Permanent Hair Removal?


Unwanted body hair has long been an aesthetic concern for both men and women, with evidence having been found for recipes for hair removal compounds dating as far back as 3000BC!  Some modern commentators feel that the proliferation of female nudes in art since the sixteenth century has encouraged the idea that the female form should be hairless.  The modern form of this is obviously the mass media exposure everyone not living in a cave is bombarded with through magazines, social media, TV and film.  Whatever the causes this is a cultural and fashionable concern that doesn’t seem set to go away in out lifetimes.

IPL

So we agree that the desire to have smooth hairless skin is something deep seated in our cultural psyche, and you have decided that you are amongst the majority of people willing and happy to follow the trend.  You are familiar with the current accepted methods of hair removal such as waxing, shaving or epilation but are getting fed up with the time involved, the discomfort and the frequency of treatments required.  You’ve heard about laser hair removal, some people have told you it’s painless and lasts for ever, and others have told you it’s agony and ineffective!  What’s the truth?

How does the treatment work?

“Watch the video here

The reason your hair grows back after most forms of hair removal is that you only remove it at the level of the surface of the skin.  The hair follicle itself actually extends quite deeply into the skin to a structure called the hair “bulb”.  This bulb will constantly regenerate the hair follicle causing return of growth within a relatively short time,  Just think of how often some men need to shave their beards to keep a smooth chin!

The goal of semi permanent hair removal is to remove the bulb itself, thus preventing future regrowth.  Both laser and IPL treatments do this using light energy.  You will know how light energy heats things up, think of how hot the buckle on your seatbelt can get in your car on a hot day.  What the Laser and IPL devices do is apply a specific part of the light energy to the skin, that is preferentially absorbed by the pigment in the hair.  This energy converts to heat along the entire length of the hair shaft causing it’s instant destruction.  When the shaft of the hair is in contact with the bulb of the hair the bulb also gets destroyed, and can no longer produce new hair.  It’s as simple as that!

 

Laser Hair Removal copy

 

Why do you call it Semi Permanent?

Good point.  You would think that when the hair follicle is destroyed that should be the end of it for ever.  Unfortunately that isn’t the case. Your skin has an ability to create new hair follicles as time goes on, meaning the hair will very slowly recover.

I’ve heard I need several treatments?  Shouldn’t it work with just one?

Won’t work with just one I’m afraid.  The reason for this related to the way it actually works.  We’ve mentioned it destroys the hair bulbs in contact with the hair shaft, and that’s the problem.  Not all hair shafts are actually in contact with a working shaft, they tend to lift off and float towards the surface as they mature.  As a rule only one quarter of the hair gets treated in any one session.  This means that between 4 and 6 sessions are often required, between 2 and 4 weeks apart.

Am I suitable for treatment?  I’ve been told before that I have the wrong skin type.

Most people are suitable for treatment, the decision is made based upon the skin colour and the hair colour.  Because the technology depends on the pigment in the hair follicle, the darker the hair the better.  Completely white hair is very difficult to treat this way, the lighter the hair colour the more treatment sessions are required.  When considering the skin, we want the energy to be absorbed by the pigment in the hair follicles, not the pigment in the skin, so we have to change the energy levels in darker skin types, so dark skin types may also require more sessions to get a good result.  So to summarise pretty much anyone can get treatment, it’s just that the number of treatments required and the overall result will differ for light hair and for darker skin.

How many treatments are required, and how long do the results last for?

For most people a course of six treatments is recommended.  This is usually effective.  Due to the regeneration of your skins hair follicles, smaller hairs tend to appear very slowly after treatment and a single session is recommended once every year or so to keep them at bay.

Is the treatment painful?

Not at all.  Older technologies using straightforward light energy alone were quite uncomfortable, but modern devices use other technologies together that reduce the overall energy required, and cooling to reduce the sensation.

 

I’d like to give it a try.  What else do I need to know?

If you’ve read this far and you are interested in finding out more or booking a treatment session there are a few things you should know.  You can’t have treatment if you currently have a tan in your skin, as it may cause burning to the treated area.  You also need to avoid sun exposure during the course of the treatment so a factor 50 spf is recommended to be used daily on sun exposed areas.  This is a medical treatment and whilst usually safe there is an element of risk.  The risk in relation to this treatment is the small chance of blistering, redness and burning of the skin.  To make sure this doesn’t happen a full assessment of your skin type is made, so the safest settings are programmed into the device.  We also require that you have a patch test of the treatment at the chosen settings at least 24 hrs before your treatment, so we can assess the response.

If you would like more information you can contact us by phone, on 0141221029 or e-mail us here

Sclerotherapy and Varicose Veins


The difference between thread veins, varicose veins and spider veins is often hard to define. Generally speaking spider veins and thread veins are the same thing. Small red or purplish veins very close to the surface of the skin, generally thinner than a millimetre or two. They don’t tend to cause bulges in the leg. Varicose veins can be described as larger and deeper veins that cause unsightly bulges in the leg.

The treatment for the two is very similar. Both types are treated with a treatment called sclerotherapy. For thin superficial veins it is micro-sclerotherapy and for deeper bulging veins it is ultrasound guided foam sclerotherapy. Often a combination of the two forms of treatment is required as many people will have both superficial and deep veins.

There are a few reasons for having the veins treated. They may be uncomfortable and itchy, they may also cause aching at the end of a day. Veins can also be treated if they are unsightly and cause embarrassment when wearing short dresses or beachwear.

Treatments are performed after a consultation and often an ultrasound of the leg veins is performed, to identify and possible risks from performing the procedure. The treatments are performed in the clinic and typically take less than half an hour.  Most people find the treatments entirely painless. After a vein treatment a compression stocking needs to be worn for one week in order to keep the veins flat and prevent them from re-filling. After one week the stocking can be taken off at night but still needs to be worn in the day time for another week.

For small areas one treatment is often sufficient, but for larger areas or bigger veins further treatments may be required. You will be advised as to the likelihood of repeat treatments at your consultation.

At Clinetix all our leg vein treatments are performed by a vascular surgeon, Mr Bryce Renwick, who has had extensive experience treating complicated varicose veins in the NHS. Read Mr Bryce’s FAQ’s on out leg vein page here

Consultations and treatments are available in our Hyndland Clinic.  For more information, or to book a consultation you can phone our clinic on 01412210229, or contact us through the website here

Regulation of Aesthetic Medicine in Scotland


With increasing numbers of the the general public seeking aesthetic medical treatments such as anti-wrinkle injections and Dermal Fillers, we are seeing a large increase in the number of aesthetic practitioners providing their services in Scotland. Whilst this may be seen as a good thing in terms of the choice now available to the public, most healthcare professionals feel that the current situation is a disaster waiting to happen.

The problem is that there is little or no regulation of the aesthetic medical industry in the UK. It was probably expected that there would never be a situation where a person may have a medical treatment outside of a clinic environment, performed by a person with little or no qualification or training. This is however the situation we now find ourselves in.

The lack of regulation and control has made it easy for unqualified individuals to access basic training and start to provide risk prone procedures in their own houses, in beauty salons, hairdressers and in some reported cases, in car parks and in toilets in nightclubs!

The public need to be made aware that these medical procedures carry risk. That risk may be infection, allergic reactions, and in some cases tissue damage and necrosis leading to permanent scarring and disfigurement. It is also now known that permanent blindness may occur as a result of treatment. The way to mitigate these risks is to have the treatment performed in a clinical environment that is hygienic and with appropriate safety measures in place and available to be used if required.

The chance of an adverse outcome is also considerably less when the treatments are performed by experienced and medically trained professionals.

We are pleased that the Scottish government is the first in the UK to announce that it will start to introduce a regulatory framework to ensure patient safety and promote and maintain high standards. The regulations are to be implemented over a three year period starting in April 2016.

The first stage of the process involves the regulation of independent clinics. Although we welcome the process and feel that accreditation of the clinics themselves is of importance we also think this is a little disingenuous as the bulk of the poor practice happens aside from the independent clinics. We feel that this approach has the potential to damage the practices that already try to maintain high standards whilst at the same time allowing unqualified, unscrupulous and dangerous practice to continue in non-clinical environments.

The second stage of the process will look at certain high risk procedures, and specifically mentions dermal fillers, and specifically dermal fillers being done in clinics provided by other health practitioners. In the detail of the report this is described as beauticians, hairdressers or similar therapists. If this is the case then again this seems like a rather pointless exercise, as although I am aware that there are non-medically trained people injecting dermal fillers in Scotland, I can’t think of a single medical aesthetic clinic premises that allows non-medical staff to perform the treatments. So exactly what this arm of the regulatory framework will achieve is not entirely certain, although some form of accreditation for beauticians with specialist training who perform treatments such as IPL, Laser, chemical peels etc would certainly be of benefit, as these are “risk prone” procedures and the training and supervision of anyone performing these should be standardised.

The third and final phase will “seek to develop a system of regulation for other groups of practitioners” By “other” I understand this to mean the practitioners who are not involved in the first two phases. That would be then people who are not medically trained and people who are not working in a Clinic environment. So this is in essence the group of people who are at higher risk of causing complications and adverse events by poor practice.

In summary whilst regulation of this branch of medical practice is clearly required, to protect the public from harm, we wonder why the government plan involves tackling the practitioners who provide high quality care first, and the practitioners who are most likely to put patients at risk last? Is it not possible to do this the other way around? Regardless of my misgivings regarding the order of the process it is most definitely a welcome process that should, over a period of a few years, reduce the number of poor quality and dangerous treatments being performed and reduce the risk of harm to members of the public who are simply trying to improve their appearance.

Read Simon’s interview for the Herald here

The full report of the Scottish Cosmetic Interventions Expert Group can be found here.

Acne and Acne Scarring


Acne is a common skin condition that is often overlooked and under managed, in the belief that it is a temporary affliction that will resolve itself with time.  Whilst there is a small amount of truth in this, acne often remains problematic for years, and the pigmentation and scarring that sometimes occurs can last for a life time.

What is acne?

Acne is a disorder of the pilosebaceous unit.  This is essentially a structure that contains a hair shaft and a sebaceous gland, that makes sebum.  Sebum is a substance we need to lubricate and waterproof our skin.  It is currently thought that acne develops after a variety of processes that narrow or block this structure.  This causes a build up of sebum within the structure leading to some irregular lumps and bumps on the surface of the skin.  This is commonly known as comedonal acne.  The blocked glands can then become inflamed resulting in pustules. These can then progress to cause rupture of the structure with inflammation extending to surrounding tissue with resultant scarring and nodules.

What causes it?

The main causes are hormonal changes and a bacteria called Propionibacterium acnes (P. acnes)  The hormonal changes are easily seen as androgen levels increase in puberty, resulting in an increased sebum production and an increase in acne lesions.  This can also be seen in who start or change their contraception.

The bacterial role is complex. P.acnes (the bacteria) is thought to increase the stickiness of some of the cells in the gland, resulting in blockage and comedone formation.  It is also thought to be responsible for secreting enzymes that contribute to comedone rupture and the tissue injuries that result in scarring and pigmentation.

How can we treat acne?

Topical treatments

The first line treatments are  usually skin preparations such as benzoyl peroxide.  Benzoyl peroxide is effective in reducing the bacteria, and also helps “unstick” the stuck cells in the blocked comedone and promote it’s recovery.  Antibiotics can also be used, either in creams applied to the skin or in tablet form.  Retinoid creams have a number of actions that help normalise the skin cells and are effective in the management of acne.

Phototherapy

If initial treatment is not effective it is worthwhile adding phototherapy to the treatment regime.  LED phototherapy uses low energy light to stimulate a variety of cellular responses that can destroy the bacteria, as well as suppress inflammation and pigmentation.  LED phototherapy is very effective, particularly when combined with topical treatments.  It is currently recommended to have treatment blocks of 10 or more sessions, two or three days in-between sessions.

Chemical Peels

Chemical peels are solutions that are applied to the skin and allowed to soak through the epidermis for a set time, before being neutralised.  Some chemical peels such as Salicylic peels or Pyruvic peels have been shown to be particularly effective in the management of active acne, with reduction in the number and severity of lesions with a course of treatments.  6 treatments or more may be required with one or two weeks in-between treatments.

What about Scarring and Pigmentation?

The long term consequences of inflammatory acne can include pigmentation changes and facial scarring.  Both acne scars and pigmentation can be improved with skin resurfacing treatments such as dermaroller, chemical peels or laser resurfacing.  The treatments vary in term of the downtime required, the number of procedures required and the outcomes.  In general terms laser resurfacing is considered the gold standard treatment with fewer sessions required and better outcomes, however there may be up to a couple of weeks of recovery after each treatment.  Dermaroller also gets excellent results but will typically require more treatments.  There is less downtime with a dermaroller, often the skin is just a little red for a few days.  Chemical peels can get good results depending on the depth of the peel.  The deeper the better, up to a point, but deeper peels have longer downtime.  You need to discuss your options with your doctor and decide on what treatment works best for you, in terms of the outcome desired, the downtime tolerable and the number of sessions you can commit to.

 

We hope this short article answers some of your questions.  If there is anything you would like to know more about please contact us here and we will be happy to answer your enquiry.

Simon Ravichandran