Blemishes

Blemish Removal is a safe, effective and quick treatment procedure that involves the removal of many vascular or viral skin conditions or lesions.

They include:

Vascular
Telangiectasia (Thread Veins)
Spider Naevi ( Thread veins emanating from a circular spot )
Cherry Angiomas (Blood spots)
Milia

Viral
Skin tags
Dermal papillosa nigra
Sebhorric Keratosis
Warts
Verucca
Xanthelasma
Syringoma

Other
Moles

We treat these with Short Wave diathermy or Galvanic current at Crysallis Skin Clinic , and you may need several treatments to remove the lesions completely. We are careful in how we apply the Short wave diathermy so as not to cause damage to the skin, or pigmentation

Both modalities use the electrical current and is extremely safe with very effective removal of the target tissue. Another method of blemish removal is Cryotherapy which works in the opposite way to SWD as it uses freeze techniques.

 

How does Short Wave Diathermy/Thermolysis work?

The Treatment principle of SWD is that we target the affected tissue by means of cauterisation or decomposition. The machine creates an alternating current that produces oscillating, high frequency waves. The current alternates between positive and negative poles.

Current is conducted through a needle, the size of which is chosen to match the size of the lesion. The high frequency current can range from 3-30m oscillations per second and moisture in the tissues is the conductor that causes molecules to be attracted to the needle and then repelled when the current changes directional flow to negative. This “molecular friction” or electrostatic attraction and repulsion of tissue fluid creates heat which dries up excess moisture, living cells and the blood supply.

The heat causes targeted tissue to undergo coagulation and destruction, and we use the term electro-cauterisation or coagulation to describe this.
We effectively cut off the blood flow to lesions, and this initiates a wound healing response from the body. We must therefore always ensure that the client has a healing capacity for this.

Galvanic current is a direct current that will produce one direction, smooth and flowing current which flows negatively and continuously. The client will hold an indifferent electrode to as to ensure the electrical circuit is complete. A chemical reaction occurs in this instance and sodium hydroxide or lye is made around the needle. This chemical solution is very caustic alkaline balance and the aim is to destroy the targeted tissue completely.

Sometimes we use a Blend of currents which is a combination of both short-wave diathermy and galvanic current. Each modality will withhold its strength and power to accomplish the targeted tissue to be destroyed making this technique unique.

 

Are there any side effects?

For a few days post treatment, the area treated can be sensitive, redness may be apparent and possible swelling if larger lesions have been treated. Small crusts will often appear for a few days whilst the lesion treated heals. Providing that the aftercare instruction is followed, and no infection develops there should be no risks of any scarring. In some cases, a small pigmented mark can be visible where the lesion resided however, this will be minute and no normally even noticeable.

Blisters can form but again rare and if treated correctly should heal quickly with no other skin issues to be concerned about.

We assess if the client is prone to post inflammatory hyperpigmentation, scarring such as keloid as these issues will either contraindicate or restrict the treatment from taking place.

 

Is it important to assess the client’s skin Types?

A thorough consultation must be carried out to review the client’s type on the Fitzpatrick scale which are groupings according to the genetic predisposition to melanin/pigment in skin cells. This indicates how their skin will react to sun exposure and their proneness to pigmentation from the treatment.

A thorough consultation must be carried out to review the client’s type on the Fitzpatrick scale which are groupings according to the genetic predisposition to melanin/pigment in skin cells. This indicates how their skin will react to sun exposure and their proneness to pigmentation from the treatment.

We also need to assess if the client’s skin is dry, dehydrated, oily, sensitive etc to know if skin reactions are within what is normal for their skin type and whether we should actually be doing the treatment on them. It also indicates healing capacity and time this will take, and the amount of erythema we should expect to see.
It also helps decide on level of aftercare product may be required for healing.
We also review skin type, and body conditions to determine any contra-indications.

 

Why do we carry out a patch test for electrolysis?

The practice of Patch Testing for allergies is a legal requirement under the COSHH Regulations of 2002. It is also and part of the Cosmetic Practice Standards issued by the CPSA.

Patch testing safeguards you against any allergic Histamine skin reactions that could be caused by the treatment. It also can check if the client’s skin reaction would result in pigmentation or scarring. This is especially relevant in exposed areas, like the face. I would wait 3 weeks until after patch tasting before treating.

We legally need to patch test every 6 months as the body can build up allergies in that time.

 

What are the Contra-indications restricting treatment?

• Product allergies
• Stye
• Conjunctivitis
• Impetigo
• Bacterial infections
• Eczema (open or bleeding)
• Dermatitis (open or bleeding)
• Psoriasis (open or bleeding)
• Benign tumors
• Skin disorders
• Cuts and Abrasions
• Inflammation or swelling
• Lack of skin sensation
• Viral infections – Herpes Simplex (cold sore), herpes Zoster (shingles)
• Fungal infections – Tinea Corporis (ringworm), Tinea Pedis (athletes’ foot), Pityriasis versicolor (white, brown or pink patches of dry skin)
• Parasitic infestations – Scabies, Pediculosis (lice)

 

How do we adapt the treatment to suit different skin types?

Depending on the client and type of treatment we may delay until the winter.
Lower the current settings to start with as well, but also make sure the treatment is still effective. Excessive diathermy current and over treating the skin can lead to pigmentation in Fitzpatrick IV – VI.
Operate slowly so the client has time to adjust to the sensations.
Ensure the needle size is correct for the blemish, and space out taps more.
Ensure the client has not had any other treatments like microdermabrasion in the area, or on compromised skin from tanning or another event.
Keep treatment short and split the treatment up in 2 or 3 appointments 4 weeks apart, so the skin has time to recover.
Ensure aftercare is understood and strictly adhered to and I would insist on a follow up consult to check progress.

 

Aftercare advice following an advanced electrolysis treatment

We give clients a leaflet with the instructions in to refer to at home.

Stress the importance of taking care of the area treated for at least 48 hours.

Do not touch the treated area and must not remove any scabs or crusts that may appear. The area should be treated like a burn.
Avoid harsh soaps, perfumes, skin sensitising creams, and chemicals as much as possible, apply my after care products witch hazel and/or aloe vera meticulously. They should also allow skin to dry naturally after washing with water/gentle cleanser, and only pat dry.
Do not cause sweating or dilation in the area though heat from a sauna, facial steaming, or through exercise for at least 24 hours
No swimming until areas treated have healed, as the chemicals are harsh and irritating
No sunbathing/UV light for 48 hours
Explain thoroughly aftercare product use
Explain normal reactions and advise that you can expect to be erythmic and possibly very sensitive and not to use any other skincare products for 48 hours.
For clients with work done on their face, the erythema reaction will reduce in a short time circa 6 hours, but to advise me if it doesn’t, and that after 48 hours there may be healing crusts. Clients should not use facial scrubs and only after 48 hours makeup can be worn, and a normal skincare resumed. The crusts should be kept as dry as possible and must not be knocked or picked and should slough off after 5-7 days. SPF 50 should be used for at least 6 weeks after the treatment, and preferably thereafter too.
For clients with work done in areas of friction they preferably not wear constricting clothes like bras etc
Do not fly within 48 hours for clients having capillary treatments

 

What are the aftercare products recommend following electrolysis treatments?

    • Witch-hazel – keep in fridge to keep cool; use chilled wet cotton pads for help with vasoconstriction and reduction in oedema. It is soothing and cooling, mildly bactericidal, can help to reduce swelling, and has some moisturizing properties
    • Aloe Vera – keep in fridge to keep cool; use chilled wet cotton pads for help with vasoconstriction. It can reduce swelling, and is cooling, has healing qualities and cellular renewal properties, and heals the underlying skin for use anytime up to the next treatment; the thicker/deeper the amount of gel the colder it will stay and reduce erythema and swelling more.
    • Sterex Après Cosmetic cream Clear – recommended of areas of high bacterial growth ( underarm/groin) and repeat 24-48 hours after. It can also be used as a moisturiser for oily, congested skin
    • Drying and soothing powder – apply in a firm rolling motion so that is fills in holes and encourages healing crusts to form quicker by drying out the area; to apply with a cotton pad morning and evening for 48 hours after treatment
    • Sterex Lightly medicated foundation aftercare creams – when applied hides redness and can be applied on top of other products above. Is also soothing for the skin.

 

Capillary Disorders

 

Dilated / Broken capillaries – Telangiectasia

This is the result of wearing and rupturing of capillary wall and the loss of elasticity on the walls of the blood capillaries – the cheeks, nose and lower legs are often most affected. This condition can result from numerous factors such as:

• Exposure to harsh weather elements
• Harsh handling-improper product use
• Lack of protection such as SPF no worn daily
• Spicy foods and alcohol
• Can be hereditary

Clients with dry and sensitive skin types are most likely affected and from the age of 18-35. It is more common in females up to four times more likely in fact. This skin type can be treated with care and good pre and post homecare.

Thread veins – legs

Very common and usually red, blue or purple. This due to the superficial blood vessels at the epidermis being visible. Often occur from 18-35 and again as with face thread veins, more common in females. Hormones and pregnancy are common causes along with lifestyle and occupation being a significant factor. The vein walls can be weakened through theses issues and blood volume exerts great pressure on the capillary wall. Lower body will mean that the venous flow is poor and therefore, it is imperative that you explain to clients that this type of modality is not very often successful.

Spider Naevus

A central dilated vessel with leg-like projections of capillaries. The face and cheeks tend to be most affected and this often occurs during pregnancy due to the increase in estrogen levels or most commonly following trauma. They can be caused through genetic predisposition also with hormones and weight gain and not always permanent. This is not infectious and can be treated.

Warts

Warts are caused by a viral infection (human papilloma virus) of the cells in the prickle cell-spinosum layer of the skin. The cells rapidly divide in a localized area causing an irregular growth to appear above the surface of the skin. A wart is formed after hyperkeratinisation takes place and hardens the growth. Warts mainly occur on the hands and will generally disappear on their own within 2-3 years. They appear as small, hard rough nodules. Although harmless very contagious.

Planter wants, also known as verrucas appear on the soles of the feet and grow inwards. Verruca’s are painful and can be differentiated from corns and calluses as they contain areas of black speckling and fine bleeding points. They should be removed via advanced practitioners or medically, although sometimes disappear by themselves. Warts and verrucae are infectious so clinical measures should be carried out to treat them.

Molluscium contagiosum , part of the pox virus, are common in children or transferred through sexual contact or if the individual has a compromised immune system.

Seborrheic Warts / Keratosis

These are basal cell papilloma’s and are harmless but very common. Most commonly pigmented benign skin growths formed from a build up of keratinocyte cells. The often appear post 40, can be single or numerous located all over the face and body. They are rough in texture and vary in colour from brown to black. They give the appearance of being stuck on and if not removed can grow.

Dermatosis Papulosa Nigra is the term is given to the same condition but in darker Fitzpatrick skins. Although they are classed as warts, they are not caused by the wart virus. They are merely an overproduction of keratinocytes. 

 

Sebaceous Gland Disorders

 

Milia (whiteheads)

If skin keratinises over the hair follicle it causes sebum to accumulate and become trapped in the hair follicle. More commonly in areas that secretions are unable to secrete normally. A milia can be seen a small white spot, which often accompanies dry skin. This condition is not infectious and easily treated to remove. Soft milia can also be treated and appear as yellow or white blockages. These can be located all over the skin and therefore treatment needs to be progressive.

Comedones (blackheads)

Comedones occur when sebum becomes trapped in a hair follicle. Keratinized cells mix with the sebum and form a plug. The head of the comedone becomes black in colour because it combines with the oxygen in the area and oxidizes. Comedones generally occur on greasy skin types and are not infectious.

Skin Tags

Skin tags can affect most parts of the body, often the neck and the underarm. They are made of loose fibrous tissue, which protrudes out from the skin, and are mainly brown/beige in colour. They are harmless and are usually caused by friction, predisposition and age. Although they tend to cause no pain only if continually rubbed, they should be removed as they can grow and multiply due to them being part of the human papilloma virus.

Syringoma

These are benign harmless eccrine sweat gland tumors that can be located around the eyelids, neck, chest, groin or even the abdomen. They are often found to be symmetrical in pattern and are usually skin colored or yellow. They are hard to the touch, round bumps that can range from 1-3mm. More common in Asian woman from the age of 40 although typically present themselves in adolescence. Can be itchy or at times cause irritation. Easily treated however, often reoccur. This procedure will also need to be checked with your insurance company to identify if the cover protects you to do so.

Xanthelasma

This condition presents itself as yellow patches most commonly found in the corners of the eye. It contains cholesterol from beneath the skin and are not harmful. Although, easy to treat if in small patches, can be a sign that cholesterol is too high, fats in the blood or possible heart disease. Therefore, it is imperative to ask the client to consult with their doctor for a general health check. This procedure will also need to be checked with your insurance company to identify if the cover protects you to do so.

Sebaceous Cyst

Common abnormalities within the body that contain liquid but are however, non-cancerous. They can be found on the face, neck or torso and although the grow slowly overtime become sore and uncomfortable. They are not life threatening as they form from the sebaceous gland. They develop if the duct or the gland become blocked or damaged. Such damage could have been a small scratch or wound that occurred weeks before the cyst presented itself. Easily treated however if the following characteristics are seen consult with the GP:
• More than 5 cm in diameter
• Once removed the lesion reappears quickly
• Any signs of infection, puss, redness or pain
Sebaceous Hyperplasia
Common and benign condition of the sebaceous glands. Most common in adults and middle age, they can be single form or in multiple formation. They are small,
yellowish or clear papules or bumps. Often found around the nose, forehead or cheeks. Typically formed due to large sebaceous glands. Can appear as a “ring donut” effect. Easily treated progressively.

 

Mole Reduction

Any clients wanting to remove or reduce their moles should firstly consult with their doctor to confirm that the mole is in fact safe to treat. However, in blemish removal we refer to this procedure as reduction. This is because all moles that are treated can leave a small “freckle” mark where it was once located. Therefore, ensure that the clients understands that this is the case so that they can choose if the mole upsets them more than the freckle would. This procedure will also need to be checked with your insurance company to identify if the cover protects you to do so.