Japan Society of Plastic and Reconstructive Surgery (specialist) Visiting Researcher, Plastic Surgery, Yokohama City University Japanese Society of Aesthetic Surgery (JSAPS) Japan Society of Cosmetic Dermatology Anti-aging society Japan Laser Medical Association, etc. Director of Customized Treatment Study Group cutera adovocates cutera advisor enlighten SR technical provider excel V ＋ technical provider CLEVIEL EXPERT
Jun Sugawara Medical institutions with doctors
In aesthetic medicine, there are options for improving spots, dullness, and bruises, such as internal medicine, topical medicine, phototherapy, and laser treatment.
There are several types of lasers used for aesthetic medicine treatment, but pico lasers are expected to improve symptoms that are difficult with conventional Q-switched lasers, and are said to reduce the risk of pain and pigmentation .
Pico Laser has multiple machines, and Enlighton SR (enLIGHTen SR) is one of them. By knowing not only the features and effects of Enlighton SR, but also the downtime and precautions, you can receive the treatment with peace of mind.
It is also important to know how to choose a medical institution (doctor) in order to obtain satisfactory results with Enlighton SR.
A pico laser (picosecond laser / picosecond laser) is a laser that can irradiate in units of picoseconds (one trillionth of a second) .
Pico lasers are said to have a relatively short downtime because the thermal effect is small because the irradiation time is extremely short, so there is little burden on the skin .
Before learning more about the Enlighton SR, let's talk about the pico laser.
In aesthetic medicine, lasers such as Q-switch lasers, carbon dioxide lasers, and pico lasers are used to improve spots, dullness, bruises, and remove tattoos.
A laser (Light Amplification by Stimulated Emission of Radiation) is a type of electromagnetic wave. While light is a collection of multiple wavelengths (colors), a laser is a light beam that artificially extracts and amplifies one specific wavelength, and when absorbed by a specific substance, it produces heat and shock waves. I have.
In aesthetic medicine, a laser with a wavelength that is absorbed by the melanin pigment that causes blemishes and a laser with a wavelength that is absorbed by the tattoo pigment is used to destroy the melanin pigment and tattoo pigment with heat and shock waves to remove blemishes. improve or remove tattoos.
The time that a single laser shot hits the skin (irradiation time) is called the "pulse width" , and the pulse width of the laser used in laser treatment is shortened to milliseconds, microseconds, nanoseconds, and picoseconds.
|millisecond (ms)||1/1,000s (one thousandth of a second): Long pulse|
|microsecond (μs)||1/1,000,000s (one millionth of a second)|
|nanosecond (ns)||1/1,000,000,000s (one billionth of a second)|
|picosecond (ps)||1/1,000,000,000,000s (one trillionth of a second)|
The shorter the pulse width, the greater the instantaneous force acting on the substance, and the greater the destructive power .
Lasers with pulse widths of milliseconds, microseconds, and nanoseconds mainly generate heat in the material when irradiated, and the thermal action destroys the target . In this case, if you irradiate with a high irradiation energy (fluence) to increase the destructive power, the heat will be transferred too much to the surrounding cells, increasing the risk of side effects such as post-inflammatory pigmentation and burns.
The pico- laser, which has a pulse width of picoseconds, generates little heat due to its extremely short irradiation time, and when irradiated, generates a destructive shock wave in the material, so it does not need to be irradiated with high irradiation energy (fluence). It can efficiently pulverize the target finely .
Pico lasers, which are good at pulverizing small substances, are expected to lead to improvements in thin spots that do not react with conventional Q-switched lasers.
The main mechanism of action of the pico laser is a shock wave that has less impact on the surroundings than heat, and since strong irradiation is not required, unnecessary damage to surrounding cells does not occur , reducing pain during treatment. Side effects such as post-inflammatory hyperpigmentation are less likely to occur .
Not all lasers with shorter pulse widths are better.
Opinion that it is difficult to produce effects on dark spots and thick spots because the abnormal keratinocytes (pigment cells with a lot of melanin, the cause of spots) that are originally intended to be destroyed cannot be damaged by the action of the laser. There is also
If the object is large, it is more likely to be destroyed by photothermal action such as a Q-switched laser than by crushing it finely with a shock wave such as a pico laser .
For example, the laser used for hair removal, which targets the melanin pigment in the hair root, and red face (telangiectasia), which targets the red pigment of hemoglobin in the blood vessels, has a pulse width of millisecond (1/1000). As with long pulse lasers in seconds, long pulse widths are effective when targeting large targets such as hair roots and blood vessels.
The Enlighton SR is a pico laser machine developed by Cutera. It is a medical device that has been approved by the Ministry of Health, Labor and Welfare, and has been recognized for its effectiveness and safety in treating spots and bruises and removing tattoos, and in some cases it is covered by insurance.
Note) Infant addition Note) Insurance calculation as YAG laser radiation therapy with Q switch
Electromagnetic waves, including lasers, have waveform energy that repeats crests and troughs, and the length from crest to crest (or trough to trough) of the waveform is called the wavelength.
Wavelengths are expressed in units of nanometers (nm), which is one billionth of a meter. Lasers are named according to their wavelengths, such as Nd:YAG (Neodymium YAG) laser for a wavelength of 1064 nm and KTP laser for a wavelength of 532 nm. are categorized respectively.
There are various types of lasers used in aesthetic medicine, and the substances absorbed by the skin differ depending on the wavelength of each laser. Therefore , the appropriate laser for treatment is selected according to the causative agent of the targeted skin problem .
Up to a certain point, lasers with shorter wavelengths act on the skin surface, and longer wavelengths act deeper into the skin. This is called the "depth of penetration" and is used as an indicator of each laser irradiation effect.
|Wavelength of Enlighton SR||Responsive color tone||adaptation|
|1064 nm||black, brown, purple||Deep (dermal) melanin pigment, removal of color tattoo|
|532 nm||red, orange, yellow||Removal of superficial (epidermal) melanin pigment and color tattoos|
Enlighton SR's SR is an abbreviation for Skin Revitalization, which means "skin regeneration". The pico laser "Enlighton SR", which causes less damage to the skin than conventional lasers, is said to be a laser suitable for skin rejuvenation treatment, which is in high demand in Japan.
Enlighton SR not only removes pigments such as blemishes, dullness, permanent makeup, and color tattoos, but also enables detailed settings suitable for improving skin quality such as fine wrinkles, pore opening, texture, skin gloss, and acne scars . being developed.
In order to achieve therapeutic effects for various skin concerns, it is necessary to have a technology that effectively combines parameters such as the irradiation energy level (fluence) and spot size in addition to the appropriate wavelength and pulse width.
Enlighton SR has two wavelengths, excellent specifications, and comfortable operability, making it easy to set the appropriate settings for skin treatment, allowing you to approach benign pigmented lesions such as blemishes and bruises more safely and effectively.
The Enlighton SR can quickly convert a wide range of parameters via the touch panel. The fluence can be freely adjusted over a wide range for each spot size, enabling detailed settings suitable for skin treatment and realizing comfortable operability.
For details, see [Doctor Only] Product Catalog and Case Photos
The skin is layered with the epidermis and dermis from the outside , but melanin pigment is present in the epidermis in the symptoms generally referred to as age spots (senile pigment spots, solar pigment spots) . The following symptoms, including age spots, are called "superficial pigmented lesions" and can be expected to improve with Enlighton SR.
Enlighton SR is also expected to be effective in improving "deep pigment lesions" where melanin pigment exists in the dermis layer . Symptoms of deep pigmented lesions include:
Enlighton SR can also be expected to be effective in removing permanent makeup that puts pigments in the epidermis and color tattoos that put pigments in the dermis .
In the dermis layer, there are components such as hyaluronic acid, elastin, and collagen that are the source of skin firmness and elasticity, and fibroblasts that produce these.
With Enlighton SR, the stimulation of laser irradiation can be expected to activate fibroblasts and regenerate capillaries.
With pico lasers including Enlighton SR, treatment is performed by using three irradiation methods separately or in combination.
|toning irradiation||A 1064nm Nd:YAG laser is applied to the entire skin at a low fluence||Uneven skin tone, dullness, melasma|
|Fractional irradiation||Attach the "MLA lens" that can irradiate in dots and irradiate the entire skin||Open pores, acne scars, fine wrinkles|
|spot irradiation||High fluence for pinpoint irradiation on blemishes and tattoos||Blemishes, freckles, tattoos|
|Combined irradiation||Irradiation by combining the above three methods||Uneven skin tone, dullness, liver spots, open pores, acne scars, fine wrinkles, age spots, freckles|
Toning irradiation is a method of irradiating the entire skin with a low fluence laser, and the toning irradiation using a 1064 nm long-pulse Nd:YAG laser by Enlighton SR is called “PICO Genesis™”.
By stimulating and discharging melanin pigment with PICO Genesis™, you can expect the effect of brightening the skin tone . In addition, when the dermis layer is stimulated, fibroblasts that produce hyaluronic acid, elastin, and collagen are activated. As a result, the texture of the skin is improved, and fine wrinkles are improved and pores are tightened .
Fractional irradiation is a method of irradiating the entire skin by attaching an "MLA lens" that can irradiate a laser in a dot shape, and by Enlighton SR, fractional irradiation using 532 nm and 1064 nm is also called "PICO Genesis™ FX". .
When fractional irradiation is performed, a large number of fine spherical cavities are formed, which can be expected to reconstruct the dermis layer due to the effect of wound healing.
Similar to PICO Genesis™, it can be expected to improve texture, fine wrinkles, and open pores, as well as improve acne scars with crater-like unevenness .
Spot irradiation has a higher irradiation output than toning irradiation and fractional irradiation, and it is possible to irradiate spots and tattoos with pinpoint accuracy .
Due to the high output of the irradiated laser, it is said that the pain felt like being flipped with a rubber band during the treatment.
Besides the Enlighton SR, Pico Laser has multiple machines. Machines that can irradiate lasers in picosecond units have different wavelengths and pulse widths for each machine, and each has different characteristics.
* ps: picosecond (one trillionth of a second)
|machine name||wavelength||pulse width|
|enLIGHTen SR|| 532 nm|
|550ps-750ps variable type|
|Discovery Pico Plus|| 532 nm|
The Enlighton SR can emit 532nm and 1064nm lasers with a pulse width of 750 picoseconds. Compared to other pico laser machines, it can be said that the pulse width is long even though it is in picosecond units .
In the case of superficial blemish treatment that uses relatively low energy (fluence), a pico laser with a short pulse width can treat dark blemishes and thick blemishes by destroying abnormal keratinocytes (having a lot of melanin) that are originally intended to be destroyed. However, with Enlighton SR, which has a relatively long pulse width of 750 picoseconds, by appropriately adjusting the energy (fluence), it is possible to treat abnormalities. It is possible to easily damage keratinocytes, so it can be used to treat various pigmented spots .
Also, in the case of tattoo removal that uses relatively high energy (fluence), the shorter the pulse width for the same amount of energy, the higher the destructive power and peak power, but the energy is concentrated on the skin surface, The energy may not reach the pigment in the back. In Enlighton SR, a relatively long 750 picosecond pulse width is set so that the energy reaches the dye without weakening as much as possible even in such cases.
Regarding the number and frequency of treatments, if irradiation is applied to local spots, improvement can be expected even once, but for treatment of spots on the entire face and treatment to improve skin quality, treatment should be performed once every one to two months. It is recommended to do this multiple times .
Tattoo removal requires multiple treatments once a month. The number of treatments varies depending on the state of the tattoo pigment, so please consult a medical institution.
In addition, since the pigment of the tattoo may fade with the interval between treatments, if it is performed once every 2 to 3 months, the treatment period will be longer, but the number of treatments may be reduced.
Treatment for cosmetic purposes is not covered by insurance and is a free medical treatment, and the cost varies depending on the medical institution.
Irradiation of the entire face is about 10,000 yen to 50,000 yen when using one irradiation method, and when using multiple irradiation methods, it varies depending on the number of irradiation methods combined, but it is about 30,000 yen to 100,000 yen. there is.
Some medical institutions set the initial fee or the fee after the second time at a low price. Prices for spot spot treatment and tattoo removal may differ depending on the size of the target area, so please check with the medical institution where you will receive the treatment for details.
Medical institutions may be covered by insurance for traumatic pigmentation, Ota's nevus, and ectopic Mongolian spots. Please consult
Immediately after the treatment, redness may occur at the laser irradiation site, but it is said to calm down in about 2 to 3 days.
If blistering or post-inflammatory hyperpigmentation occurs, use ointment or whitening topical medicine according to the doctor's instructions. The blisters become scabs and peel off in about a week, and the post-inflammatory hyperpigmentation subsides in about 3 to 6 months.
When spot irradiation is performed, a thin scab may form, but it will fall off in about 5 to 10 days. If you force it off, it may cause post-inflammatory hyperpigmentation, so wait for it to peel off naturally. Unlike Q-switched lasers, the color does not darken to a scab-like dark brown color, and it is said that tape protection is unnecessary.
When fractional irradiation is performed, petechiae may appear for about 2 to 5 days, but it can be made less noticeable with makeup.
When spot irradiation is performed, there are individual differences in how pain is felt, but it is said that the pain is repelled by rubber. Some medical institutions prepare anesthetic creams and local anesthesia, so if you are worried about pain, please consult with the medical institution.
Depigmentation may occur due to high output and high frequency irradiation. In this case, improvement may be expected by fractional irradiation.
You can shower from the day of the treatment , but avoid long baths, saunas, and strenuous exercise as they may promote swelling and redness . Since the skin is sensitive after the treatment, it is recommended to properly moisturize and protect against UV rays .
Also, if you have had a tattoo removed, you will need to apply an ointment and protect it with a case for about a week.
A doctor will examine you and decide on the treatment. Tell your skin concerns and hopes, and if you have any concerns or worries, ask the doctor at this time and resolve them.
(2) Face washing/anesthesia
Remove make-up and wash your face to cleanse your skin.
(3) Taking pictures and changing clothes
Depending on the medical institution, a photo will be taken to check the condition of the skin before the treatment. In addition, in the case of body treatment, change into special clothes for treatment.
In order to protect the eyes from laser irradiation, a shield is worn before irradiation. Treatment time is about 10 to 20 minutes depending on the content of the treatment.
Finish by cooling the treatment area.
For example, if you want to improve blemishes, there are various types of blemishes. Senile pigment spots (solar pigment spots) that tend to appear with age and are caused by ultraviolet rays, chloasma that is thought to be related to female hormones, and ADM (acquired dermis) that is considered to be a kind of bruise rather than age spots. melanocytosis), etc.
In many cases, it is difficult to distinguish between bruises and chloasma, which are thought to be so-called ordinary spots (senile pigment spots). Without proper treatment for each symptom, the results will be unsatisfactory.
First of all, it is most important to consult a doctor who has extensive knowledge and experience in treating dark spots and improving skin quality, and selecting the appropriate treatment method .
Treatment with Enlighton SR is delicate, with different effects depending on the distance from the skin surface to the target and the irradiation method. The doctor's skill is required to optimally combine the appropriate wavelength, spot size, and irradiation energy level (fluence) for the treatment target .
Therefore, it is important to choose a medical institution that has a wealth of experience in pico laser treatment, including laser treatment and Enlighton SR, and has a doctor who is familiar with the features of the machine .
Professor Jun Sugawara, who supervised the article, taught me about Enlighton SR.
Introduction of supervising doctor
Dr. Jun Sugawara, who is well versed in both surgical and laser fields, has obtained a doctorate in medicine for his research on laser treatment of melasma. Through the Customized Treatment Study Group, which serves as a director, and the "enLIGHTen Training Program" at the first laser training facility for doctors certified by Cutera in Japan, the original irradiation method "Multipass Technique™" that controls the risk of pigmentation that occurs in blemish treatment. We are energetically engaged in enlightenment of
Jun Sugawara Medical institutions with doctors
We asked Professor Jun Sugawara about Enlighton SR.
Product catalog and case photos provided by the manufacturer.