LASER and IPL TREATMENTS

Anatomy of the Skin

The Epidermis

The epidermis is where skin cells are born and pushed through their natural cycle to where they keratinize and shed. The deepest level of the epidermis is known as the stratum basale and cells grow here because they are close to their nutrient source(in the dermis), as they are pushed up and away they begin to die(the stratum granulosum). After they die they start to fill up with Keratin.

Merkel Cells

Merkel Cells have a function in sensory pain and pressure. They are special skin cells that help you feel touch. They're like tiny sensors in your skin, especially in areas like your fingertips. When something presses against your skin, Merkel cells send signals to your brain so you can feel textures, shapes, and pressure. They are found in the stratum basale, where skin cells are born.

As you grow older, the number of merkel cells decrease. This is important to take into account when working on younger kids and adults, they will likely feel the laser more.

Langerhans Cells

Langerhans cells are dendritic cells that are responsible for the immunity of your skin. They are susceptible to heat, meaning they will move away from a heat source for up to a week. This is important as its important to advise your client to continue cooling the treated area after leaving the clinic/spa to allow for a better and faster recovery.

Skin Anatomy

There are 3 layers to skin:

  1. Epidermis

    • Thinnest layer of the skin with a depth of 0-150 microns (this is an estimate and varies from patient to patient)

    • Indications: Tone, texture improvements

    • Strongest layer of the skin

    • doesn’t have vascularization, therefore it relies on absorbing oxygen and nutrients from the blood vessels in the connective tissue.

  2. Dermis

    • Depth of 150-700 microns (varies patient to patient)

    • Indications: Fine Lines

    • Most of the body’s collagen is found in this layer

    • Stretch marks are caused by tears in the collagen of this layer

  3. Hypodermis (Subcutaneous Layer)

    • Depth 700 microns and beyond

    • The “structure” of the skin

    • Home of dormant fibroblasts and melanocytes

    • Indications: Deeper wrinkles, scars.

Conditions of the Skin

Blisters

When you rub the skin, it stimulates cell division = callous

If you rub it too hard, the stratum basale tears away from the basement membrane and causes a gap, which is filled with fluid.

The epidermis then dies because it’s too far away from nutrients.

  • Remember the epidermis has no vascularization

Smaller blisters, less than 5 mm in diameter are knows as vesicles

Larger blisters, greater than 5 mm in diameter are know as bullae

Skin Cancer

Skin cancer is the most common cancer in the USA. The major risk facto of all skin cancers is ultraviolet light.

Three major ypes:

1) Basal Cell Carcinoma

  • Cancer of the blood vessels in the dermis

  • the most common type of skin cancer

  • accounting to about 75% of skin cancers

  • Almost never metastasizes or crosses the basement membrane, so almost never fatal

  • The most easily cured through surgical removal no chemotherapy or radiation is usually needed

  • Symptoms: shiny nodules, usually on the nose or other sun exposed areas

2) Squamous Cell Carcinoma

  • about 25% of all skin cnacers

  • Will metastasize if not treated

  • Actinic Keratosis

    • This is a premalignant condition of thick, scaly or crusy pathes of skin

    • it’s more common in fair skin, in sun-exposed areas

    • 20% of these lesions progress to squamous cell carcinoma

      • Begin as flat, dry, scaly areas and later grow into tough, wart like lesions

    • We DO NOT want to stimulate these with heat. Always ask for a doctors note if you are unsure of any skin conditions

3) Melanoma

  • Cancer of the melanocytes of the epidermis

  • about 1% of skin cancer

  • Highly metastatic, causes 75% of skin caner deaths

  • Asymmetrical, sharp but irregular borders and edges

  • Not uniform in colour