Page 18 - LASERS & IPLS IN MEDICAL/AESTHETIC APPLICATIONS

Chapter 1 – Fundamentals of Medical/Aesthetic Lasers and IPLs v1.1
it around 30 to 40 minutes before application to allow it to melt slightly. Ideally, you should apply a ‘crunchy’ gel such that it contains ice crystals when applied to the skin surface. You should apply the gel to relatively small areas of the skin at any one time – somewhere around 10 x 10 cm – cold gel will rapidly warm up once applied to the skin!
Clearly, using a device with a properly designed skin-cooling system is much more preferable since it ensures good cooling throughout the treatment. It should be remembered that most injuries/damage caused by photothermal treatments is primarily due to excess heat generation within the skin, with little to no cooling. Cooling is absolutely critical!!
Somebody recently asked if the gel should be ‘warmed up’ before applying IPL treatments!!! This is because it is generally warmed before ultrasound examinations.... NO! NEVER!!!
A serious issue which must be addressed is that most laser/IPL suppliers/manufacturers produce clinical protocols which are next to useless. There is a good reason for this.
No supplier wants to be legally challenged due to unexpected or unwanted clinical side-effects. As a direct consequence, many suggest output parameters which are too ‘low’ – these simply cannot yield good clinical outcomes. (Many systems will also output lower than claimed – or shown on the screen - fluences, making them even more useless!!)
These suppliers are not overly bothered by this since they don’t deal with frontline clients! They can also ‘ignore’ complaints from their customers by claiming that ‘they are not carrying out treatments properly’. The suppliers are much happier with this scenario than having to deal with claims from badly damaged patients! Hence, they deliberately understate clinical parameters to minimise the chances of that occurring.
This is a very serious problem in the medical/aesthetic laser/IPL industry. Too many manufacturers/suppliers have been ‘getting away’ with this for far too long.
Our experience has also shown us that many equipment suppliers do not train their customers properly. In fact, in many cases, their training is next to useless. This is why they resort to understating parameters – coupled with poor training, you, the customer, get a raw deal!
To add to an already bad situation, the insurance companies muddy the waters further by stating that their policies only apply when users follow the ‘recommended guidelines’ – even though those guidelines may be total garbage!
The medical/aesthetic laser is full of ‘charlatans’ looking to make a quick buck. Armed with a little knowledge, you should be able to spot these people and, hopefully, not fall into their traps.
This book will help you gain some of that knowledge.
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Chapter 1 LEVEL A Fundamentals of Lasers/IPLs
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