Savvy clients have moved beyond feel-good treatments and are looking toward result-oriented skin care to target specific skin conditions and address their individual concerns. This is especially true when it comes to treating mature or aging skin as this demographic is very often educated on the topic and willing to invest in skin care treatments and modalities that deliver results.
Turning to equipment or devices to treat skin is nothing new. The first high-frequency machine was developed by the scientist Nikola Tesla in the late 1800s. It was later used for medical purposes mainly as an antibacterial treatment before antibiotics were available. The French biophysicist Jacques-Arsène d’Arsonval later pioneered the use of high-frequency current in skin care treatments, and Elizabeth Arden helped popularize its use by introducing her Vienna Youth Mask in 1928, a device which claimed to have a rejuvenating effect by stimulating the circulation of blood through the facial tissues.1 High-frequency has been a treatment staple ever since.
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SCOPE OF PRACTICE
The options for skin care equipment and device-based treatments are more plentiful than ever before, so how do skin care professionals make the best investments for their practice? The first step is getting educated on what is permitted at a state level. For example, in the state of California, “The Board of Barbering and Cosmetology (Board) does not approve or regulate equipment or products used in the barbering and beauty industry. Consequently, the Board provides no opinion on the contemplated use of any machine a licensee is considering purchasing… The Board’s regulations specifically prohibit invasive procedures which result in the removal, destruction, incision, or piercing of a client’s skin beyond the epidermis or the application of electricity which visibly contracts the muscle (Title 16, California Code of Regulations, section 991).”2
The Industry Bulletin of August 10, 2022 continues with, “The use of electrical stimulation in providing skin care services falls within the practice of an [aesthetician] under certain conditions…
The Board understands that the following machines [or] devices while used in a proper
current range may not constitute an invasive procedure:
Galvanic current
Microcurrent
High-frequency current
Ultrasonic (low-frequency, low powered, topical devices intended for skin cleansing, exfoliation, and product application)
LED devices (410 nanometers to 945 nanometers).”
It also provides a list of services which may be considered invasive and provides parameters to consider when determining scope of practice.When considering whether a machine or treatment is within the scope of practice, ask if the intent of service is to beautify skin or to treat a disease or illness.2 The bulletin closes by advising the professional to maintain an equipment binder to answer any questions that may arise during an inspection, so they can stay in compliance with professional standards.3
It is imperative that skin care professionals review their state’s statutes regarding skin care equipment as each state board is responsible for regulating their respective licensees by determining if the intended use of the device is within the licensee’s scope of practice. Typically described as medical devices, the FDA regulates all devices sold in the United States, so their guidelines should be reviewed as well.
CHOOSING THE RIGHT DEVICE
After professionals examine what is allowed within their scope of practice and familiarize themselves with the intended use of each device, they can determine which devices align best with their skin care philosophies, support their treatment options, and meet their clientele’s needs and wants for addressing maturing skin.
The most common aging skin concerns are dull or dry skin, fine lines and wrinkles, hyperpigmentation, loss of elasticity and volume, and rough or uneven texture. In many cases, clients express a desire to address more than one of these considerations, so having equipment that can effectively multi-task is a great investment.
Microdermabrasion
Microdermabrasion is a noninvasive procedure that gently exfoliates skin to diminish signs of aging.5 This treatment is a great example of one that addresses several aging skin concerns (dull complexion, hyperpigmentation, fine lines, and uneven skin tone and texture) with no downtime. There are three main types of dermabrasion: crystal, diamond, and hydradermabrasion. Crystal is the traditional method involving a handheld device that sprays aluminum oxide crystals onto skin and simultaneously vacuums up dead skin cells, dirt, and the used crystals. Diamond utilizes a diamond-tipped wand that can more accurately remove the top layer of skin with no crystal particles left on skin. Hydrodermabrasion is a newer technique that combines the power of water and oxygen to remove impurities from the pores while exfoliating. It provides a deep cleaning, along with the added benefit of the delivery of antioxidant serums into skin.
No matter the method used, all clients need a series of treatments performed weekly or semi-monthly, or ongoing monthly maintenance to see the most effective results. Post-treatment, clients are advised to avoid exfoliants or active ingredients for two to three days to protect their skin.
Microdermabrasion, while an effective treatment, is contraindicated for anyone with rosacea, moderate to severe acne, active keloids, skin cancer, eczema, herpes simplex, or an active skin irritation, such as a rash.
Microcurrent
When looking for other multi-tasking devices for treating mature skin, professionals can also consider a microcurrent therapy machine. Microcurrent facials are FDA-approved skin care treatments that have been clinically tested for toning, contouring, and firming skin using gentle waves sent through the tissues and facial muscles. Studies have shown that microcurrent stimulation promotes mitochondrial function and induces adenosine triphosphate synthesis, the energy-carrying molecule found in the cells of all living things, which manages the creation of key structural proteins such as collagen and elastin.6,7 Microcurrent also increases circulation, improves fibroblast activity, and promotes lymphatic drainage, all of which can minimize the appearance of fine lines and wrinkles. The effects of this treatment are cumulative, and there are no harmful side effects. Given all these benefits, microcurrent facials are a great choice for a noninvasive, antiaging treatment that can be performed monthly or semi-monthly, with most clients opting for a series initially and ongoing routine maintenance for best results.
Microcurrent facials are contraindicated for anyone who is pregnant, has metal implants, or has a pacemaker. This treatment should be avoided by anyone who has received fillers or injectable neurotoxins in the past two to three weeks or has severe acne as it can aggravate inflammation.
LED Therapy
If looking for an antiaging device with proven results that can treat all skin types, light-emitting diode (LED) therapy is a great option. While most think of the aesthetic value of LED therapy as a recent development, it actually has a long history of use in the medical field. In 1903, a Nobel Prize of Medicine was given to scientist Niels Finsen for the use of light therapy, once known as phototherapy. Research progressed and by the 1960s phototherapy, now referred to as LED therapy, was being used primarily in Eastern Europe for treatment of chronic pain, arthritis and associated conditions, joint rehabilitation, and soft-tissue injury along with other medical ailments.8 In 1989, NASA stumbled into the world of medical light therapy, noting wound-healing as a side effect to experiments with photosynthesis.9
While there have been numerous studies on the medical applications of LED therapy for acne, dermatitis, eczema, psoriasis, rosacea, scarring, wound-healing, and photodynamic therapy, the studies of the aesthetic application for skin rejuvenation are equally impressive. LED treatments improve the appearance of photoaged skin, and, in contrast with thermal-based skin-tightening devices, such as radio frequency and focused ultrasound, do not produce thermal injury. The skin-rejuvenating effects of LED systems are produced by a mechanism known as photobiomodulation.10
Photobiomodulation is a form of light therapy that utilizes nonionizing forms of light sources, including lasers, LED, and broadband light, in the visible and infrared spectrum. It is a nonthermal process involving endogenous chromophores eliciting photophysical (linear and nonlinear) and photochemical events at various biological scales. This process results in beneficial therapeutic outcomes including alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration.11
Antiaging LED treatments typically revolve around the use of red light, infrared light, or a combination of the two. Red light therapy reduces inflammation, promotes circulation, decreases fine lines and wrinkles, improves skin tone and texture, and increases skin firmness and elasticity by stimulating fibroblast activity in the dermis. This helps the body produce the key proteins, collagen and elastin. Infrared LED light penetrates the deepest into skin and supports cellular regeneration while reducing inflammation.
LED therapy is a safe, noninvasive, painless, and highly effective treatment that is suitable for all skin types. However, it may not be advised for clients suffering from an active rash or who are currently using isotretinoin. Similar to microdermabrasion and microcurrent protocols, clients receiving LED facials are generally advised to begin with a series of treatments with ongoing routine maintenance for the best results.
SELECTING A BRAND
After spas identify the key device-based treatments they want to offer their clientele seeking antiaging services, it is important to know how to choose a brand or supplier to invest in the equipment. There are a number of factors for consideration when it comes time to make a decision.
Quality: To provide the best client experience and deliver optimal treatment results, the highest-quality equipment needs to be used. Think about whether the equipment being considered is the latest technology.
Features: Do research and always read supplier and product reviews to see if the features are worth the investment. Always consider clientele and treatment protocols.
Safety standards: Inquire on where the device and its components were manufactured. Almost all aesthetics devices are built overseas, but it is important to know if the devices come from a reputable manufacturer that produces machines built to safe standards.
Price: Budget can be a deal-breaker, so before buying any medical equipment, review the cost to determine if it is a worthy purchase and will provide the best value for the money. Weigh outright purchases of equipment against the cost of leasing, which can reduce upfront costs.
Service and maintenance: Any costs associated with the upkeep of the equipment needs to be factored in. Inquire with the supplier about what the maintenance on the equipment is, if they will provide this service, and who can provide immediate assistance in case problems arise or repairs are required. Equipment downtime will impact clients and potentially lead to a loss of revenue.
Warranty: Ask about the warranty period as well as what is covered and what is not. Also keep in mind that after the warranty is up, the professional is responsible for any costs associated with repairing and servicing devices.
Consumables: Are there consumable costs associated with usage? If so, this needs to
be a critical part of the decision-making process when determining which equipment piece
will be added to a spa business.
Training: Find out if training is required to best understand how to operate the
device. Ask if the supplier offers product demonstrations and training as part of the sale and onboarding process. It is critical that anyone using the equipment knows how to do so properly and that it is done safely for both the spa team and the spa’s clients.
In the booming world of technology, the spa has many tools at its fingertips ready to oblige a loyal client base. Remember to research scope of practice, the different device options, which brand to purchase from, and how to master any new modality before making the jump.
References
1. Diathermy. Cosmetics and Skin: Diathermy. (n.d.). Retrieved February 14, 2023, from https://www.cosmeticsandskin.com/efe/diathermy.php
2. Skin Care Machines/Devices. BarberCosmo: Board of Barbering and Cosmetology. (2022, August 10). Retrieved February 14, 2023, from https://www.barbercosmo.ca.gov/forms_pubs/publications/skin_device.pdf
3. Equipment evaluation form -California. (n.d.). Retrieved February 14, 2023, from https://www.barbercosmo.ca.gov/consumers/equip_evaluation.pdf
4. FDA. (n.d.). Medical devices. U.S. Food and Drug Administration. Retrieved February 14, 2023, from https://www.fda.gov/medical-devices
5. Microdermabrasion: Overview. American Academy of Dermatology. (n.d.). Retrieved February 14, 2023, from https://www.aad.org/public/cosmetic/age-spots-marks/microdermabrasion-overview
6. Yu, C., Hu, Z.-Q., & Peng, R.-Y. (2014). Effects and mechanisms of a microcurrent dressing on Skin wound healing: A review. Military Medical Research, 1(1). https://doi.org/10.1186/2054-9369-1-24
7. Encyclopedia Britannica, inc. (n.d.). Adenosine triphosphate. Encyclopædia Britannica. Retrieved February 14, 2023, from https://www.britannica.com/science/adenosine-triphosphate
8. What is the history of LED Therapy? Lightwave Therapy. (n.d.). Retrieved February 14, 2023, from https://lightwavetherapy.com/faq/what-is-the-history-of-led-therapy/
9. NASA. (2022, May 19). NASA research illuminates medical uses of light. NASA. Retrieved February 14, 2023, from https://spinoff.nasa.gov/NASA-Research-Illuminates-Medical-Uses-of-Light
10. Ablon, G. (2018, February 1). Phototherapy with light emitting diodes: Treating a Broad Range of Medical and Aesthetic Conditions in Dermatology. The Journal of clinical and aesthetic dermatology. Retrieved February 14, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843358/
11. Anders, J. J., Lanzafame, R. J., & Arany, P. R. (2015). Low-level light/laser therapy versus photobiomodulation therapy. Photomedicine and Laser Surgery, 33(4), 183–184. https://doi.org/10.1089/pho.2015.9848
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Lila Castellanos has focused her energies into the beauty industry for the past 19 years, specializing in skin rejuvenation. As a licensed aesthetician, she has lent her expertise to several different environments including working as a paramedical aesthetician in the medical spa field as well as in both day spa and mobile spa business models. It was through these varied experiences, along with the interactions with her loyal clientele, that she honed her passion for improving and maintaining the health and integrity of her clients’ skin. Castellanos thrives on being able to use her extensive knowledge to customize each treatment to help her clients achieve the results they are searching for. Her adaptability and versatility are equally impressive in providing antiaging facials, treating acne, and minimizing the appearance of scarring or when addressing skin conditions that arise as a result of hormonal changes.
