At the moment, one of the main problems in laser aesthetic medicine is the low level of professionalism and the unwillingness of doctors to improve their skills. They don't need it because no one controls it.
Unfortunately, this situation directly leads to an increase in the number of complications. For the last three or four years, the problem of increasing complications has been actively discussed among professionals, because this is a situation that not only requires analysis and the search for an optimal solution from the community, but can also lead to a negative attitude of patients towards the industry in general.
The risks of complications after the procedures depend on the qualifications of the operator, the individual features of the patient, compliance with the conditions of the procedure. Therefore, all risks must be assessed by the physician and discussed with the patient BEFORE treatment is prescribed.
PhD, dermatovenereologist of the 1st category, President of the Association of Laser Medicine of Ukraine, a specialist in laser technologies, agreed to share his rich experience with specialists in the field of aesthetic medicine Egor Kolodchenko. In the article estet-portal.com you can get acquainted in detail with the causes of possible complications of the use of lasers and preventive measures.
What complications should be feared
E.K.: Common complications after laser treatments include:
• Post-procedure hyperpigmentation. This is a complication that is manifested by darkening of the skin, which persists for more than 1 month on the patient's skin after the procedure. However, it should be distinguished from transient pigmentation (usually lasting for several days), which is normal and an indicator of a correctly performed procedure. It often happens that if the parameters of the procedure are not chosen clearly enough (there is a deviation from the recommendations in the protocols) or the patient has not followed the recommendations of a specialist, then persistent hyperpigmentation occurs after the procedure, which must be dealt with.
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Climate change with increased solar activity also contributes to the development of hyperpigmentation. The culture of attitude towards solar radiation in our mentality is not developed, patients often do not understand the importance of UV protection. Representatives of European countries constantly use sunscreens, preventing the occurrence of destructive processes in the skin under the influence of solar activity. This is a problem of general distrust of doctors in our country in recent years.
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• A paradoxical increase in hair growth – this is a well-known phenomenon that occurs as a result of the stimulation of metabolic processes under the action of a laser device. The essence of the phenomenon: white vellus hair after heat treatment sessions in the process of laser hair removal acquire dark pigmentation and it seems that the hair has become larger.
The situation is unpleasant, first of all for the patient. I have a positive attitude to this, because this complication is easily solved - when removing hair during the next procedure, the positive effect will be more pronounced, more hair will be removed. This needs to be explained to the patient.
• Hypopigmentation. This complication is an indicator of excessive aggression of laser irradiation, in other words, inconsistency of treatment parameters with the patient's skin condition. This may be, in particular, after a fresh tan, which the patient forgot or did not consider it necessary to report. The loss of pigment from the cells of the epidermis is very difficult to correct and is an urgent problem. It requires the care of a specialist when choosing the parameters of the procedure in order to prevent the appearance of hypopigmentation.
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Is there seasonality in the use of laser techniques
Е.К.: The opinion that laser procedures cannot be performed in summer and winter should be expected – this is one of the common myths that I have been trying to dispel for about 15 years. For example, in Florida with year-round high solar activity, there are a lot of laser centers where procedures are performed using laser technology.
The risk of pigmentation does not depend on the season of the year.
It is also worth considering that on the tops of the mountain slopes covered with snow, the sun's rays force climbers to actively use sunscreen, despite the winter season. Those. the impossibility of carrying out procedures in the summer is nothing more than fiction.
Protocols for managing patients in aesthetic medicine
E.K.: The Association of Laser Medicine and Cosmetology is working on the unification of protocols for the treatment of patients in aesthetic medicine.
The main principles that are reflected in the protocols include:
1. preparation of the skin before the procedure;
2. carrying out the procedure according to the recommended parameters for a certain phototype;
3. protection of the skin during the rehabilitation period.
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Knowing the physical parameters of 8 existing lasers will allow you to navigate a wide range of laser trade names.
The wide range of different lasers requires in-depth knowledge of the beautician. Many service providers confuse the name of lasers with their mechanism of action. In fact, there are not so many lasers – there are only eight of them, and each of the lasers has absolutely standard physical principles, the knowledge of which levels the gap between the specialist and the variety of laser trade names.
Patient management in the post-procedure period
Е.К.: Different procedures require different post-procedure care, universal principles are the need to soothe the skin, be sure to apply UV protection, stimulate regenerative processes. Antibacterial agents are rarely used, because the use of laser techniques is not associated with infection.
Modern trends in aesthetic medicine are aimed at minimizing the invasiveness and aggressiveness of methods that imply a short painless post-procedure period.
Anesthesia is not required and is used in a maximum of 10-15% of cases with a preference for topical methods.
I always try to work in partnership with the patient. The specialist must understand that in a glossy magazine the patient sees a "before" photo; and "after", the interim period is neither shown nor explained.
A common problem is the patient's high expectations after the procedure, which are replaced by deep disappointment the day after the procedure, when absolutely normal and natural consequences of the influence of the high-energy "Laser" system occur. Therefore, the better everything was explained to the patient before the procedure, the easier it is for the patient and the doctor to go through a period of rehabilitation after the session.
After a clear and accessible explanation of the processes that will be carried out during the rehabilitation period, compliance is achieved easily.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Cosmetology" section. You might be interested in Selection of patients for laser procedures will help to avoid complications
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