The cost of cheap skin treatments?

What is the cost of treating our clients safely? High, as most of us in the industry know. We use some impressively dangerous devices and manufacturers that wish to supply us, Canadians with their devices need to go through proper application and licensing with our government, so that the devices in question, when used accordingly deliver results, safely. When you consider R&D, production, safety data, clinical studies, permits… etc. you start getting a glimpse of the true cost of a treatment. So, why then, is there such a huge difference in prices we see on the market? Cheaply imported equipment from countries like China, is one example. There isn’t much that can’t be brought to Canada however it doesn’t mean it’s legal or approved. Sadly, for many new technicians, as well as seasoned ones, the desire to keep their operating costs low can be overwhelming. Time and time again, I get shocked by how many of these technicians don’t do their research before jumping, both feet in, into buying widely available equipment, by training institutions we consider reputable, is astounding.

Some years ago, I worked at a gorgeous day spa, this place was top notch in every way possible. We had back to back I.P.L. hair removal appointments at discounted prices to attract new clients. It worked. Many numerous attempts to talk my boss into raising prices per treatment, fell on deaf ears. You can guess how this ended? Our I.P.L. handpiece eventually, as I tried to explain to my management, ran out of pulses. It was time to replace the handpiece. The cost of the new handpiece couldn’t be worked into the budget. Wonder why? (insert eyeroll) Management figured it would be cheaper to purchase a brand-new platform from some unknown online company. I kid you not, the platform, along with an I.P.L. handpiece to perform hair removal, skin rejuvenation, acne and vascular/pigmentation issues, for under $6000.

For those that know me, know I would fervently advise against this purchase, first, this device wasn’t approved by Health Canada. I asked my employer, in all seriousness if the insurance policy covers liability for the device, in case something should go wrong. Once again, no research was conducted, and I was told, they are good: “We have a Salon Policy” please, for all those, with “Salon Policies” that operate medi-spas, I urge you to read the policy, then immediately set up an appointment with your broker, so you can discuss your needs. A salon policy is an umbrella policy and wouldn’t give you all the necessary coverage.

Shall I get back to the newly acquired equipment then, you see, something did go wrong not long after they received the new machine. A client came in for her scheduled skin rejuvenation appointment and left with 3rd degree burns to her face.

I need to clarify; the new machine was not to blame. It was the technician’s fault. She failed to re-asses the client intake form, she did not perform a new patch test as is required with each new piece of equipment, she failed to adjust the parameters of the treatment from one machine to another and this client ended up scarred for life. Lawsuit was filed, against the spa as well as the technician, by the victim, and she deserved every penny of the millions she was awarded due to negligence. This case never made it to court, as it turned out, the insurance provider wouldn’t cover liability once investigations revealed, the equipment used wasn’t approved by Health Canada. The spa had to pay the awarded monies out of pocket, and they tried selling the business until they had no choice but to shut down in the end.

Yes, you can get insurance. However, there are many limitations and as a provider you need to do your homework to ensure you will get coverage when need arises. Many insurance companies blindly offer coverage in an attempt to get those premiums, nevertheless in an event of negligence or simply, your client not following post protocol could cost you millions if it turns out your equipment is not approved for use in Canada.

As mentioned before, many “reputable” training institutions offer affordable equipment that includes training, but it will always be your responsibility to find out if such equipment is approved. This is very easy to find out. Simple Google search for, MDALL, will take you to government website where you can search in their ACTIVE LISTING or ARCHIVED LISTINGS SEARCH. It either is in there or “NO MATCH FOUND” means the equipment is not approved.

Your next step, if you can’t find the device on the government listings, but still desire to buy anyway, is to set up that appointment with your insurance broker and have an honest conversation about what ifs and would you be provided coverage?

My advice remains same, find a reputable company, that went through application and licensing process to be able to sell you the equipment, yes it will cost more but you do need to price your service menu accordingly. Value yourself, the time and money you invested into your education and business. You do not need every client out there, just the ones willing to pay you your worth in exchange for great results, safely.

To all our amazing clients, you too need to be involved and do your homework. Please remember, skill and expertise along with powerful equipment, shouldn’t come cheap. It’s better for everyone if you wait until you can afford these treatments, because at the end of the day, it’s not a need, it is a want.

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Fractional Resurfacing Treatments

Our world is excessively focused on youth and beauty, otherwise there would not be millions upon millions of creams, peels, lotions, potions, serums, advanced technology or injectables! For majority, it is all too confusing, but how could it not be? We have many manufacturers quickly spit out treatments, put a slightly different tweak on it and try to convince you, it is brand new, the best, the greatest! When in fact, they are using already discovered treatments and are attempting to refurbish them to convince the end user, there is nothing else out there like it.

I will focus my attention on Fractional Resurfacing treatments. On tv, on social media, in clinics it’s all the rage, and over the last decade, the variety and tweaks to good old-fashioned fractional treatments has exploded.

What is then a fractional treatment? Think of it like aerating your lawn. The purpose is to cause small areas of damage, to allow the healthy surrounding area an increase in oxygen and nutrients and to jumpstart the healing, which at the end of the healing cycle improves the look of your lawn, or as is the case for your skin using fractional resurfacing. The analogy isn’t perfect but it’s dang near close.

Now that we have established the benefits of using fractionated treatments for the treatment of aging, fine lines, wrinkles, hyperpigmentation, scarring, the list goes on… let’s figure out what equipment is best for the job.

You have more than likely heard about the Fraxel, the Pixel, the Clear Lift, the CO2, the Venus Viva, the Fractora, eMatrix, and many more, yet what no one takes the time to clear up is the fact that all these technologies take a form of energy, supplied by the electromagnetic spectrum, and apply it to the skin in small “dots” in a matrix (or a grid pattern for the purpose of injuring a tiny portion of skin and relying on your own skin’s injury healing mechanism to take care of the rest. (The Wound Healing Cascade) Same concept applies to all forms of microneedling as well!

So, what exactly sets these numerous machines apart? First, the spectrum of energy it uses and what is powering it? The electromagnetic spectrum is simply a range of frequencies of electromagnetic radiation, as well as their respective wavelengths and photon energies. We are surrounded by this spectrum; we live and depend on it for many things. The science has discovered a multitude of applications, when a specific spectrum is selected to produce different effects, in our case, for therapeutic and medical purposes.

Now, getting to the second part, the power supply, the excitation portion. In the case of true light therapy (IPL and Laser) plugging in to the outlet to get electrical power will not make you the type of light that can accomplish the job, this is when we need the help of a medium, this can be gas, liquids or solids. (More on this in my first article, Laser vs I.P.L., you should check it out)

So, you have a C02 Fractional, that means you are getting a laser treatment, or maybe it’s an erbium yag (er:Yag) in which case it is still a laser treatment using a solid medium… and so forth (do you see the pattern?)

Let’s work our way though the electromagnetic spectrum and pick up a radio frequency out of the line up. Still rather a simple concept of using form of energy to “burn” a dot into the skin, or a grid of dots. Therefore, the treatment is still fractionated but is using a different kind of energy to accomplish the job.

Usually, around this part of the lesson, the confusion arises over when to use which energy. Questions of who is a good candidate? What are contraindications for each? When would you use one over the other? Etc…

The short answer: you usually can’t afford more than one technology and those that do, have large clinics with more equipment than capable technicians. In my humble opinion, all these previously mentioned technologies are very lovely, they deliver the promised result but only when used to its potential correctly. Downfall to our industry, are uneducated technicians operating equipment far superior to their limited knowledge. It is not as simple as plugging it in and hitting a few buttons before we blast holes into your skin.

Expert knowledge of skin components and how they work is paramount, as is the understanding of lifestyle and contraindications so we can determine which treatment, how often, how many and what pre and post care protocols will be involved before you can ever bring the technology to the patient’s face. All technology has limitations and that is acceptable in the hands of a technician who isn’t afraid of admitting, the equipment they invested in, may not be the very best option for everyone. In their pursuit to make a sale, there is no winners or benefits to you, the consumer.

Laser vs IPL

Recently I got banned from commenting on an ad, by Hey Silky Skin Co., on Facebook. These ads have been plaguing my feed incessantly that I decided to check out this little “laser at home” device. As I was scrolling through countless comments, the utter confusion among the consumers rampant and a company not willing to be honest about their product was disturbing to me. (In all honesty, it does not take a lot to disturb me) It was time to chime in and hopefully clarify some of the misconceptions.

The company responded to my inquiry about the lack of safety googles and nothing about what was being used in the device as the exciting medium. Of course not, their device is a strong lightbulb, why would you need eye protection? Which brings me to my point, making the consumer aware of what they are purchasing under the guise of a “laser”.

Shall we have a little comparison? It’s fair to first establish a few major differences between “laser” and “IPL” to help us better understand applications of each. Theory of light therapy is vast, I know, I teach it at a wonderful college here in Calgary. But to help anybody understand the basic principles of light I will only scratch the surface of the iceberg that is lasers and IPL.

First things first, what is light? Light is a part of the electromagnetic spectrum. This spectrum is a collection of ALL waves: ultraviolet, visible light, infrared, microwaves, radio waves, ×-rays, gamma rays.

Many scientists theorized and experimented to figure out the phenomena that is light. That is until Albert Einstein proposed light has the characteristics of both particles and waves. So, we now have tiny particles = Photons = energy bundles = traveling in an oscillating pattern (waves = wavelength). Imagine turning on an ordinary light. Those tiny particles scatter and “shower” us with light.

Pretty basic, right?

So, then what happens when amazing scientists can harness these particles into a high-powered, hand-held, computer-controlled FLASHGUN?

The result is a very intense, visible pulse of light. Hence, I.P.L. = Intense Pulsed Light. The resulting light has a variety of ranges (nanometers) that can be filtered out to perform a specific task. The job is always the same, based on the principle, that light is attracted to dark and since dark absorbs that energy, the result is heat.

To be more specific, the light will focus its attention to a molecule (chromophore) that gives tissue/ mass its color and this chromophore (ex. Melanin in hair/skin) absorbs the light until enough heat is created to coagulate (kill, zap, cook) the target.

Here is the thing, in order to understand how light therapy can be applied to the human body for a variety of therapeutic, medical and cosmetic purposes, you also need to learn about human anatomy. That is not the purpose of this article, not today.

Back to I. P. L., it is:

                1. Scattered (polychromatic = multiple colors)

                2. Covers large areas quickly

                3. Less pain

                4. More affordable

 Theory of light remains the same, regardless of technology or equipment. It comes down to how this light is “packaged” and delivered. Which brings me to LASER. It is an acronym for Light Amplification by the Stimulated Emission of Radiation.

Easiest way to remember this, we need to have a medium/lasing/excitation material to excite and help multiply our lovely energy bundles (photons) until enough are produced to form a powerful beam of light, to perform the same treatments, or like I.P.L.

Which brings me to the characteristics of L.A.S.E.R.

                1. Monochromatic (single colour)

                2. Collimated (parallel to one another)

                3. Coherent (consistent)

True laser technology will deliver a high energy output that uses those deeper wavelengths of the spectrum. Meaning, because the beam is small in diameter, with all the photons traveling tightly bound together in the same direction, the beam is capable of deeper penetration, and in terms of what that means for human skin can be quite damaging, (yes, we injure the skin on purpose and rely on our injury healing mechanism to force regeneration) more reason to understand human anatomy!

So, there we have it. Plain and not quite so simple.

Hey Silky Skin Co., like many over the counter products was designed to have the energy of a flashbulb that emits about 4.9 Joules/cm2 if you are lucky. The more you use your handheld device the weaker the energy output. Did you really think they would allow high amounts of energy in the hands of the public?

Could you imagine the lawsuits in the making? I can!

Before I reach my conclusion, I would like to apologize to the clients and customers worldwide, on behalf of all trained and highly skilled laser technicians, on receiving less than stellar results and often time painful and scarring treatments caused due to lack of education and training. Our industry is unregulated, and anyone can get their hands-on light therapy equipment. If you have the money you too can buy and operate a laser/IPL. Unfortunately. Back to Hey Silky Skin Co., this device will not produce satisfactory results, not long term and my biggest concern is that our overwhelmed landfills will be plagued as much as my social media feeds. I will recover, this planet is the only one we have, please consider carefully if buying this hand-held device and save your money for proper treatments.