help to keep the body warm and are also a form of protection. The eyelashes prevent substances from entering the eyes, and the hairs that line the nose and ears help to trap dust and bacteria. The hair is made up of three layers:  

  • Cuticle – is the outer part of the hair and consist of a single layer of scale-like cells. These cells overlap like tiles on a roof. No pigment is contained within this layer.  

  • Cortex – lies inside the cuticle and forms the bulk of the hair. It contains melanin, which determines the color of the hair. The cortex helps to give strength to the hair.  

  • Medulla – is the inner part of the hair and is not always present. Air sacs in the medulla determine the color tone and sheen of the hair because of the reflection on light.  

 

Hair follicles – is an indentation of the epidermis with the walls of the follicle being formed and extended into the dermis.  

 

• Arrector pili muscle – are small muscles attached to the hair follicles. When we are cold or frightened the contraction of these muscles causes the hairs to stand on end. This results in the appearance of goose bumps. Air is trapped between the skin and hair and is warmed by body heat.  

• Sweat Glands – Sweat consists of 99.4 percent water, 0.4 percent toxins and 0.2 percent salts. There are two types of sweat glands in the body:  

- Eccrine glands – which excrete sweat and are found all over the body. The sweat duct opens directly on to the surface of the skin through an opening called a pore. Sweat is a mixture of water, salt and toxins. Ethnically darker skin tones contain larger and more numerous sweat glands than white skin tones.  

 

- Apocrine glands – these are found in the armpits, around the nipples and in the groin area. They secrete a milky substance. These glands are larger than eccrine glands and are attached to the hair follicle; they are controlled by hormones and become active at puberty. The break-down of the apocrine sweat by bacteria causes body odor. Substances called pheromones are present in this milky substance; the smell is thought to play a part in sexual attraction between individuals and the recognition of mothers by their babies.  

• Sebaceous glands – are small, sac-like structures that produce a substance called sebum. These glands are found all over the body except for the soles of the feet and the palms of the hand.  They are more numerous on the scalp and areas of the face, such as the nose, forehead and chin. The glands are attached to the upper part of the follicle and its duct enters directly into the hair follicle. Hormones control the activity of these glands and, as we get older, the secretion of sebum decreases, causing the skin to become drier.  

• Sebum – is a fatty substance and is the skin’s natural moisturizer. It keeps the skin supple and helps to waterproof. Men secrete more sebum than women. Sebum and sweat mix together on the skin to form an acid mantle. The acid mantle maintains the pH (acid/alkaline level) of the skin.  

• Blood and capillary network – blood is supplied to the skin by small blood vessels known as blood capillaries, these enter the lower regions of the dermis and rise to supply the pilo-sebaceous follicles and the sub-epidermal network, which also supplies the epidermis. The blood flow within the skin operates as an aid to vital respiration. Capillaries also help with the heat regulation by dilating (widening) and constricting (narrowing) to prevent body heat losses.  

• Sensory Nerves – the skin contains sensory nerve endings that detect changes in the environment and send messages to the brain. These nerves respond to touch, pressure, pain, cold and heat and allow us to recognize objects from their feel and shape.  

• Motor Nerves – the skin contains motor nerve endings that convey impulses from the brain, through the spinal cord and to the muscles, glands and smooth muscular tissue.  

• Fibers Nerves – are cordlike structures carrying impulses from the periphery, muscles and joints to the brain and spinal cord. Messages pass along the nerve fibers as electrical impulses via a network of interlocking fibers surrounding the upper part of the follicle, forming a collar. Fibers extend to the sebaceous glands, epidermis, arrector pili and sweat glands.  

 

The Lymphatic System: A system of fluid balance and immune defense. 

When plasma passes out of capillary walls into the surrounding tissues, it is called interstitial fluid and provides the necessary nourishing substances for cellular life. 

This interstitial fluid contains proteins that help draw fluid across the capillary wall. 

Here, it will be drawn to the hyaluronic acid content of the glycosaminoglycans gel, aiding the support of collagen, elastin fibrils, and the many other cells that reside in the dermis. Some fluid will move up through the dermal/epidermal junction towards the epidermis to aid the hydration of the epidermal cells and become part of the trans-epidermal water loss (TEWL) of the epidermis. 

After bathing the cells, 90-98% of the interstitial fluid re-enters the capillaries, returning to the heart through the veins. The other 2-10% returns via the lymph capillary system, which is a system of dead-end capillaries that extend into most tissues, paralleling the blood capillaries. 

Lymph fluid is the nourishing fluid of the cells. The lymphatic system is not only a reservoir of organic fluids and defense system against microbial invasion: Lymph fluid is also the healer of wounds, the builder of tissues and regenerator for the body. 

Glycation 

Sugar attaches to proteins; a process called glycation, and the proteins collagen and elastin become linked. Whereas protein strands normally slide over to one another, become attached to the glucose and cannot move about freely. 

Role of Glycation in ageing 

Perhaps the worst consequence of glycation is linking, which is the formation of chemical bridges between proteins and other large molecules. 

 

A material that undergoes linking usually becomes harder, less elastic and has the tendency to become brittle and fragile. In an aging skin, glycation causes the loss of resiliency (bounce back) and feeling of adhesion (hardening) under the skin and stiffening joints. 

 

Advance glycation end products (AGE’s) 

AGE’s exert their harmful effects on two levels; most obviously, they physically impair protein, DNA and lipids, altering their chemical properties. They also act as cellular signals, triggering a cascade of destructive event when they attach to their cellular binding sites. 

 

A sagging and inflexible skin is a result of this process; aggravating the appearance of aging in addition it can have a detrimental effect on microcirculatory system of the skin. 

Anti-glycation Agents 

Immune system cells called macrophages, which combat glycation. 

The only apparent draw back to this defense system is that it is not complete and levels of AGE’s increase steadily with age.

 

One reason is that kidney function tends to decline with advance age; another is that macrophages become less active, thus having a negative effect with the skin immune system. 

 

Once AGEs form they can directly induce the linking of collagen, even in the absence of glucose and oxidation (free radical) reactions. 

 

Carnosine: anti-glycation 

The natural di-peptide carnosine may be another answer to the aging process, especially glycation. Carnosine is a multiple function di-peptide made up of a chemical combination of amino acids beta- alanine and L-histidine. Carnosine has the remarkable ability to rejuvenate cells, restoring normal appearance and extending cellular life span. It also inhibits the formation of AGE’s, it can protect the normal proteins from toxic effects of AGE’s that have already formed. Carnosine is by far the safest and most effective natural anti -glycation agent. Studies have shown that carnosine inhibits damaged protein from damaging healthy proteins, and helps the proteolytic system dispose of damaged and unneeded proteins. The main dietary source of carnosine is red meat, poultry and fish so take note during the consultation process of your clients eating habits to ensure they are balanced.

 
 
 
Chapter 3 - Section 5 - Adept Beauty
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3.03(b)

Pre-Procedure

 

What to tell the client before treatment: 

  • WAIT until all the scabs have fallen off. Although clients can resume their activities immediately after each session, they will not look their best during the healing process which lasts up to 7 to 21 days in normal circumstances. 

  • The area treated MUST NOT be covered with any type of makeup, mascara, until the area has fully healed. Wash gently with soap twice a day. Any other treatment or wearing of any type of makeup could result in unnecessary infections, skin tattooing or undesired effects. 

  • The treatment could be uncomfortable to the client; therefore, numbing products shall be used for ease of treatment and comfort reasons during the plasma tightening procedure. 

  • Swelling one to five days after the cosmetic treatment is normal and to be expected. It is always better to make the client aware of this at the consultation stage. 

  • Plasma tightening brings about cumulative minor improvements of the appearance of saggy or droopy eyelids. Do not promise the dramatic results, which can be accomplished with surgery. 

3.03(c)

NeuroMed-BLT-Combo-Packets-Full-Size-Moc

Numbing Products

 

Plasma fibroblast tightening is not the only aesthetic treatment when the use of numbing products is recommended. Tattooing, laser tattoo removal, lasers skin tightening, moles removal procedures and several other aesthetic treatments require the use of some numbing products to put the client at ease during the aesthetic treatment. 

A very common topical numbing product available on the market, in most parts of the United States, is EMLA. (EMLA is available in 5% formulations from most chemists).   This is a product which can be purchased and used without a medical prescription. Because of this, EMLA is also the preferred numbing product used by tattoo artists for tattooing and performing body piercings. 

EMLA is used by 1. Applying the cream on the treatment area, and 2. Covering the cream with a normal cling film, such as Saran Wrap.  The cling film is applied in order to cause an occlusion effect which will amplify the impact of the numbing ingredients in the EMLA numbing cream.  The area is then left to rest for approximately 40 to 45 minutes in order to achieve the desired numbing effects. 

Unfortunately, EMLA’s numbing properties leaves the client waiting a long while for the area to numb and it is not generally very effective if a cling film is not applied on top of the cream. If you attempt to start the aesthetic treatment before the client has been numbing for at least 40 minutes, the area will likely not be very numb and the procedure not very comfortable for the client. Additionally, the topical effects of the EMLA formulation end within 5 to 10 minutes from the time the cling film is removed and EMLA residues wiped off. Therefore, the window of time while you can perform the treatment in comfort is relatively brief. We suggest using the fractionated tip to open the surface cells for better product penetration. 

Given that the use of numbing products is heavily regulated, EMLA is the main product available over the counter. Some Medical practitioners can be authorized to use other numbing products. The formulation that has been used extensively and successfully by medical practitioners who use plasma arcing devices for aesthetic purposes is a topical custom formulated product. 

Formulation active ingredients are: lidocaine 20%, prilocaine 5%, tetracaine 5%.

This topical product is either made in a gel or cream formulation. In the U.S., this type of topical formulation can only be made under medical prescription at a compounding pharmacy (therefore under the sole responsibility of the medical practitioner who orders the product). 

Due to current regulations, this is a product that can be used by medical practitioners only or under their direct supervision. The main advantage of using this type of formulation is that the desired numbing effects are achieved almost immediately and are so good that the client will only feel a tickling sensation when the plasma arc is applied. The area where this formulation is applied becomes numb within 5 to 10 minutes after the application and may turn pink. Please note that these types of products are not meant to be completely absorbed; therefore, simply apply the cream or gel, on the treatment area and leave the product to take effect. With this formulation, there will be no need to apply a cling film because the product itself will be strong enough to achieve the desired numbing effects. 

Whenever beginning the treatment on the client, remember to remove the topical anesthetic on a small area. The common mistake made by beginners is to remove all the numbing product at once. For example, if the topical anesthetic has been placed on both upper eyelids, the untrained beginner usually removes the cream on both eyelids before starting the treatment. The main problem is that the effect of most topical numbing products will not last long (in case of EMLA only 5 to 10 minutes at most). Therefore, the effect of the topical anesthetic could start to fade before the end of the treatment, making the procedure cumbersome.   

3.04

Jen Woehle Beau Ideal Lashes .jpg

Instructions on Procedures and Methods

Most procedures will all begin in the same way; we will describe how to begin the treatment below. 

Make sure client has signed all consents and is fully aware of the course of treatment, healing expectations, before and aftercare, desired results, possibility of additional treatments, etc. 

Take before and after photos. This is a very important step. The area treated will continue to improve for up to 3 months: It is a slow process and some clients will state no difference is noticed, until you present them with a comparison photo. 

Provide clients with a disposable bonnet or spa facial headband to keep all hair out of the treatment area. Offering a face mask will also help with reducing odors from the procedure. 

We start with cleansing the skin of all makeup, oils and debris using our oil-free makeup remover. We recommend Beau Ideal House of Beauty’s Oil-free Makeup Remover. It is gentle, fortified with vitamins and chamomile for soothing properties. It is important to stress the use oil-free makeup remover, because any residual oils will interfere with the numbing product absorption. Next we cleanse and disinfect the skin with Chlorhexidine Gluconate. Use the fractionated tip, on pulse mode, setting of 3-5 (whichever setting is comfortable for the client) to stamp the area of skin being treated for a few seconds, making sure to cover the entire treatment area. Apply the numbing cream to the treatment area and then occlude it with the plastic film for better product penetration.

The only treatment we would not use the fractionated tip and numbing for would be to treat active acne. Acne scarring would start with the above prep as well.

3.04(a)

Spot and Spray Techniques/Methods

 

Skin tightening using plasma arcing can be accomplished in two main ways: 

  • Using the spot technique. 

  • Using the spray technique. 

 

Both methods deliver the required heat into the skin needed to cause a very localized skin tightening. This localized skin tightening, in turn, reduces the appearance of saggy skin and fine lines. In particular, the fine lines are improved by the pulling effect of the skin tightening effect applied between the lines. The spot mode is the preferred method to apply skin tightening by using plasma arcing, on various parts of the face. It is the preferred method because it delivers consistent and repeatable results and it is very easy to learn especially for beginners. 

These are placed randomly and between the wrinkles and never inside the wrinkles folds. The tighter the spots the higher the tightening effects. 

 

We should feather out the treatment as we move away from the tight wrinkles. In other words, the spots are applied in a tighter fashion where the wrinkles are deeper.  As we move away from the tight wrinkles we then distance the spots slightly further apart. 

Also note that, in case of fine lines, the wrinkles tend to disappear while applying the spots. This is not a permanent effect. This is a normal immediate reaction of the skin to the dehydration effects of the superficial carbonization caused by the plasma arcing. 

The spot mode is carried out in the following way: 

  • By applying short bursts between the wrinkles and not inside the wrinkles' folds. Applying the spots inside the wrinkles could worsen the appearance of fine lines instead of improving them. 

  • The bursts must be placed randomly, without forming lines or patterns of any type. Applying the spots randomly ensures the most uniform skin pulling effects.  

  •  

The spray mode is not normally used for skin tightening; instead, it is commonly used for: 

  • Tattoo Removal. 

  • Permanent Makeup Removal. 

  • Mole Removal, inclining Xanthelasma, Seborrheic Keratosis, Syringoma Removal and most of the other benign lesions and hypertrophic skin imperfections removed for aesthetic reasons. 

  • Skin resurfacing to improve the appearance of hypertrophic scars.  

 

One of the ways to increase the treatment intensity is decreasing the distance between the spots.  When first starting to use the device for skin tightening, it is best to gain confidence in stages and over a number of sessions. First practice using the device on a test product, such as an orange, and have enough confidence in your ability to generate the arc when the device is set at the minimum power level. Also, the very first time using the device for skin tightening, do so in the mildest way possible, at the very lowest intensity. Then, as you see the results after each treatment, progressively gain confidence with the use of the equipment for this particular aesthetic application. 

Because the spot technique leads to consistent results and it is very easy to learn, the best way to start using the device for skin tightening by using plasma arc is by applying the spot technique with the device set at minimum power, distancing the spots at least 3 to 4 mm apart. Also, the duration of the application of the arc at each spot needs to be brief, resembling a short burst (average maximum duration one-quarter of a second). Confidence is gained by seeing the results of the mild aesthetic treatment: Then slowly start to increase the intensity of the treatment by increasing the spot duration, and/or decrease the distance between the spots or the power setting of the device etc.

3.04(b)

Chapter 3 - Treatment of Acne - Adept Beauty
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3.04(c)

Treatment of Brown Spots

 

Coming from years in  the medical field we will start by saying treatment of brown spots are risky. If you are not completely sure as to what you are removing we would stay away from removing them. If a client comes in and has a brown spot that has not been seen by a dermatologist and you remove it without the knowledge of what you are removing, you risk removing a skin cancer that could potentially do harm to your client. 

Removing the spot may not remove the cancer in it’s entirety, allow it to spread, and not be able to now identify the source of where the cancer began. 

Basal cell carcinomas can be colorless, pearly nodules and to an untrained eye, maybe mistaken as a wart. Removing that without proper pathology can result in furthering the skin cancers well. So in this section we will teach you how to remove it properly but do it at your own risk. You don’t want to be liable for undo harm, because you aren’t a medical professional. 

Using the spray or spot technique on continuous © mode at a power level setting of 3-7 depending on what your client can handle. We numb and treat the spot itself, not the surrounding tissue of the skin. Once the spot has a solid carbon crust, use a piece of gauze or q-tip to dip into saline solution, rub the spot until it is gone.  Applying the plasma arc to the same area multiple times, may be needed.

3.04(d)

Treatment of Stretch Marks

 

The improvement in the appearance of stretch marks.   

The technique normally used is the spray technique. The device should be set to continuous © mode power level of 5-7, if comfortable for the patient. The plasma arc has to be applied within the lines of the stretch marks to allow the skin to coil and come together. The power setting to be used is low when first beginning this type of procedure as to not risk scaring.   

Another method to treat is to cover an entire area in  sporadic dots using the same settings on the device. This has been shown to improve overall texture, but not call so much attention to the actual stretch marks while healing.  

In order to get satisfactory results, a number of treatments from 3 to 6 may be required depending on the individual or the intensity of the treatment. We must warn all patients that the stretch marks will remain pink until all the treatment cycles have been completed. As this process brings the blood to the surface of the skin to allow for healing, the skin is thinner and the redness will be more visible. This may be hard for a client coming to you with flesh colored stretch marks and may turn them away from future treatments. So making sure we manage their expectations is very important. 

3.04(e)

Thermal Abrasion with Osmosis 

It is noted that the clinical advantages of using thermal abrasion with osmosis over laser treatment for tattoo removal are possibly more effective and efficient with the following advantages: 

  • Less potential harm to the client because less sessions are required. 

  • The cost of the instruments required for tattoo removal are a fraction of specialized tattoo removal lasers. 

  

Why thermal abrasion with osmosis more than halves the number of sessions required compared with conventional laser removal equipment? 
 

Like with laser treatment, thermal abrasion causes the color pigments to be broken down. However the protocol of thermal abrasion involves also packing the area treated with sodium chloride for 5 minutes to 1 hour after thermal abrasion. 

 

The sodium chloride is applied because it causes osmosis. Osmosis draws the broken tattoo pigments to the surface removing them from the deeper part of the dermis. It therefore facilitates and speeds up the tattoo discoloration and hence eventual removal. 

Additionally, from a clinical stand point, it is important to try and find any possible way to minimize the number of exposures to burns or to any similar skin abrasion. The more the skin is exposed to laser treatment or any other thermal abrasion techniques the more damage is caused to the skin. 

3.04(f)

Treatment of Permanent Makeup Removal 

Our Plasma Arcing Device Removal Protocol: 

  • Our device setting: minimum power level, continuous mode 5-7. 

  • Use the spray operation to gently break down the tattoo pigments. From time to time remove the carbon residues. Remember that this treatment has to be performed so that the ablation is only superficial. If you notice some bleeding this may be a sign that you have already ablated enough by going too deep into the dermis. Remember the ablation has to be very superficial. 

  • Once you have finished your ablation using plasma arcing, apply a paste made  of sterile fine salt and sterile saline solution. There is no need to apply any occlusion by bandaging, this practice should be avoided for this application. The paste application does not need to be very long. An application between 10 to 20 minutes usually suffice. So that you can see how the particular person’s skin handles the treatment we suggest only applying the paste for 5-10min for the first treatment. Everyone heals differently.  Please remember that the intensity of the treatment is also very much dependent on the duration of the application of the sterile saline paste. The longer you keep the paste on the more the osmosis effects and consequently the better the removal results. However please do not exceed the duration of the application of 20 minutes. Any longer duration has the risk of infection becoming a higher possibility. Once you remove the paste, disinfect the area with a mild antiseptic and follow all post care instructions. 

  

Do not use any bandaging or any plastic to cover the area. The treated area will start scabbing two to three days after the treatment, if left very dry. But remember as we learned previously, wounds heal faster in a wet environment, than they do in a dry. Pay attention for signs that there may be some ongoing complications (generally infections). If this is the case, all efforts must be made to cure the infection in order to avoid scarring.   Any scabs must fall off by themselves and must not be picked. 

Repeat the treatment after 8 weeks if required.

3.04(g)

Tattoo Removal 

Keys to remember: 

  • Do not rub 

  • Sodium paste: sterile water and sterile salt 

  • 5-10min first time 

  • Regulate osmosis by regulating time of paste on treatment area. 

  • Avoid osmosis on waistline, bending areas will be more challenging for healing 

 

Thermal Abrasion 

 

Some clinicians, aware of the damaging effects caused by repeated exposure to lasers for tattoo removal have devised, since the early 80s, superficial thermal abrasion with and without osmosis. This has long been done with devices operating in either elecrofulguration or electrodesssication mode. The preferred operational method for this procedure is electrofulguration, which is why plasma arcing is a great method to treat this condition, as the ablation requires to be very superficial. This provides an effective way to remove tattoos while minimizing the number of sessions required to achieve the desired effects, also minimizing the risks of collateral damage or scarring. The risks to the skin are minimized drastically because thermal abrasion with osmosis allows removing tattoos, in most cases halves the number of sessions otherwise required with laser treatment. 

 

Although different tattoos present different levels of difficulty in their removal, depending on the type of ink and instrumentation used to draw it, experience has shown that thermal abrasion with osmosis can remove tattoos within 3 to 6 sessions, on average, per area treated. If thermal abrasion is applied without osmosis the number of sessions required for tattoo removal increases dramatically. 

 

Limitations of Tattoo removal by applying thermal abrasion with osmosis have  been shown to be very effective in removing tattoos without leaving any scars and within only few sessions. 

 

However, scars could develop when: 

  • thermal abrasion had been carried out to cause extensive damage to the dermis. 

  • the treated area had become infected 

  • the client has a particular predisposition to developing Keloids or hypertrophic scars 

3.04(h)

Mini Face Lift 

Apply the normal pretreatment routine before carrying out the aesthetic treatment. 

 

The main principle applied to mini face lift using electrical arcing or Plasma is localized skin tightening. Use skin tightening between the lines and do not apply the plasma arc on the lines themselves. Mini-facelift by using electrical arcing (or plasma) is usually carried out by applying the skin tightening where the skin would be pulled during a normal face lift procedure, which is close to the ear and hair line. For extra tightening the submental area would be treated as well  

 

It is important to manage the client expectations of this type of procedure because the improvements will only be minor and cannot be compared to the dramatic results achieved with surgery. However since, the localized skin tightening effects of plasma arcing are cumulative, repeating the treatments a number of times will lead to good results. 

 

The incision during a standard facelift is carried out on along the hair line and around the ear to achieve the desired pulling effect. While using electrical arcing the voltaic spots are applied close to the ear to reproduce a similar “pulling” effect. 

 high-intensity treatments are usually carried out to perform mini-facelift using plasma arcing. Although when you first use plasma arcing devices for skin tightening type of treatment it is highly recommended you use low intensity treatments

 

The first time you use plasma arcing for a mini-facelift, Apply the spots distancing them 2 to 3 mm apart and use an instantaneous spot duration (approximately one-quarter of a second). As you gain experience you can then progressively increase the intensity treatment by decreasing the distance between the spots and holding the arc for longer. 

 

Wounds heal faster in a wet environment than In a dry and there is less likelyhood of scarring. Be sure to follow all post care instructions to reduce any possible side effects. You can repeat the treatment at 4 to 6 weeks intervals. 

 
 
 
 

Treatment of Acne

Active vs Acne Scarring   

Active Acne uses the acne tip with collet and plastic sheaths to treat. Be sure not to use numbing for this procedure. Remove sheath from the film and apply directly to the skin over the active breakout. 

 

Set to continuous © mode at 7-9 power level. While pressing the shot button, slowly create small circles over top the patch.

 

This allow the small but proper amount of UV radicals to be fired from the plasma to heat and help resolve the breakout.

 

The heat also allows for the medication in the patch to be absorbed by the skin. For multiple areas of acne, the plastic sheath can be put over the acne tip and plastic cover applied as to keep the tip in place. The process would be the same, continuous mode © power level 7-9, small circles all over acne areas instead of directly to the patch, because the patch is covering the tip, the effects are the same of the device releasing the correct amount of UV to heal the skin. 

 

If you are not a licensed esthetician or cosmetologist, you are not legally allowed to treat the active breakouts.   

 

Acne Scarring uses the skin tightening tip, this is in the scope of your practice for either licensed or non licensed individuals. Place the device on continuous © mode at a power level of 3-7 depending on what your client can handle. Place the needle tip within 1mm of the skin. The device needs that space of air to react with the site and create the plasma arcs. Plasma arcs are created around the scar itself, not within the centers, for pitted scars to stretch. We recommend 2-3 sporadic rows out from the center of the scar for structural support. 

 

3.05

 

Introduction to the Products

Placental Cream

Placental Cream is a luxurious, regenerating, anti-wrinkle, heavy cream. Wheat Placenta does not contain animal ingredients, but it offers the same effect of increased cell renewal and is a scientific substitute for animal Placenta Extract. It effectively helps improve elasticity, while nourishing the skin. Pharmaceutical-grade Placenta Extract (wheat origin) has shown to be very effective in helping restore elasticity and moisture to the skin. Marine collagen, a soluble protein, effectively helps diminish wrinkles and age-lines, while also helping to restore elasticity to the skin. This product contains Pentapeptides for improved collagen and elastin production, to further reduce and slow the formation of new lines and wrinkles. Witch Hazel, Hops, and Ginseng Extracts, combined with Aloe Vera Gel provide soothing and healing properties. Lecithin, Mango Butter, Olive Butter, Glycerin, and Squalane protect from moisture-loss and provide nourishment to the skin. Glycosaminoglycans, Retinyl Palmitate and Ergocalciferol show skin renewal properties and help calm inflammation and refine pores. It is recommended for all types of non-oily skin as an immediate post treatment cream. For specifically dry skin, it can be used during the day, under makeup. 

Directions: After cleansing, gently smooth over the face. use as many times daily to remain moist, as needed. Most apply a thin layer every 4-5 hours until carbon dots have fallen away. 

Ingredients: Aloe Vera Gel, Caprylic/Capric Triglyceride, Squalane, Sorbitan Tristearate, Steareth-2, Cetyl Alcohol, Glycerin, Polysorbate-65, Sweet Kernel Oil, Witch Hazel Extract, Hops Extract, Ginseng Extract, Tocopherol, Stearth-20, Palmitoyl oligopeptide, Palmitoyl tetrapeptide-7, Retinyl Palmitate and Ergocalciferol, Beeswax, Lecithin, Mango Butter, olive Butter, Phenoxethanol, Marine Collagen, Glycosaminoglycans, Wheat Extract (Placenta), Fragrant Oil, Potassium Sorbate, Sodium Benzoate, Citric Acid. 

Caution: Avoid contact with mucous membranes. Keep out of reach of children. Use only as directed.

 

 

Sun Protective Cream

Sun Protective Cream - SPF 30 is a moisturizer for all skin types. It contains sun filters for protection against UVA and UVB rays. Cocoa Butter and Glycerin help protect the skin’s moisture balance. Green Tea Extract, Allantoin, and Aloe Vera possess soothing and healing properties. This product helps improve skin’s suppleness, elasticity, skin tone, and hydration.  

Directions: Apply after cleansing, before sun exposure. Reapply every two hours as needed. 

Active Ingredients: Avobenzone 1.5%, Octinoxate 7.5%, Octisalate 5.0%, Oxybenzone 5.5%. All ingredients purpose is sunscreen. 

 

Inactive Ingredients: Water, Glycerin, Octyl Palmitate, Camellia Sinensis, Aloe Barbadenis Leaf Juice, Glyceryl Stearate, Cetearyl Alcohol, Stearic Acid, Methyl Gluceth-20, c12-15 Alkyl Benzoate, DEA Cetyl Phosphate, Tocopherol Acetate, Ergocalciferol, Retinnyl Palmitate, Phenoxyethanol, Green Tea Extrct, Mixed Tocopherols, Cocoa Butter, Propylene Glycol, Allantoin, Panthenol, TEA Carbomer, Micronized Titanium Dioxide, Methyl Paraben, Propyl Paraben, Butyl Paraben, Diazolidinyl Urea. 

CautionDo not use on damaged or broken skin. When using this product keep out of eyes.  Rinse with water to remove. Stop use and ask a doctor if rash occurs. Keep out of reach of children.

 

Fading Gel

Fading Gel is a light, oil-free gel recommended for all types of non-sensitive skin. Its water-based formula is ideal for oily skin types. This formula uses the superior brightening properties of Kojic Acid, Niacinamide, and Bellis Perennis Flower (Daisy) Extract, Alpha-Arbutin and Glucosamine to help improve pigment abnormalities. Glycerin and Sodium Hyaluronate help protect the skin’s moisture balance. Aloe Vera and Yarrow Extracts possess soothing and healing properties. This product helps improve skin tone and hydration and is great for lightening sun spots, age spots, freckles, and pigmented scars. Repeated use helps reduce the appearance of dark spots and discolorations. Use of sun protection is required to achieve desired results. 

Directions: Apply after cleansing, twice daily, to prevent post inflammatory hyperpigmentation. 

IngredientsAloe Vera Gel, Glycerin, Kojic Acid, Niacinamide, Bellis Perennis (Daisy) Flower Extract, Salvia Officinalis (Sage) Leaf Extract, Panax (Ginseng) Root Extract, Achillea Millefolium (Yarrow) Flower Extract, Sodium Hyaluronate, Hydroxyethyl Cellulose, Alpha-Arbutin, Phenoxyethanol and Caprylyl Glycol and Ethylhexylglycerin and Hexylene Glycol, Glucosamine HCl, Algae Extract, Saccharomyces Cerevisiae Extract, Urea, Polysorbate 20, Citric Acid. 

 

CautionAvoid contact with mucous membranes. Some users may experience a mild stinging or mild skin irritation. Discontinue use if irritation becomes severe. Keep out of reach of children. Use only as directed.

 

Chapter 3 Quiz
1. Because of its higher degree of precision in tissue carbonization, electrofulguration is used in aesthetics for:
2. Contraindications for Plasma Fibroblast Therapy are the following, EXCEPT:
3. Oil-free make up remover is used to clean the skin, as our first step. Why?
4. We have found, once comfortable, medium intensity treatments give the best results. What is a medium intensity treatment?
5. When treating brown spots, once the spot has a solid carbon crust, use a piece of gauze or q-tip to dip into saline solution, rub the spot until it is gone. Applying the plasma arc to the same area multiple times is never needed.
6. Why is sodium chloride applied to the skin after the plasma arcing?
7. scars could develop when: 
8. It is important to manage the client expectations of a mini face lift because the improvements will only be minor and cannot be compared to the dramatic results achieved with surgery. However since, the localized skin tightening effects of plasma arcing are cumulative, repeating the treatments a number of times will lead to good results.

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