Medical Spa Training Manuals


Training Manuals & Study Guide For Non-Physicians

The Medical Esthetician Training Manual & Study Guide, and the Advanced IPL & Laser Training for Non-physicians is part of your staffs, and your clinics, success.

Written by Paula DiMarco Young RN, leading cosmetic practices use these manuanls to train every new hire on what cosmetic procedures are offered, how they work, and what alternatives there are. These training manuals are a must have for any serious cosmetic clinic.

IPL Burns

The Independent newspaper in the UK has an article today in their Health & Wellbeing section from a reporter who was badly burned by an IPL treatment at a 'Top London Med Spa'.

The photos show the reporter with large uneven red welts on her chest and areas of redness on her face also. According to the story the correspondent was seduced by the promise of a `fast and effective way of removing the visible ravages of time without surgery’.

This is the second high profile newspaper report in recent times (see also News anchor gets burned by photo facial). I wish this were even less common than it is, but I've seen a number of IPL & laser burns before. These are often the result of rogue operations (Mesotherapy Lipodisolve Horror Stories) poorly trained staff AND physicians who intimidate their staff.

If your a plastic surgeon or dermatologist running a skin clinic, med spa, or laser clinic and your staffs first reaction is not to tell you somethings going wrong or they're not sure about an IPL or laser setting, you're just setting yourself up to have problems.

These types of IPL and laser burns are almost invaraibly the result of a physician who has medical estheticians or laser technicians who are afraid of confronting them with a problem or question. The doctor's defense? They were told what to do... but problems always arise and doctors who don't want to be hassled are the ones putting both their patitent and their laser clinic at risk. It's just a numbers game. If you treat 1000 patients at least some of them will have problems. Your staff should never be repremanded or belittled for ANY question.

The technician told me she would use a strong setting to get better results. As she passed the handpiece across my face the feeling grew hotter and hotter. By the time the device reached my neck, I could barely imagine continuing with the burning sensation. When she started on my chest the pain was intolerable and I had to ask her to stop repeatedly before continuing with what felt like torture. I'd thought of "no pain, no gain" and I soldiered on.

I got dressed, with a burning hot chest and a face that looked as if I'd been pulled out of a forest fire.

I was scheduled to return in two weeks for the next IPL treatment, in a course of six that costs £1,200. I went to a make-up shop and was dusted with a mineral powder, suggested by the spa, to camouflage the redness of my face.

A woman at the same counter asked me what the hell I'd had done. When I proudly informed her I'd had an IPL photo facial – she looked at me with total horror. "I don't mean to worry you, but I've had a course and it never looked like that." I largely shrugged off her words of warning. Why would I question the skill of a technician at the high end of the market? It's not as if I'd taken a chance and visited a high-street beauty parlour.

When I got home and looked in the mirror at my chest for the first time since the treatment - only an hour later – I was horrified. Angry red rectangular burns covered my chest in a random grid. Little did I know when I'd set off that morning that I would return after my first exciting treatment scorched and traumatised. What made no sense to me was that the treatment had not been done uniformly which was more obvious on my chest where I looked like I'd been branded with a hot iron.

The next day, on the advice of a friend, I called a top dermatologist – Dr Nick Lowe – known as the god of dermatology. He is also the man the rich and famous depend on when they need to be fixed, without resorting to the knife.

Dr Lowe saw me as a medical emergency the following morning. He works at the Cranley Clinic, off Harley Street, London, has a private practice in Santa Monica, California, and is clinical professor of dermatology at the UCLA School of Medicine, Los Angeles. He has his own skin care range and is the author of many books, including, most recently, The Wrinkle Revolution.

He was horrified by what he saw and concerned that no doctor was present at the IPL treatment – but it didn't surprise him. Along with other doctors, he is lobbying to get these types of treatments regulated in the UK. He believes treatments including Botox, line fillers, laser and light should only be conducted by doctors or administered under a doctor's supervision.

"The UK is one of the few countries in Europe that does not have sound legislation. It is much more regulated in France, Spain and Italy where only trained doctors can administer these treatments. The UK has failed totally to protect the public in this arena," says Dr Lowe.

Sciton BBL treatment parameters for pigment & redness.

Not to be left out of the IPL section, the Sciton BBL IPL treatment parameters for pigment and redness.

I have a Q regared the 515 filter and lentigines. With the 10ms pulse widths I have seen moderate rxns at 11-12J with 25 cooling in type 2s ( moderate erythema with accentuation and darkening of lentigines). When I moved to 20ms 9-10J with 18 cooling in type 3 and 4s I saw no immediate response (eythema or darkening). I spoke with a patient today who stated minimal darkening 24hr out. These are the recommended settings but they do not appear to have the punch. Has anyone tried lowering pulse widths to 15ms or even 10ms with cooling let's say 15 to protect surrounding skin?? I have lot's of type 3-4s with lentigines. Your suggestions appreciated...

Live Physician Chat: Sciton BBL (Cosmetic IPLs & Lasers)
Tuesday February 24, 2009 9 - 10 PM EST

Fraxel 1500: Rashes, reactions and treatment protocols.

More from the Fraxel 1500 crew here at Medical Spa MD Forums; Fraxel 1500 treatment protocols, rashes, and reactions.

In response to a complaint of redness after a treatment with the Fraxel 1500:

Maybe this can help...

I have seen rashes like this occuring after thedoctor (chiropractor) at my office performs a fraxel treatment. He is known to not wipe the numbing cream off thoroughly and then puts the gliding gel on directly after. After performing the treatment he does not thoroughly clean the skin and immediately puts aloe on the skin. Clients usually come in days later complaining of a rash and itchiness, especially on the cheeks and chin. Im guessing the rash is from a combination of the heat and multiple substances still being on the skin. It is very important to make sure that the skin is very clean before, during and after the treatment. The topical we use is a 7/7 lidocaine/tetracaine combo and most clients that I've treated come out pretty good without any complications after aside from the swelling.

After the treatment I let the client sit with cold aloe vera along with the simmer chiller blasting cold air onthe face for about 15 mins. Then I have them rinse the skin and I immediately apply the Neocutis BioRestorative Gel that is very light in texture and great for post op care. The Neocutis line is great for burns, scars, rashes, irritations and is best for after fraxel treatments for the first week. It helps the skin get back to a normal state. i usually sell these products along with the Fraxel package so that the client can use the products at home and continue caring for the skin properly. Using anything thick like a vaseline base, bacitracin, heavy creams immediately after the treatment and during the first week post op will irritate and clog the skin and cause more complications.


Fraxel 1500: Pain control when performing fractional treatments.

There are some new comment threads of interest in the Physician to Physicain Forums including this one on the Fraxel 1500 and pain control when performing treatments.

What is the strongest numbing cream that you can order from a compounding pharmacy?

I currently get a combination of lidocaine/prilocaine that the pharmacy will not tell me how and what concentration it is. It is better than Emla, but is there anything else out there? Currently we are getting people through the CO2 first pass with my cream, a 10 mg of Vicodin and 2 mg of Ativan, all PO, but when it comes to the dynamic phase where I blend, they start squirming. I am at the point, I may start to do conscious sedation with Fentyl and Versed. If anyone is using the Lutronic CO2, my settings are 100-160 mJ and 100-150 spots/cm2(density is automatically calculated for you)...

Sciton BBL IPL Live Chat Scheduled

Next live physician chat has been scheduled for Tuesday, February 24th at 9PM EST. IPLs including the Sciton BBL will be discussed. All interested parties are welcome.

Transcripts of past medical spa physician chats: medical spa marketing & advertising, Thermage, Fraxel, Fractional C02Laser, & Fraxel Technology & Protocols.

Next live physician chat:

Sciton BBL (Cosmetic IPLs & Lasers)
Tuesday February 24, 2009   9 - 10 PM EST

All IPL users are welcome. Intense Pulse Light (IPL)Chat Tuesday February 24, 2009 9:00 pm - 10:00 pm Eastern Sciton BBL and others. All Welcome.