BIANCA Cosmetic Surgery & Medical Spa
Pico toning is a toning irradiation procedure using a picosecond laser that oscillates in pico (1/1 trillion) seconds of irradiation time per laser shot.
Toning irradiation is one of the irradiation methods that can be done with a picosecond laser, and can be expected to have a tone-up effect that improves general skin problems such as age spots, freckles, dullness, and texture .
It is an irradiation method used in many medical institutions, but if you receive it without knowing the characteristics of toning irradiation, you may get the impression that it is "ineffective". Before receiving pico toning, know the characteristics of the treatment, the treatment that can be expected to have a synergistic effect when received in combination, risks / side effects and precautions, and receive a satisfactory treatment with peace of mind.
Table of contents
The energy intensity of a laser is expressed by "fluence", which is the average energy density of one shot per unit area. The method of irradiating with low fluence is called toning irradiation.
Toning irradiation is used to treat age spots, freckles, and dullness that spread throughout the face. Since it irradiates a laser with weak energy, there is almost no downtime to return to the condition of the skin before the treatment, and it is known as a treatment that does not burden the skin.
In addition to continuous irradiation, laser irradiation methods include pulse irradiation, which irradiates intermittently at regular intervals. The laser irradiation time per shot by pulse irradiation is called "pulse width".
The laser with a pulse width of picoseconds is the picosecond laser , and the lasers used in aesthetic medicine include the picosecond laser, which is also called the "short pulse laser," the nanosecond laser, which is called the "Q switch laser." There is a laser in millisecond units called "long pulse laser".
|Picoseconds (ps)||1 / 1,000,000,000,000s (1 / trillionth of a second)|
|Nanoseconds (ns)||1 / 1,000,000,000s (1 billionth of a second)|
|Microseconds (μs)||1 / 1,000,000s (1 / 1,000,000 second)|
|Milliseconds (ms)||1 / 1,000s: Long pulse|
In many laser treatments, the melanin pigment that causes age spots and the red hemoglobin that causes redness are destroyed by heat to improve skin problems, but the characteristic of picosecond laser is not the destruction by heat. The point is that it can be crushed into pieces by a shock wave.
It can be said that the toning irradiation started when the low fluence irradiation of the Q-switched YAG laser by the laser machine "MedLite C6" was called "laser toning".
For this reason, low fluence irradiation is called toning irradiation, and picosecond laser toning irradiation is called picotoning.
Laser toning with a Q-switched laser generates heat when the object is destroyed by laser irradiation.
Therefore, if you increase the energy (fluence) of the laser because you want to increase the destructive power, you must be aware of side effects such as post-inflammatory hyperpigmentation and burns due to the heat being transferred to the surrounding cells.
On the other hand, when aiming at the same object with pico toning, the shock wave of pico toning does not require strong energy because the peak power and destructive force, which are the momentary forces acting on the object, are large .
In addition, since the shock wave traps energy in the object and crushes it, heat damage is not applied to the surrounding cells . The risk of side effects such as post-inflammatory hyperpigmentation and burns is low because it does not require strong energy and does not cause heat damage around it.
The higher the amount of melanin pigment, the darker the stain, and the lower the amount, the lighter the stain . Therefore, the darker the stain, the easier it is to obtain the effect. However, shock waves can be aimed at even small targets, so even thin spots that cannot be improved with a Q-switched laser may not be noticeable with pico toning.
There are several types of picosecond laser machines, but all toning irradiation by each machine is picotoning.
All picosecond laser machines have different pulse widths and wavelengths, albeit in picosecond units.
Laser is an abbreviation derived from the acronym "Light Amplification by Stimulated Emission of Radiation" and means "amplification of light by stimulated emission".
Light from the sun and incandescent light bulbs is a collection of multiple wavelengths (colors), but lasers are artificially created by extracting the required wavelengths from the light.
The wavelength is extracted by a substance called "laser medium" such as carbon dioxide, ruby, alexandrite, ittrium (Y), aluminum (A), and garnet (G), and the laser is based on the laser medium as "ruby laser" and "YAG laser". Is called.
Picosecond lasers include the YAG laser (1064nm), the alexandrite laser (755nm), and the ruby laser (694nm).
|Machine name||wavelength||pulse width||Approved by the Ministry of Health|
|PicoSure|| Alexandrite laser|
|PicoWay||YAG laser|| 294ps|
|enLIGHTen3||YAG laser|| 2ns|
|Discovery Pico||YAG laser ruby laser|| 370ps|
|SPECTRA PICO|| YAG laser diode laser|
|PICOCARE||YAG laser diode laser||450ps||〇|
Up to a certain point, the longer the wavelength, the deeper the depth of penetration that reaches the skin (Er: YAG laser with a wavelength of 2940 nm reacts well to moisture, so it is absorbed by the skin surface even though it has a long wavelength, and the depth of penetration is deeper. Is a shallow laser). In addition, the degree of reaction (absorption) to melanin pigment and hemoglobin differs depending on the wavelength, which makes the treatment result different.
It is said that toning irradiation can destroy melanin pigment without stimulating the melanocytes that make melanin pigment.
The destroyed melanin pigment is excreted from the body by "macrophages" that digest dysfunctional cells, and gradually leads to improvement of spots and freckles.
Since it can be applied to the entire skin rather than locally, the dullness of the entire skin is improved, and you can aim for bright skin with no uneven color .
Chloasma is a common symptom in women in their 30s and 50s. The cause is not yet known in detail, and it is said to be a symptom caused by many causes such as excessive production of melanin by ultraviolet rays, imbalance of female hormones, and rubbing irritation to the skin.
It may be difficult to distinguish it from senile pigment spots caused by ultraviolet rays, but the difference is that it can be symmetrically formed in the range of inverted triangles from under the eyes to the cheeks . In addition, it tends to be aggravated by irritation , and laser treatment for treating senile pigment spots has also been contraindicated for chloasma.
However, many medical institutions are performing treatments because it can be expected to improve chloasma by irradiating with a uniform energy density by laser toning.
However, if you do not train the irradiation method, there is a high possibility that "white spots" (vistiligo) that lose the pigment of the skin will occur, so it is necessary to select a clinic with a large number of cases and well-developed technical guidance. it's important. In addition, it is recommended to check for vitiligo with an image skin diagnostic machine and prevent it.
Some aesthetic medicines do not allow treatment of thin skin around the eyes, but picotoning has low fluence and weak irradiation energy, so it is possible to irradiate under the eyes .
In addition, it can irradiate not only the face but also the back and back of the hands, so it can be expected to improve the darkening of the body .
Phototherapy with a pulse width of milliseconds is good at destroying large targets because it has a longer pulse width than a picosecond laser .
For this reason, dark spots with large melanin pigments and thick spots may be treated with phototherapy, and if they remain, pico toning may be performed. Even light spots with less melanin pigment that could not be improved by phototherapy can be expected to be improved by shock waves with picosecond laser.
Light therapy machines include icons, BBL, photofacial M22, and photosilk.
In addition to toning irradiation, picosecond lasers can be used for fractional irradiation, which irradiates the laser in dots, and spot irradiation, which can be aimed locally. Spot irradiation with a picosecond laser is called a pico spot.
If you want to improve a certain spot, spot irradiation is more effective than toning irradiation.
Picofocus is fractional irradiation with a picosecond laser, and is also called picofractional .
Fractional irradiation is a method of irradiating the skin with a laser in a dot (shower) shape. It is said to be an irradiation method that accelerates the recovery of damage caused by laser irradiation by intentionally interspersing the parts that are not hit by the laser and the parts that are hit by the laser.
The skin is layered from the outside to the epidermis layer and dermis layer, and the dermis layer, which is the majority of the skin, contains components that keep the skin healthy, such as collagen, elastin, and hyaluronic acid.
The cells that produce these components are called "fibroblasts," and when stimulated and activated by fractional irradiation, the production of components in the dermis layer is promoted.
This can be expected to improve the firmness and texture of the skin, tighten pores and improve fine wrinkles .
Even with toning irradiation, the effect of tightening pores and improving fine wrinkles due to the heat of the laser is not zero, but if you want more effect by activating fibroblasts, fractional irradiation can be said to be effective.
With the picosecond laser, fractional irradiation is possible by changing the irradiation lens, so it is also possible to receive fractional irradiation on the same day as toning irradiation.
It is also possible to perform three types of irradiation, toning irradiation, spot irradiation, and fractional irradiation on the same day.
Genesis is a long pulse YAG laser machine that performs treatment with low fluence and hollow irradiation. The treatment by Genesis is also called laser peeling, and it can be expected to have effects such as removing old keratin and promoting turnover, which is the metabolism of the skin epidermis.
Some medical institutions recommend regular maintenance after improving skin problems with pico toning.
Before pico toning, treatment may be performed with the following internal medicines, topical medicines, and medical skin care products. Alternatively, it may be used in combination with pico toning.
|Tranexamic acid||Oral||Suppresses the production of melanin pigment and prevents inflammation|
|Vitamin C||Oral||Suppresses the production of melanin pigment|
|Vitamin E||Oral||Suppresses the production of melanin pigment|
|Retinol||For external use||Tightening pores, improving fine wrinkles, promoting turnover|
|Hydroquinone||For external use||Suppresses the enzyme that produces melanin pigment|
|Zeoskin Health||Cosmetics||Medical skin care cosmetics|
Peeling, which removes dead skin cells by applying a drug to the skin, is performed before pico toning, which makes it easier for the laser energy to reach deep into the skin . Types of peeling treatments include chemical peels, collagen peels (massage peels), and hydra facials for peeling machines.
Iontophoresis is a treatment that introduces the active ingredient into the skin by passing weak electricity, and ultrasonic introduction is a treatment that allows the active ingredient to penetrate into the skin by vibration caused by ultrasonic waves. Both are performed after pico toning to support the recovery of the skin after the treatment . There are the following types of active ingredients.
Dermapen is a pen-shaped beauty machine with a needle, which is a beauty medicine that uses the wound healing power to heal wounds by making holes in the skin. When combined with the active ingredients of the skin, the active ingredients penetrate deep into the skin through the needle holes.
The combination treatment of dermapen and toning irradiation on different days can be expected to have a synergistic effect compared to the treatment of each treatment alone .
Water light injection, which injects the active ingredient into the skin, is also introduced as a menu combined with toning irradiation.
The active ingredients of the skin in Dermapen and water light injection include the following types.
The interval and number of treatments vary depending on the condition of the skin, but it is recommended to receive multiple treatments, such as 10 to 20 times, once every 2 to 4 weeks.
Since the melanin pigment is gradually excreted, the effect will appear with repeated treatments.
Since pico toning is a free medical treatment, it is not covered by insurance and the fee varies depending on the medical institution.
In most cases, multiple treatments are recommended for pico toning, and the treatment for the entire face costs about 15,000 to 50,000 yen each time . Some medical institutions set a trial fee of 10,000 yen or less for first-time users.
Pico toning is a treatment that irradiates with low fluence, so basically there is almost no downtime. Makeup is possible immediately after the procedure, and face washing and showering are also possible from the day of the procedure .
However, on the day of laser treatment, it is generally recommended to refrain from drinking, strenuous exercise, and improving blood circulation such as in the sauna, as redness and swelling may increase.
In rare cases, a thin scab may appear on the irradiated area, but it will improve spontaneously within a few days . Post-inflammatory hyperpigmentation may occur, so wait for spontaneous disappearance.
Irradiation with a laser may cause temporary swelling, redness, and petechiae. It will settle down in about half a day to a day .
If you have chloasma, repeated treatments may cause vitiligo, which causes the skin to lose color. It is said that it will improve in a few months to half a year, but please follow the doctor's examination regarding the frequency and frequency of treatments.
Basically, there is almost no anesthesia with toning irradiation. If you are worried about pain, some medical institutions offer anesthesia that you can apply, so it is safe to check before the procedure.
Pico toning gradually becomes effective after multiple treatments, so it is not uncommon for one treatment to not be effective . Instead, it is a treatment with less pain, side effects, and risk, and you can treat even public work without taking a break.
Depending on the degree of sunburn on the irradiated area or after sunburn, the treatment may be postponed at a later date instead of the treatment on the day.
(1) Counseling / medical examination
Decide on a treatment policy by communicating your skin problems and wishes for treatment. If you have any concerns or concerns, ask a question at this time to resolve them.
(2) Cleansing / washing face
For facial treatments, cleanse the makeup and wash the face to keep the skin clean.
(3) Taking a photo and changing clothes
A photo will be taken to check the condition of the skin before the treatment. In the case of body treatment, change into a special clothing for the treatment.
To protect your eyes from laser irradiation, wear a shield before irradiating.
(5) Cool and finish
Cool the treatment area and finish.
After pico toning, the skin is in a very sensitive state, so it is necessary to keep UV protection in mind and moisturize it sufficiently .
The irradiation time itself is about 5 to 10 minutes. If you combine it with another menu, such as receiving fractional irradiation at the same time, the treatment time will be longer accordingly.
In addition, toning irradiation with picosecond laser is less irritating because it irradiates with low output, and it is possible to receive treatment even for sensitive skin and atopic skin, but please consult with a medical institution for details. ..
If you interrupt the treatment in the middle of the recommended number of treatments by the doctor, you may not be able to expect the effect, so it is important to pay attention to daily skin care such as moisturizing and UV protection according to the treatment plan. ..
Toning irradiation is performed while moving the handpiece, which is the tip of the machine, like a pendulum. It is necessary to irradiate evenly and evenly at a constant speed, and it can be said that the effect will differ depending on the practitioner, so it is safe to check the state of the treatment and the number of cases on SNS etc.
In addition, there are some symptoms that are difficult to improve with toning irradiation, such as "ADM", which has melanin pigment in the dermis layer of the skin. You need to choose a medical institution that has a proven track record of diagnosing symptoms that can be improved by pico toning.
Professor Kazuaki Hotta, who supervised the article, taught me about pico toning.
Introduction of supervising doctor
Dr. Kazuaki Hotta, the director of Bianca Clinic. After working as the director of a major clinic, he launched a clinic specializing in laser toning and is active as a general doctor nominated all over the country. In 2018, he opened "BIANCA cosmetic surgery & medical spa" and became the director. The menu we handle is wide ranging from cosmetic surgery to cosmetic dermatology, and its popularity can be seen from SNS and other media.