Body talk

With more clients seeking skin rejuvenation treatments beyond the face, Ellen Cummings explores some popular areas for laser and IPL

As technology has advanced, laser and IPL treatments have become increasingly versatile and suitable for treating concerns all over the body. This evolution is well-timed to meet the growing client demand for treating areas other than the face.

“I think people are starting to look after their skin health as a whole and not just focusing on their face,” says Kerry Belba, clinic director at Laser Skin Solutions in Bournemouth and executive board member of the British Medical Laser Association. She adds, “If there is something that patients or clients wish to improve, there’s pretty much always a technology now that can help.”

This demand has stemmed from an increasing client awareness of both the science of skin and the technology that can make damage less visible. Nilam Holmes, owner of Dermaspa in Milton Keynes and brand ambassador for aesthetic device manufacturer Alma, says, “In particular, clients are a lot more aware of the ageing effect and more importantly the dangers of sun damage and this is probably the concern most commonly treated with laser. IPL also helps to reduce sun damage and has the added bonus of skin rejuvenation; therefore, it has become more popular.”

While laser and IPL can now be used to treat a range of concerns from head to toe, we’ve taken a deep dive into three of the most popular areas.

Hands

The hands are one of the first areas of the body to show signs of ageing because they’re exposed to the elements daily but are often neglected when it comes to regular SPF application and protective skincare. This makes them a popular choice for skin rejuvenation treatments.

“Hand treatments are gaining popularity as people recognise that hands can reveal age, and anti-ageing efforts extend beyond the face,” comments Joanne Leahy, head of training at device manufacturer 3D Aesthetics.

It’s likely that most people will see some signs of damage on their hands, but when it comes to who is seeking to remedy it, Belba says, “Clients looking for hand rejuvenation tend to be more mature, and while skin rejuvenation on the face is popular for both men and women, hand rejuvenation is predominantly a treatment sought by women.”

Laser and IPL treatments can tackle a range of concerns on the hands, including pigmentation, sunspots, skin laxity and general skin rejuvenation. Leahy adds that laser treatments can also promote collagen production, reducing fine lines and wrinkles while improving skin texture and elasticity.

Both laser and IPL treatments work through selective photothermolysis, using light to target specific skin components. Leahy says, “In lasers, a focused beam emits a single or triple wavelength while IPL uses a broad spectrum of light. The targeted light is absorbed by chromophores in the skin, inducing controlled damage.

“Certain wavelengths of laser will be attracted to different chromophores in the skin, offering different benefits and different outcomes. While lasers offer high precision, IPL is versatile but may be less precise due to its broader spectrum. The choice between the two depends on specific skin concerns, individual skin types, and treatment goals.”

When it comes to choosing a device to treat concerns on the hands, Belba advises, “Medical grade IPLs working at around 585nm wavelengths are excellent at removing sunspots. For paler sunspots, a ruby laser (694nm) will get better results. While a KTP laser (532nm) can also effectively remove sunspots, due to the high absorption of blood (as well as melanin), this laser can cause unnecessary bruising in the area.”

As with any laser or IPL treatment, there are various contraindications – so a full medical history should be taken, and a patch test carried out.

Leahy explains, “There are a number of contraindications that therapists need to be aware of, such as photosensitivity from medications, certain health conditions, pregnancy, skin cancer history, keloid tendencies, the use of photosensitising topicals, and recent sun exposure.”

Belba adds, “Tanned skin is completely contraindicated for laser treatment. This is because the laser light is absorbed by melanin – the pigment in our skin cells. When treating sunspots, we want to selectively heat the melanin in the sunspot while protecting the skin. If your skin is tanned, the laser light will heat both the sunspot and tissue, thereby potentially creating a burn.”

Additionally, practitioners need to take care when treating thin skin on elderly clients, especially when the bones in the hand protrude due to volume loss.

When carrying out any laser or IPL treatment, the experts recommend that practitioners have a minimum of an Ofqual-registered Level 4 laser qualification, a Core of Knowledge certificate and manufacturer training. Belba says this level of training and qualifications is important for everyone – regardless of whether they are a beauty therapist or a doctor. “Being in the medical profession does not automatically make you a laser expert,” she says. “It’s the laser training and qualifications that count.”

Neck and décolleté

The skin on the neck and décolleté is particularly delicate and prone to laxity, pigmentation, broken capillaries and wrinkles, making it an increasingly common area for skin rejuvenation treatments.

“At my clinic, we tend to see predominantly female clients in their late 30s and early 40s upwards,” says Belba. “Necks tend to be almost as popular as faces, but clients have started thinking about the décolleté area too.”

When treating broken capillaries and blood vessels, Belba says, “Laser/IPL light is absorbed by the vessels coagulating the blood, which is then removed from the body by a process called phagocytosis. White blood cells engulf the dried-up blood and carry the particles away via the lymphatic system.”

If improving skin texture is the goal, fractionally ablative skin resurfacing works by creating controlled thermal damage in the skin, triggering a wound-healing response in the body. While attempting to repair the damage, the fibroblasts in the dermis produce collagen while the upper layers of the epidermis are shed, helping the skin to appear plumper and smoother.

Depending on the colour of the veins, Belba says lasers like the Nd: YAG and IPLs working around the 585nm mark work well for reversing sun damage. “For skin texture and crepiness, fractional skin resurfacing works well with fractionally ablative Erbium YAG lasers which operate at 2940nm. CO2 lasers can also be used for this area. While the pulsed dye laser is used for vascular treatments, it’s not generally recommended for this area due to the significant bruising it can use which would take a long time to heal.”

Belba adds that practitioners need to take care when treating this area as the skin can be thin on older clients and it is an area that can be prone to hypertrophic or keloid scarring. Holmes also encourages exercising caution: “I find IPL with a strong cooling system is best, and safest, for this area because it’s so fragile that it is very easy to burn and blister the skin.”

Stretch marks and C-section scars

Some clients can be self-conscious of stretch marks that come from the rapid growth of the abdomen during pregnancy, and the experts say that they often see clients requesting treatment for this.

With stretch marks, skin texture can be improved and redness reduced. Holmes says, “Unfortunately, stretch marks are actually scar tissue where the skin tissues have separated and torn so it is impossible to return to the original condition of the skin, but the appearance can be hugely improved. The sooner the client is treated after developing the stretch marks, the easier they are to treat.”

C-section scarring can also be treated with lasers to help minimise and flatten the scars, although Belba believes that treatment of this area isn’t as popular as it could be. “My feeling is that this is probably because people may not be aware that laser treatment could be beneficial,” she says.

As with stretch marks, C-section scars present challenges for laser practitioners. “These are really difficult to treat because the incision is made through all of the layers of tissue including the fat and the muscle, so a multi-faceted approach is needed to address the problem in all these layers,” explains Holmes.

“For example, the surface scar may be white and shiny whereas midway down the tissue could have hardened and contracted from the join, causing puckering and an uneven surface, and there could be an indentation in the fatty tissue.”

The treatment works by deliberately damaging the scar in a controlled, safe manner to induce enhanced repair and collagen production. “By creating this trauma, we can soften and remodel the scar tissue,” says Holmes.

Belba expands on this, explaining, “The laser light heats the water content within the epidermis to around 100ºC, causing ablation within the skin. Some lasers work by causing full ablation (removal) of the upper layers of the epidermis, while others fractionally ablate the skin, treating around 20% of the skin at any one time.

Fractionally ablative lasers have less downtime and risk but will require more treatments.”

Belba recommends fractional skin resurfacing using an Erbium YAG laser, in addition to fractional CO2 lasers. “IPLs can work well to reduce the vascularity (redness) present in some stretch marks,” she adds.

The usual contraindications for laser and IPL treatment apply here, and Holmes adds that practitioners also need to consider post-pregnancy hormones, which might increase the risk of post-inflammatory hyperpigmentation.

C-section scars must be healed before starting treatment, but as with all scarring, results are best if laser treatment is carried out within the first six months of surgery, and stretch marks also tend to respond better when they are newly formed.