Episode 6: LaseMD Laser

Lasemd is a fractional non-ablative laser that keeps the top layer of the skin (epidermis) intact and lays down tiny little micro zones into the top layer of the dermis to help stimulate elastin and collagen.  It also is a powerful tool to allow for the topical delivery of cosmeceuticals.  
This laser does not carry a very long downtime (there is some redness and a "gritty" sensation) for several days.
It is one of our "gateway" laser procedure to begin to minimize the fine lines and wrinkles and for helping to minimize the benign pigmented spots on the skin.
We have before and after photos on our instagram page at SalujalaserMD. 

Thank you for your listenership!

Transcript

Dr. Saluja

Hi everyone. Thank you so much for joining us for the next episode of just Laser It and all things cosmetic. I am here with our Motley crew, which consists of me, my husband, Kane, and our quieter dog Link. Our louder dog is probably downstairs barking at Amazon drivers or who knows what. But Kane, how are you doing?

Kane: I'm doing wonderful. Thank you.

That music always gets me dancing a little bit. 

Dr. Saluja: So what we're going to do today, we're going to start to go into different lasers that we recommend at the practice, and one of the first lasers that we're going to talk about is specifically Lasemd, which is a laser that's made by Lutronic.

And Kane, what we're going to do is we're going to kind of go through why we even do this laser, why we're trying to build collagen and elastin and what's happening in our skin with time. And then we'll go through the classic patient for this and what they can, how they can prepare for it and what they can expect during the treatment.

Kane: Perfect. This is, I'm excited for this topic because it's probably one of our more popular procedures. A lot of patients come in for this, but a little more knowledge I think will be, will be well received.

Dr. Saluja: you're right, it is one of our gateway procedures for sure. And you know, oftentimes I'll hear, hear patients say that, okay, I am on tretinoin, which we love for patients to be on. I'm on my sun protection, my moisturizer, I've done some Diamond Glows. I've done some chemical peels. What is the next step? And this laser as well as PicoSure is kind of our next step laser

Kane: What makes you say that? Why?

Dr. Saluja: because it is a procedure, a fractional non-ablative laser, so it can be used on any skin type, which is great.

And if you go back to episode 1, differentiating between non-ablative and ablative, it carries a lesser downtime and it's quicker to heal from. So it's kind of the first step when you're kind of walking into lasers.

Kane: Okay, so we'll, let's dive a little bit more into that. But first, why would we need.

Dr. Saluja: Well, what happens is, you know, there's kind of a pace of aging that occurs in our skin.

And what I mean by this pace of aging, there was actually a British Journal of Dermatology, looked at this and looked at how quickly we lose collagen. And actually, starting in our early thirties, we begin to lose 1% of our collagen from our skin per year.

You add that up over time and you're sitting in at maybe 38 and 40 and all of a sudden, you're thinking, gosh, what should I be doing for these mild wrinkles that are starting to show.

Kane: We will talk a little bit about collagen.

So, what if you lose 1% per year, like what's it doing?

Dr. Saluja: Collagen is the most abundant protein in our skin. It comprises about 75% of our skin is the protein collagen, and it's basically the structural or the mechanical support of our skin. So when we lose collagen, what happens is the dermis begins to collapse and we start to form lines and wrinkles in our skin.

So think of it as the pillars or the structural support of our dermis

Kane: Kind of the scaffold?

Dr. Saluja : That's a great way of looking at it. The scaffold of the skin. Correct. Now along with that is also elastin, which is also a protein. Elastin is different than collagen. Elastin is what gives us that youthful rebound, kind of, that recoil to our skin.

I almost laugh because as, as I've gotten older, of course I'm going to lose elastin collagen. Of course, I'm in my chair trying to rebuild it back up. But I've noticed that if I was to get a massage, I can carry around that massage table imprint for longer than I used to when I was much younger. You know, before you, your skin would bounce right back, but when you get older, you start to lose at elastin.

So this helps with that as well. 

Kane: Got it. So, so you're losing a little bit of the structure and the bounce?

Dr. Saluja : The bounce, yes. The elasticity, that recoil mechanism that youthful resiliency to your skin.

Kane: So that's where this particular laser, LaseMD, can come into play to start to rectify that.

Dr. Saluja: Correct. And there's other things that occur with aging as we know now. Granted broken capillaries that's done more with IPL, Lasemd does not target the hemoglobin, but what Lasemd does target is it targets the water that's in the dermis. So, it gets down to the top layer of the dermis, the papillary dermis.

And it's creating these little fractional zones in the skin. Little heat zones or little micro columns in the zones, which are like little micro wounds that stimulate the body to create this elastin and collagen. But these little micro zones can also brighten the skin. So, you can often see with aging, you can start to see some, what we call dyschromia, which is discoloration, kind of patchy discoloration of the skin.

It can help with that as well. So that's the brightening effect that can occur.

Kane: So by creating these little wounds, the body's saying, oh, I need to, I need to correct this wound. And by doing so, it stimulates, is it more collagen and elastin? 

Dr. Saluja Yes. And think about like even when you scratch yourself, you know that that little scratch, that little abrasion heals over.

And why? Because we're building our collagen. So same thing. We're creating thousands of little micro wounds. So this device has got little rollers on it. And for every one centimeter that you roll, you're laying down about 40 little pulses. And so, we're doing countless passes on the skin, six to eight passes.

And so we're getting about 12,000 to 15,000 little micro wounds on the skin that heal over and create collagen and elastin.  

Kane: And so how long does a face typically take to do?

Dr. Saluja:Not long at all. It takes about 10 minutes to do the face. We also do the neck. There's a popular area and we also do a lot of hands.

Some people have had their arms done as well, but primarily I'd say the most popular areas for this are face and the neck area. And LaseMD stands for something. It stands for laser assisted single effective Molecule delivery, which means that it also is a cosmeceutical delivery system, so when you're creating these little zones in the skin, your kind of creating little microfractures in the skin, which allows for product delivery to be placed on top of the skin to get down to the dermis.

LaseMD has some proprietary blends that they have, but we also use, this is a key area. We also use exosomes, which have growth factors in it to place on the skin to help augment that collagen and elastin 

Kane: Those microholes, I guess what you're creating also creates a pathway for some of these topicals to penetrate a little bit deeper. 

Dr. Saluja: Correct it. It does. And you know, again, back to that 1% collagen loss. What's so important to know about this pace of aging is that there are things that we can do. We, we can't stop aging. Stopping aging would unfortunately be death. At death. We stop aging. But what we can do is we can slow aging down and certainly, aside from just lasers, what we could do with about slowing the aging would be making sure that we wear sunscreen, making sure we don't smoke.

Smoking can certainly accelerate aging. Making sure that we have good nutrition and sleeping well. All those factors can if we don't have that can accelerate aging. But what a laser does is it improves the skin. You can almost think of yourself as a seesaw. And so, when we're young, that production, collagen production is on the high end, so you're sitting up high on that seesaw. Degradation is on the lower end, but then what happens is our degradation kind of begins to get a little bit more so than our production, and we start to see this loss of scaffolding, which creates lines and wrinkles. With a laser for a momentary period of time, about six months or so, it'll start to produce more collagen so that we're, in essence, kind of reversing aging, so to speak, but each day we wake up, we're still going through the process of aging.

Kane: Now, you told me to think of myself as a seesaw. What you just described to me is more of an hourglass, right? So the sands of time, they're, they're going down. But if you use a laser, you can maybe temporarily just kind of plug it up, turn it, well plug it up, or turn it upside down temporarily to kind of slow that the sands of time from dropping. 

Dr. Saluja : That's right. And, and so patients often ask, you know, how long will something like this last? And really, there's so many factors that go into that. And one of the factors again is how nutritionally. You know, adept they are or how they're wearing the sunscreen or how, just also genetically how, how they're aging.

So there's intrinsic and extrinsic factors, but a laser will help produce more collagen. And then I always tell patients, you know, once a quarter or once every six months, come back and do a treatment just to keep that collagen and elastin producing

With the LaseMD that's what I see a lot of patients come in, is it's almost, I don't know if I'd call it maintenance, but it's, it's almost like they come in just periodically every couple of months and have the LaseMD done.

Kane: And, and you know, one of the things that, that I notice when people leave is there's not a whole lot of visual. Damage. It kind of looks like there's just a, a mild sunburn or something that, that probably goes away relatively quickly. So, talk a little bit about the downtime. 

Dr. Saluja: Okay. So, and let's also talk about the prep for it as well. A lot of times we recommend tretinoin (retinoic acid) or retinols for patients. We, often ask for patients to stop it about a week before. Some studies have shown to continue on until the day of, but we typically say stop it a week before, and that way we do call in numbing cream that patients apply to their skin so that they're a little bit more comfortable during the treatment.

Kane: That's not an absolute necessary though, is it? I mean, some, some, patients don't numb.

Dr. Saluja: Right. It's not an absolute necessary, but I, so I do say it's optional, but I highly recommend it. I think I'm a wimp and I prefer it to have numbing. And I think, for example, a lot of our front staff will come back and have a treatment done and they do it without numbing, but I think it's.

It's preferable to numb. It just makes experience a lot more comfortable. And going back to staff, this is something that we do once every couple of months on our skin just to kind of maintain it as well. But prior to the treatment, we will take baseline photographs without makeup, just so we can watch to check progress as, as we go along with this treatment.

Topical numbing placed on; we clean it off prior to the. And Lauren, our PA and even our aesthetician run Blair run this device. And, and I do too. We have two devices in our practice because we use them so much. And what we do is we go over the skin. We'll put anywhere between six to eight passes, sometimes even 10 passes.

There's a little calculator to see how much of the skin is covered over. We don't like to go above 30 to 35% and depending.

The selection of the energy and the number of passes you can experience, maybe either one to two days of redness. On the higher settings. It might be three to four days of redness.

You might be a little puffy under the eyes, but your skin. For the first four or five days, we'll feel a little gritty from these tiny little micro crusts that are all over the skin. So you'll, you'll have kind of a dry sensation to the skin. And Kane, have we ever done this on you? I can't remember. Okay.

So we'll have to do it on your skin as well, but so you can see what it feels like, but it's, it's really easy to heal from. You can wear makeup the next day. Now, when we do put exosomes on the skin, we ask for patients not to wear makeup again, certainly even with or without exosomes until the next day is what I prefer.

And, but you can wash your face that night. You can put on, if you choose your retinoic acid that night as well certainly your moisturizer, and then go back to normal. 

Kane: Well just setting expectations as well. And, and so is this, would you have noticeable, see a noticeable difference after just one of these, or do you really need to have a series to start to see a difference?

Dr. Saluja : You can, a discerning eye can see a difference after one, but it typically takes about six weeks to see that. But we do recommend a series of them. I recommend three to five treatments of Las md and then after a series you might wanna do one every six months or so just to, just to maintain the 

Kane: So if I were to summarize what, what I'm hearing you say is this is, it's a relatively, it's, you referenced it earlier as kind of a gateway to the energy-based treatments.

It's relatively quick. It's not extremely painful. You have very limited downtime and you can get some really good results with the collagen and elastin over time. And it just really, overall, if I were to think about it helps your tone and texture of your skin. 

Dr. Saluja : Absolutely. And you'll see me using this in combination with IPL. We use it in combination with radiofrequency microneedling. It's just a great way to augment treatments when you do the combination treatment.

So I think that one of the key areas, again, is the face> I forgot to do that last time, so I'm going to do it this time. So I think “lase the face” is our phrase that saves.

Kane: You like, you like to rhyme. I think next, next episode, you need to rap.

Dr. Saluja: You need to rap!

Kane: we want people to listen.

Dr. Saluja : So “Lase the Face” is the, the phrase that saves. And for the next three patients that call in on Monday and they say, I'd like to “Lase the Face” we're going to give you 10% off an already discounted package of three. And we'd love to have before and after photos. So I'm always asking patients if they'd ever liked to share their photos.

We just do a photographic consent form, and we'd love for you to be one of.

Kane: That would be great. And I do want to say thank you to everybody for listening. We've had great, great feedback from a lot of people that these are relatively brief but packed full of information and, and people are learning a lot and we appreciate that feedback. So thank you!

Dr. Saluja : Absolutely. This past week, I was overwhelmed when patients came in and said that.  I just feel like this is doing what we want it to do, and that is, it's extending the consultation. So sometimes when patients come in, and I might recommend certain procedures, I almost feel like I have verbal diarrhea back there because I'm blah, blah, blah, blah. Talking about different things. And sometimes I wonder if they walk out saying, now what did she just say? So I, what I'm trying to do is reference different episodes. If we talk about fillers, I might say, listen to episode four. In this case with Lasemd, I'll say, listen to episode six. So thank you all  and remember, “Lase the face”

But that's it. This is a short one. Just just to give you a little information about LaseMD and I don't know what we're going to do next time. I'll think about what the next, maybe what we might do is go over Cool Peel, which is a fractional CO2 laser and differentiate it between Deka Pulse, which is one that I do as well.  That is the Tetra CO2 Laser which is in Cartessa’s lineup 

All right. Thank you everybody.

Thanks so much. Bye.