When Miranda Stanley became a nurse, she started in the ICU, worrying about hearts, kidneys and lungs, not skin. Later, working at the Institute for Facial Surgery, she saw the need for skin care expertise, and after deciding to become a family nurse practitioner, she focused on the skin. “I saw a need for it in our office, but also in the community, since it can take four to six months to see a dermatologist,” said Stanley. “I thought, as a nurse practitioner I can treat acne, or when a patient asks how to get rid of sun spots, we can help. I never in my wildest dreams thought that I would find it (skin care) so interesting.”
Laser Platform Technology
SKIN at the Institute of Facial Technology uses a Palomar Starlux 500 Laser and Intense Pulsed Light (IPL) platform. The platform allows them to attach multiple pieces to the laser. IPL does a lot of different things: permanent hair removal, treats facial veins and hyperpigmentation (sunspots), builds collagen, removes fine wrinkles and facial vessels and treats scars.
Most of the procedures done with the laser cause little or no down time. “We also have an actual laser hand piece which is the 1540 Erbium Fractional non-ablative Laser,” said Stanley. “That does some skin resurfacing and stimulates some collagen growth. I use it a lot for acne scars as well as for tightening fine little wrinkles on the face. Fractional means there is little or no down time, maybe a little bit of redness and swelling which may last 24-48 hours. There are ablative lasers in the community and you get better results quicker, but you have to put up with more down time, maybe up to two weeks.”
Treating acne marks is one of the most difficult things they do at SKIN. “Sometimes the laser is successful, sometimes not,” said Stanley. “If the marks aren’t too deep the laser is very effective. When I attend seminars on acne scarring they all say sometimes you have to use fillers or do a macrodermabrasion.”
The recommendations for hair removal are four to six treatments. The light from the laser is attracted to the pigment in the hair, so for blondes, or those who have turned gray, it may not be very successful. Permanent hair removal is 90% effective, can be done all over the body and people do see a reduction after the first treatment.
Continuing education is very important, and Stanley attends conferences three or four times a year to learn the latest developments and recommendations in skin care. At a recent conference, she had a specific purpose in mind; research two of the latest procedures and decide which one was right for her patients. “The laser is great for fine, little wrinkles around the eyes and mouth, but not when patients have a lot of skin laxity in the lower third of their face and you start to notice some jowling,” she said. “I went on the hunt for something that was non-invasive, with minimal down time that could help with those cases.”
Based on her findings, SKIN now has The Pelleve (pell uh vay) Wrinkle Reduction System. Stanley explained the difference between the laser and the new Pelleve system: “The laser fires a hundred different columns of heat into the skin while the Pelleve maintains the heat in the skin. It uses radio frequency waves that deliver energy deep into the skin and warms up the dermis, which stimulate it to produce collagen. It also tightens the collagen on the superficial layers so it creates a tightening on the outside of the skin as well. It takes one to three treatments and the results from one treatment may last up to six months, some research says up to eighteen months. Women will see a tightening right away from the swelling, not a bad swelling, which will go away in 24 – 48 hours. The body has been stimulated and after about 30 days a person will really start to see a difference and those changes will last up to six months.”
Treatments are usually 30 days apart and they will depend on how much of a difference a person wants to see. She is cautious about the patients she will see, since a person has to have collagen to stimulate more collagen. “I don’t want to let my patients down, so I may question the treatment of women in their 60s and those that smoke,” she said.
Stanley stresses that prevention is the key to any successful skin care regime. “Elastin is what makes our skin snap back, and our bodies stop producing it around the age of thirty,” she said. “As we are exposed to stress, UV rays and/or cigarette smoke, our elastin breaks down. We can stimulate more if we are actively working at it. Same thing with collagen. One of the easiest ways to prevent, or slow this down is to use sunscreen.”