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Medi Spa > Chapter 5: ER YAG 2940 Nm Fractional Laser > Flashcards

Chapter 5: ER YAG 2940 Nm Fractional Laser Flashcards

1
Q

What is fractional laser?

A

Skin resurfacing
Textural damage

Lines and wrinkles

Skin dullness

Open pores

Skin types 1-V

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2
Q

Explain further about skin resurfacing

A

Elimination of Rhytids, improving skin texture

Improvement in appearance of sun & age spots

Partial to full epidermal peeling

Minimized downtime, minimal side effects & minimal risk of complications

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3
Q

What does laser radiation do to the tissue being treated?

A

generates internal heat of tissues

In accordance to the absorption of tissue content chromophore with regards to the specific wavelength

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4
Q

What wavelength is water absorption of light most optimal?

A

2940nm

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5
Q

What % of skin tissue content is water

A

60-80%

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6
Q

What effect does the 2940 nm laser- tissue interaction result in?

A

The ablation of superficial skin layers with minimal collateral thermal damage

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7
Q

What is cold ablation?

A

Is when the duration of the energy delivery to the target is too short, ablation occurs before significant heat diffusion can take place

This results in lowered heat distribution to the surrounding tissues

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8
Q

Thermal ablation

A

Our devices and protocols offer longer pulse durations (widths) which allow greater heat diffusion and increases the thermal effect on surrounding tissues

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9
Q

What is fractional mode?

A

An array of micro beams that produce a spatial pattern of dots rather than one single large dot

The ER:YAG Laser affects small islet of tissue, while tissues in between these islets remain intact m

Deeper tissue ablation and quick re-epithelialization can be achieved which leads to shorter healing times

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10
Q

What is fractional intended to be used for?

A

Superficial skin resurfacing

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11
Q

What is fractional effective in treating?

A

superficial textural damages, light pigmentations

In some cases (mild scars) acne scars

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12
Q

How is downtime & post secondary treatment reduced?

A

Fractional mode reduces downtime since the intact areas of the skin (between the spots) accelerate the healing process of the ablated areas

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13
Q

 The ER:YAG fractional mode handpiece is supplied with two matrix tips..

A
  1. 7X7 matrix

2. 9X9 matrix

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14
Q

7x7 matrix

A

Penetrates deeper
Greater energy per dot
lower dot density

 (49) > greater heating achieved

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15
Q

9x9 matrix

A

Less energy per dot, yet higher density
(81)

Recommended for preservation as it is less thermal

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16
Q

Energy per pulse

A

1.4 J/ pulse

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17
Q

Pulse width (duration)

A

Ranges between 1 - 1.2 - 1.5 - 2 msec

18
Q

Spot size

A

11x11

19
Q

Rate

A

1-2-3 Hz

20
Q

Energy per dot

A

7x7 matrix = up to 28 mJ/ dot

9x9 matrix = up to 17 mJ/ dot

21
Q

What is the procedure duration?

A

30 minutes

22
Q

How does the skin appear after tx?

A

Red and swollen

23
Q

What if the patient previously suffered from herpes simplex in the treatment intended area

A

It is recommended to use prophylactic oral or antiviral agents following the treatment as well as 24 hours prior treatment

..until full epithelialization occurs according to the physicians discretion

24
Q

What is useful as a preparation for laser skin resurfacing treatment to reduce the potential risk of hyperpigmentation?

A

Pre-treatment with glycollic acid or topical hydroquinone 

25
Q

What if a client has a tattoo near the tx area?

A

Avoid the tattoo and 1 cm surrounding it

26
Q

If a client is receiving treatment surrounding the eyes what do you do? 

A

Make sure the patient stainless steel protective eyewear is properly and Stabley positioned

27
Q

What needs to be applied before the procedure?

A

Topical anaesthesia

28
Q

Can you completely remove a damaged lesion in the first treatment?

A

Sometimes it’s not possible

it is better to gradually treat the desire tissue and consecutive treatments

29
Q

How many passes with fractional?

A

Number of passes should be between 2-4

However a higher number of passes make cause close overlapping and void fractional properties 

30
Q

Greater caution is required when treating patients with skin types

A

Greater than four

>IV

31
Q

Pre-treatment consultation must include a detailed discussion of

A

Planned treatments

Potential risks, benefits and costs

Realistic expectations

Lesion type must be accurately identified

Patient forms such as consent form, medical history form etc. must be filled out and signed

32
Q

Treatment protocol

A

Clean & disinfect area

Ask if they’ve had sun exposure or tanned in the last 2 -3 weeks

Take before pictures

Apply topical anesthesia 1 hour prior to tx & remove prior to treatment

Prepare cold packs to apply before, during, and after treatment. With an external cool air device.

Set treatment parameters

Protective eyewear & gloves

Ensure you have the correct hand piece tip

Handpiece should always be perpendicular with skin, gentle contact with 20% overlap

Keep skin taut in wrinkled/ saggy areas

Patient Is expected to report a gradual healing sensation at the treatment site

Once procedure is done, what disposable cloth in cold water and gently lay the cloth on the treated area without touching the skin

Post tx

33
Q

Recommended parameters

A 
Area: forehead/ peri orbital 
Pulse width: 1 msec 
Tip: 7x7 for tx 9x9 for preservation 
Number of passes skin type 1-3: 1-2
Number of passes skin types 4 to 5: 1
Area: upper chest & neck 
Pulse width: 1-1.2 msec 
Tip: 7x7 for tx 9x9 for preservation 
Number of passes skin type 1-3: 2-4
Number of passes skin types 4 to 5: up to 2 
Area: face
Pulse width: 1-1.5-2 
Tip: 7x7 for tx 9x9 for preservation 
Number of passes skin type 1-3: 2-4 
Number of passes skin types 4 to 5: up to 2
  • greater ms and more passes for thicker skin and deeper lines
  • shorter ms and 7x7 tip are recommended for 1st treatment
34
Q

Immediate Post treatment

A

Apply cold packs or wet disposable cloth for 10 minutes

Apply soothing cream

Do not rub

35
Q

Post treatment following days

A

Apply antibiotic cream to prevent infection

Frequent washing with soap free cleanser

Ointment until scabs are gone

Avoid sun

Wear protective headwear, clothing and sun protection of at least spf 30

36
Q

After re-epithelialization

A

A daily regimen which includes sun block, soothing cream, or gels and moisturizer

37
Q

When should you photograph clients during this treatment

A

1 week, 2 weeks, 1 month, 3 months, 6 months following treatment

38
Q

Post treatment effects

A

Immediate:
Mild burning sensation
Mild redness & swelling for a few days
Mild bleeding for a few minutes

Following days:
Discomfort, irritation, itch, mild burning

After 1-3 weeks:,
Healing continues, peeling, superficial crusting

Temporary hyper/hypo pigmentation

Skin fragility & sensitivity to sun & cosmetic products

39
Q

Final results

A

Skin texture improvement

Spot blanching

Glowing skin

40
Q

Fractional program facts

A

Treatment: skin resurfacing

Number of treatments: 1-6

Interval: 4-6

Total course: up to 6 months

1st tx to initial visible results: 1 week post tx

First tx to final results: up to 9 months
Follow up 12 months after last treatment

Medi Spa (7 decks)

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