1. Preoperative necessity for:
special cooling gel (coupling plastic), paper towels, scarves spatula, eye protection (wet gauze can be used instead), cold bags, EMI. A drug or other surface.
camera as normal before surgery, complete surgical consent.
2. How-to:
(1) treatment parts: should be carried out usually does not include the whole face including the upper eyelid treatment (with a few male patients in order to avoid possible hair reduction treatment of the phenomenon rather than the Ministry of beard), items, chest and hands can be included.
(2) Anesthesia and Clean: In the treatment of pain in patients sensitive to topical anesthetic can be used (use of preoperative 1h).
remove all of the cosmetic treatment, clean face with a tissue, to patients and goggles to wear hijab (wet gauze can be used instead).
(3) treatment parameters: In theory, the shorter the wavelength and pulse width, a short pulse interval of the epidermis and superficial dermis layer of melanin and more superficial small blood vessels of the thermal effect is relatively stronger in; longer wavelength and longer pulse width for the skin texture, fine wrinkles, large pores to improve even more effective.
① IPL wavelength class Ⅰ - optional 560nm (Quantum) of the filter, or 550 nm, 570 nm of the filter (PhotoDerm);
Ⅱ class IPL is optional then the 640nm filter in (Quantum), or 645nm, 695nm, 755nm filter in (PhotoDerm), can be combined PhotoDerm (VascuLight) in the 1 064nm, Nd: YAG laser treatment of low-energy density.
② pulse width: the longer pulse width, single skin, the less the heat distribution, heat penetration deeper. Adjustment principles: the thicker the skin, the deeper the lesion distribution, PWM long; with 3 pulses, the last the longest pulse width; extended pulse width, may be appropriate to improve the energy.
③ Pulse interval: the longer the pulse interval, the more thoroughly cooling the skin, but also reduce the temperature of the lesion. Adjustment principles: the darker the skin, pulse interval modulation length; with 3 pulses, the first two pulse interval slightly longer than the first one.
④ energy density: the treatment of common low energy from the start. Adjustment principles: the darker the skin, the more sensitive, energy density modulation is small; more severe skin reactions, the energy density transfer is small; from 3 times to 2 times impulsive switched pulse therapy, energy reduced by 20%.
treatment parameters can refer to the following: the larger the individual differences in patients, specific clinical parameters should be used to treat the response was determined the individual parameters should be implemented. The following is the recommended treatment parameters of the laser company (for reference).
① skin conditions are the "color" issue.
1st scan
3 times pulse width 2.5-3.0/4.0-4.6/4.6 -5.2 (ms)
pulse interval 15-25/20-30 (ms)
test energy density 24-26J/cm 2
2 scans (for the deeper parts of pigment distribution)
2 times pulse width 2.6-3.0/4.0-4.4 (ms)
pulse interval 20-40 (ms)
average energy density of 24-28 J/cm 2
② skin condition mostly "red" issue.
1st scan
3 times pulse width 2.8-3.2/4.0-4.6/4.4 -5.2 (ms)
pulse interval 15-25/20-30 (ms)
test energy density 25-27 J/cm 2
2 scans (for capillary vasodilator heavier parts)
2 times pulse width 3.6-4.0/4.2-4.6 (ms)
pulse interval 20-40 (ms)
average energy density of 25-30 J/cm 2
③ skin conditions are the "texture change" issue.
1st scan
3 times pulse width 3.6-4.0/4.4-5.0/4.0 -4.8 (ms)
pulse interval 20-40/15-30 (ms)
test energy density 25-27 J/cm 2
2 scans (for the heavier parts of the texture change)
2 times pulse width 3.6-4.0/5.0-5.6 (ms)
pulse interval ; 20-40 (ms)
average energy density of 25-33 J/cm 2
(4) steps: a special cooling the colorless gel directly applied to the skin can also be applied to the treatment of head (filter crystal surface.) Will filter out the crystal surface of the skin 1-2mm (for sensitive parts should be raised to about 3mm, for example, lower eyelids, lips Week, etc.), the filter spacing of the crystal and the skin should pay special attention. Treatment of white ear and even the surrounding area began to expand, followed by exposure to facial skin. Note the direction of the crystal filter change at any time to the surface is always parallel to the skin surface, so that the effect of uniform.
3-4 in the ear region adjacent to the test immediately after the irradiation spot immediate skin reactions observed. Energy density appropriate, the patient may be slightly hot sensation, but the duration of no more than 30s, immediately after exposure to 1,2 min a slight redness in skin, pigmented spots may occur at slightly blackened. Periodically wipe the cooling gel and treatment area has been carefully examined to observe the reaction of the skin and the area with no treatment were compared.
energy adjustment:
① When no significant response to treatment in your skin when you need to adjust the energy density, but increase the energy density per Super 1-2 J/cm 2 ;
② If there is severe skin redness, should reduce the amount of energy density;
③ patients of darker skin color may be delayed skin reactions, immediate response is not obvious because of increased energy hastily;
④ site for serious diseases can be 2 scans, while for the heavier parts of the skin reaction immediately prohibit the use of two scans;
⑤ the neck or chest, should be lower energy density, when the incremental adjustment of the energy is smaller, each treatment is only for 1 scan;
⑥ less for the subcutaneous site, such as the forehead, then raise the treatment of head, it should also reduce the energy lo%;
⑦ In each treatment, each patient according to the results of the previous treatment to change each individual specific parameters of the treatment in the future to improve the energy density of each 1-2 J/cm 2 .
treatment of lower eyelid should carefully protect the eyes. Treatment around the eyes and eyebrows, use a spatula to protect the eyebrows and eyelashes occlusion. Skin texture changes significantly at the implementation of the radiation can be gently stretch the skin.
treatment interval and frequency: 1 treatment every 3 weeks time, get a good number of the efficacy of treatment required an average of 3-6 times. For special treatment of the skin between the implementation of the two skin care, during treatment in patients with melasma using hydroquinone cream.
3. Postoperative reaction and care:
after reaction: typical phenomenon after may be: mild burning feeling the heat, may last 0.5-2h; slight redness may last 4-12h; for freckles may appear slightly darker, usually 1 week to drop off.
postoperative care: the treatment site after cooling with cold bags of at least 15-30min, until the heat-sensitive decline. Within a few days after use of hot water should be avoided, but should use cold water soft clean skin, apply morning and synthesis of vitamin C cream and sunscreen, night after cleansing the skin apply moisturizer.
4. Side effects
treatment parameters, such as reasonable, accurate and meticulous operation, postoperative should be no side effects occurred. However, improper operation of the energy is set too high and the following side effects may occur:
1. Transient purpura, blisters due to the treatment head and the energy is too high or too close to the distance between the skin To, you can use a mild corticosteroid ointment or other topical bFGF, when the blisters rupture leaking oil available nitrofurazone topical zinc oxide.
2. Edema prompted significant photosensitive patients may use drugs or herbs. Used oral corticosteroids and topical treatment.
3. Hypopigmentation or depigmentation there may be darker in color, sun exposure or by the people. For such patients before use of bleaching cream (hydroquinone cream, Retina-A) 2-6 weeks, the parameters should be appropriately increased pulse, increased pulse interval, reducing the energy density, focusing on prevention.
No comments:
Post a Comment