PROBES: Insulated Probes STEREX Green Box Fine capillaries / Cherry Hemangiomas/ Milia Sebaceous Hyperplasia / Sun/Age Spots Non-Insulated/Stainless STEREX Blue Box Skin Tags / Hard nodules / Insertions Medical Applications (w/medical Director) MILIA: Ø Ø Scratching Technique add CONDUCTOR sweeping action w/probe and keeping foot pedal on at all times. Sun/Age spots using the probe like a broom sweeping the skin and apply in a hash tag or tic-tac-toe pattern do not go below the epidermis stay on top of the top layer of the skin (light application) Ø Ø Tapping Technique NO CONDUCTOR tapping w/probe and keeping foot pedal on at all times Capillaries tap vigorously along surface do not break skin - do not drag probe - start at smaller end and work towards bigger end. Make sure the area is clean of all moisture, sebum and product. Tapping technique produces a cleansing action by heating up the salt, fat and water in the sebum blemish it turns the liquid sebum into a soap-like solid. It is like heating a raw egg white into a hardboiled egg. It becomes a solid matter, making it easy to exfoliate, unlike the liquid gooey liquid. Ø Ø Insertion Technique NO CONDUCTOR inserting into the follicle pressing pedal after insertion into the follicle. Thermolysis (hair epilation) Insert probe duplicating the direction that the hair is protruding out of the follicle (NO current), step on pedal once @ 40 volts for 1-3 seconds, release and pull out probe. Repeat again if hair does not release. Use sterile tweezers to lift hair out of follicle. 1
Sun/Age spot reduction (insulated probe) Treat sun/age spots 8mm in size or smaller (larger spots should be seen by a Dermatologist) Make sure you take the time to go through the ABCDE factor (see below) make sure it is not a mole Scratching technique / Use insulated probe/needle Use conductor on the area (spray or Q-Tip), water based gel (ultra-sound gel) or topical skin desensitizer Use LO current or (90-150v) on ethnic, fragile and sensitive skin types use 80-90v Do not penetrate the skin touch the probe on top of the epidermis and allow the current to dehydrate Apply a "HASH TAG" pattern on the sun/age spot - leaving good skin in between your strokes Look for a darkening of the skin (coffee ground look) Wait 5-10 minutes after treatment to make sure you have accomplished goal Healing time is 7-14 days (do not use anything on treated area for 24 hours) A B C D E (moles) DO NOT TREAT when the following is present: A. Asymmetry: does the mole have an irregular shape? B. Border: is the border of the mole ragged, blurred or uneven? C. Color: does the mole have more than one color (i.e. a darker spot in the middle of lighter pigment)? D. Diameter: is the mole bigger than 6mm? E. Evolution: has the mole changed in size, shape or color? If itching is present, do not treat. Skin Tag removal - (NON-insulated / Stainless Steel probe) Treat skin tags 4mm in size or smaller (larger skin tags should be seen by a Dermatologist) Tapping technique Tap onto skin vigorously at the base of the tag / Use Stainless Steel probe/needle Hold onto the tag with tweezers w/one hand and treat w/probe with the other hand stay parallel to skin DO NOT GO BELOW THE EPIDERMIS Option: bend probe 45 angle to avoid touching the epidermis Use water on the area (spray or Q-Tip) Use HI current (250) - push bottom button twice to HI Leave probe on the skin and sizzle it until the soft skin tag turns hard (I.e. turning a grape into a raisin) Keep treating until the skin tag is completely shriveled up (like a grape turns into a raisin) You do not have to remove the tag (however it may come off), it may fall of in 4-7 days (if treated properly) Healing time is 7-14 days (use anti-biotic like Bacitracin or PolySporin 2
Capillary reduction - (insulated probe) Treat red capillaries 6mm in size or smaller no green, blue or purple no legs Tapping technique / Use insulated probe/needle Try not to penetrate the skin No water on the area - make sure area is completely clean with alcohol, astringent and/or topical Use LO current - or (90-150v) on ethnic or older skin which is thinner use 80-95v Place the probe on top of the epidermis and allow the current to dehydrate the water in the capillary Tap from the smallest visible area to the largest moving from the middle of the body, outward Look for blanching and wait 5-10 minutes after treatment - make sure all reds are completely treated Healing time is 7-14 days (do not use anything on treated area for 24 hours Cherry Hemangioma (Angioma) reduction - (insulated probe) Treat red capillaries 6mm in size or smaller no green, blue or purple any part of the body is okay Tapping technique / Use insulated probe/needle Try not to penetrate into the dermis No water on the area - make sure area is completely clean with alcohol, astringent and/or topical Use LO current - or (90-150v) on ethnic or older skin which is thinner use 80-95v Place the probe on top of the epidermis and allow the current to dehydrate the water in the capillary Tap around the outside of the imperfection (think of an aura) from the smallest visible area to the largest Treat from the outside - towards the inside in a clock or counter clockwise manner Look for blanching and wait 5-10 minutes after treatment - make sure all reds are completely treated Healing time is 7-14 days (do not use anything on treated area for 24 hours 3
Milia removal - (insulated probe) Insertion technique Insert into skin @ 45 angle into epidermis / Use insulated probe/needle No water on the area Use LO current (95-150v) Insert probe into the skin with no energy @ 45 angle (avoid penetrating into the dermis) Step on pedal for 3-5 seconds (look for white blanching) and repeat 3-4 times in a circular pattern Treat with sterile tweezers, push sebum out or use comedone extractor Healing time is 14-28 days if needed use anti-biotic like Bacitracin or PolySporin Sebaceous Hyperplasia reduction - (insulated probe) Tapping technique / Use insulated probe/needle No water and make sure skin is completely clean Use LO current (90-150v) Tap probe on the skin and with the goal of drying up sebum stay in the epidermis - if it is a donut, do not treat the center Look for whitening like a raw egg white cooking into a hard white egg white Healing time is 14-28 days if needed use anti-biotic like Bacitracin or PolySporin 4
Unwanted Hair reduction - (insulated probe) Inserting technique / Use insulated probe/needle / larger the hair, the larger the probe No water and make sure skin is completely clean Use RF button 40-60 volt - for fine or shallow depth hair Use RF button 60-80 volt - for medium depth hair Use RF button 80-100 volt - for coarse deep rooted hair DO NOT PRESS on the foot pedal or apply energy until the probe has been inserted follicle follow protocol: Insert PROBE into the proper depth of the hair follicle Step on PEDAL - for a 5-7 second count Step off PEDAL Remove PROBE from follicle Remove HAIR with clean sterile tweezers If the hair does not epilate easily, you have the option of retreating or just tweeze. The next hair you treat, increase energy (5 volt increases) or step on the foot pedal for 2-3 seconds longer As you become more experienced, you may want to use your dominant hand to insert into the follicle and your other hand to test the hair (while treating your foot pedal should be pressed). Once the hair is loose and ready to release from the follicle, you can step off the foot pedal and epilate the hair. Look for blanching around the follicle if you see this step off foot pedal immediately and lower your energy 5-10 volts. You can always give the treatment more time in exchange for energy. If the client is uncomfortable with the treatment, lower the energy and go longer with time. Healing time is 7-14 days if needed use anti-biotic like Bacitracin or PolySporin 5
Consultation - ThermoCLEAR TREATMENT PROTOCOLS Radio Frequency / Thermolysis (RF) treatments explain thermo = heat Listen to client to understand her/his expectations and goals Consent form presented and explained After and Home CARE explained Address and discuss downtime and realistic expectations Let client know about the downtime. Thinner and fragile skin could take longer and no picking Process more than 1 treatment/visit is usually necessary not just one visit I Identify/Qualify what you are treating. Example: stay away from moles and warts. o Consent form reviewed and signed o Differentiate moles from sun/age spots o Mole vs. skin tag mole solid, attached all the way around; skin tag attached at one small place o DO NOT treat moles or warts without a doctor s permission o Schedule ample time to do treatment no hurry up be relaxed do not rush the treatment!! Suggested Pricing o $50 office visit - Average about $600-hour - $300-½ hour - $150-15 minutes - or o $50 minimum (includes up to 3 sunspots, 5 cherry hemangiomas or 2 skin tags) o $25 per skin tag (small to average size) o $10 per cherry hemangioma (small to average size) Treatment Techniques clean skin thoroughly before treating Scratching Sun/age spots (apply water on treated area will increase conductivity) Tapping Red capillaries, cherry hemangiomas, acne, etc. Inserting Hair Removal / epilation milia skin tags Pre-Treatment - clean skin thoroughly before treating Clean with Baby Wipes Remove ALL oils and product - (w/alcohol, Bactine, Witch Hazel, Sea Breeze) Identify - what is to be treated aesthetic or medical (Medical Director) Qualify - if it is something that can realistically be properly treated Topical de-sensitizer or anesthetic If you plan to use topical anesthetic (OTC) be aware that capillaries may constrict Use topical on tiny nose capillaries (inside and out) and on lip liner where capillaries are evident Do not leave topical on more than 10 min. and then thoroughly cleanse area before treating (capillaries) Post Treatment Options - Bacitracin (best choice), Neosporin, Polysporin, Caladryl lotion and/or ice (bagged) Kleenex as patient may sneeze or have watery eyes and nose Do not cover, let dry naturally and then leave alone instruct to not pick area!!!!! Leave alone for 24 hours with only the above options applied to skin Goal is to have treated area dry up - Makeup okay after 24 hours Remind patient that they will look bad for a week or so the 2 nd day they WILL look the worst - REMEMBER - Be careful of thinner skin Remember 7-10 day s downtime Keep the energy low (95-100v) if skin looks angry When in doubt to treat, don t be afraid to refuse treatment or refer patient to a medical doctor or Dermatologist If you are a non-medical professional you can only treat cosmetic procedures, not medical Keep probe clean during treatment if treatment becomes less effective 6