2015年12月10日 星期四

MDA


Indications:
l   Atrophic Post Acne Scarring
l   Melasma
l   General Extrinsic Ageing
l   Acne (NOT cystic, inflammatory acne)
l   General Skin Refresh
l   Skin types I, II & III for level 2 and level 3, Skin types IV, V & VI for level 1

Contradindications:
l   Skin types IV, V & VI for level 2 (moderate) to level 3 (intense) MDA
l   Severe cystic or painful acne
l   Current and recent (< 6 months) Roaccutane® therapy
l   Rosacea and/or severe telangiectasia (don’t do it on the telangiectasia)
l   Patient with unrealistic expectations
l   Patient who don’t practice good sun protection
l   Active cold sores (don’t resurface to close to the lips)

Levels:
l   Level 1 Mild: Ablation of upper epidermal layers (resulting in erythema). Usually 2 passes at suction 4 or 20kPA, media 4 for face, and suction 4 or 20kPA, media 3 on eyes and neck.
l   Level 2 Moderate: Ablation of upper and mid epidermis (resulting in mild grazing). Usually 3 passes at suction 6 or 25kPA, media 5 for face, and suction 4 or 20kPA, media 3 for eyes and neck.
l   Level 3 Intense: Intense: Ablation to basal layer (resulting in grazing and pinpoint bleeding)
Intensity increases with:
l   larger coarse crystals
l   longer treatment period
l   increase in suction
l   skin prep with exfoliating cosmeceuticals
l   more crystal outflow
l   continuous suction
Mechanism of action:
l   The inflammatory response elicited by a series of microdermabrasion treatments resembles a reparative process in the dermis and epidermis. This appears to be the mechanism by which microdermabrasion produces its clinical effects.

Cautions:
l   If you’re preparing your patients skin with a highly active cosmeceutical such as retinoic acid, you must allow at least a 2-week period for the skin to adjust to the new product. If you were to perform MDA before this, the results become very unpredictable. Any erythema, irritation, inflammation and/or flaking may indicate your patient is still adjusting to the active cosmeceutical.
l   Chemical peels applied immediately post MDA treatments can cause significantly more ablation/exfoliation than expected.

Pre care:
l   Preparing the skin 1 to 2 weeks prior to MDA treatment will give a better treatment outcome and help reduce complications such as post inflammatory hyperpigmentation. Any exfoliating cosmeceutical (eg. AHAs, Vit. A), tyrosinase inhibiting cosmeceutical (eg. Vit. C or botanicals), always an SPF 30+

After care:
l   Down-time approximately one week: Swelling and erythema lasting 24 to 48 hours, mild crusting lasting 5 to 7 days, mild purpura lasting 48 hours.
l   Using highly active cosmeceuticals post MDA can result in an unpredictable response. In general, stick with basic cleansers and moisturisers free from active ingredients, perfume and colours.

Potential complications:
l   Corneal damage
l   Hyper/hypopigmentation
l   Infection
l   Skin reaction with post procedure skin car

Procedure (Machine used: Diamond flower peel machine):
1.          Explain to client the importance of keeping their eyes closed so that the crystals do not get into the eyes.
2.          Wipe down noozle with alcohol wipe and put it on the hand piece.
3.          Set the MDA machine: media, suction.
4.          Level 1: 2 passes, Level 2: 3 passes.
5.          Keep shaking out crystals and wiping away crystals from the face. Never hold it over the eyes as grains can fall in.
6.          Hold skin with thumb and middle finger.
7.          Hold hand piece like pen, as low as you can. Move back and forth, overlaps/passing each other, not crocodile teeth.
8.          Start with forehead up and down, progression towards neck. Left temporal area side to side motion, move towards the right until the mid chin. Then go to client’s left side and go from cheeks to left chin.
9.          Above the lips by feathering.
10.      Then work upwards to nose. Across the nose by feathering and twirling (cyclone effect great for drawing up blackheads).
11.      Turn down the settings and do under the eyes by feathering, then neck doing upwards motion.



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