Cam Sylabus Mastercopyfinal

2017 CERTIFICATE IN AESTHETIC MEDICINE
AYUAESTHETICS
PVT LTD
[CERTIFICATE IN AESTHETIC
MEDICINE]
HAND BOOK OF COSMETOLOGY, TRICHOLOGY AND SLIMMING TREATMENTS WITH MOST PRACTICAL
APPROCH
AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506
CONTACT 08856860463 e MAIL : ayuaesthetics@gmail.com Page 1
CERTIFICATE IN AESTHETIC MEDICINE
Facial and decolletage lines and wrinkles, Stretch marks, Aged and sun damages skin, Scars
(including acne), Rejuvenation of hands
Galvanic treatment
➡Galvanic Facial. ... This treatment involves the use of a device that uses low-level galvanic
(electric) current to facilitate the transport of key ingredients into the deeper layers of the skin
for improved cleansing, hydration, circulation, and radiance. Recommended for most skin
types, including sensitive skin.
High frequency
➡ High frequency treatments are used to stimulate, sanitize and heal the skin by high
frequency currents that generate warmth in the skin and stimulate nerve endings, in turn
increasing blood circulation, nourishing the skin and improving product penetration within the
skin. Direct high frequency offers the results of treating dry and dehydrated skin by increasing
the activity in the sebaceous glands and causing a skin warming effect and provides benefits for
those with blemish prone and acneic type skin by killing bacteria and eliminating oils.
Electroporation
➡A therapy that allows optimal product absorption into the skin is electroporation.
Electroporation is a popular method that allows for transdermal product absorption by using
electrical pulses to split open skin cells.
Mesotherapy
➡ In Mesotherapy Superficial microinjections are inserted just below the epidermal layer of
the skin into the appropriate tissues to stimulate the mesoderm layer in the skin, which lies at a
depth of about 1mm beneath the surface, in order encourage the hair’s natural regeneration
and proliferation process.
Mesotherapy treatment has now been used for decades to successfully restore luster and
volume to thinning hair and to promote significant hair regrowth for both women and men who
have experienced the beginnings of balding or Alopecia Areata.
The technology at the root of the treatment is based on the understanding that most hair loss
problems are a result of lack of proper nutrients, reduced blood circulation to the scalp and
hormone imbalances around the hair follicle, in particular an excess production of the hair loss
androgen DHT.
For hair restoration treatments, the Mesotherapy solution injected into the scalp contains a
special combination of specific chemicals, minerals, amino acids, vitamins, nucleic acids and co-
enzymes specifically tailored according to the patient’s unique requirements.

➡Electrocauterization (or electrocautery) is often used in surgery to remove unwanted or
harmful tissue. It can also be used to burn and seal blood vessels. This helps reduce or stop
bleeding during surgery or after an injury. It is a safe procedure.
A small probe with an electric current running through it is used to burn or destroy the tissue. A
grounding pad is placed on the body (usually the thigh) before the surgery to protect the
person from the harmful effects of the electricity.
Thread lift ( theory )
➡ PDO therapy is an effective cosmetic technique that lifts and tighten sagging skin tissues by
inducing collagen production. It involves the implantation of fine, absorbable
polydioxanone threads (similar to those used in medical suturing) into the subcutaneous layer
of the skin using small needles.
RF cavitation / body contouring
➡ Noninvasive radio frequency for skin tightening and body contouring. ... Currently, the most
common uses of RF-based devices are to noninvasively manage and treat skin tightening of lax
skin (including sagging jowls, abdomen, thighs, and arms), as well as wrinkle reduction, cellulite
improvement, and body contouring.
EMS slimming
➡ EMS stands for Electric Muscle Stimulation. Technically, EMS is a total body workout with
body current. In this context, it might be helpful to know that our muscles contract through
electric impulses (bioelectronics) in normal state. The EMS training makes use of this effect.
➡ EMS for face
The faradic facial treatment or electrical muscle stimulation (EMS) uses the application of
electrical pulses, which are applied to the face to stimulate the muscles to contract, resulting in
a tightening and toning effect.
Cryolipolysis
Cryolipolysis is a medical treatment used to destroy fat cells by freezing. The functional
principle is the controlled application of cooling, within the temperature range of +5 to
−5 °C, for the non-invasive, localized reduction of fat deposits, in order to reshape the
contours of the body. The degree of exposure to cooling causes the apoptosis (cell
death) of subcutaneous fat tissue, without apparent damage to the overlying skin

Skin analysis
Once the patient is comfortably positioned on the examination table, and you have washed
your
Hands and begin skin analysis.
Ask the patient if he or she would prefer to have his or her eyes covered with cotton
wool rounds, or if the patient would just like to close them.
Look closely when doing a skin analysis.
Use a magnifying lamp to illuminate the face, and study the facial contours, jaw line, chin, nose,
cheeks and forehead.
You need to examine following points in patient:

• the skin’s general condition
• pore size
• any area of shininess
• dry flaky patches
• comedones or blocked pores or papules
• skin problems, e.g. acne rosacea or acne vulgaris
• the contours of the face – any loss of elasticity or dropped contours
• dilated capillaries
• the colour and texture of the skin
• areas of pigmentation.
NVQ 3 BEAUTY THERAPY: Facial treatments – theory and consultation

Keys to good practice
When looking at the skin, you can also talk about the patient’s current skin care range,
and how happy the patient she is with the results.
For example:
• Is she using a regular exfoliant to help slough off the dead skin cells?
• Does the colour look a little flat and dull?
• Would the skin benefit from having the circulation stimulated, bringing oxygen and nutrients
to the cells?
• Are the current products drying out the top layers of the skin?
• Does the skin look plump and full of moisture, or dehydrated and dry, with lines?
• How firm is the jaw line? Is the patient developing a double chin?
• How much water is the patient drinking every day to keep the skin clear and healthy?
Manual examination of the face

Most of the information gathered on the record card is from questioning the patient and
observation of the facial skin condition, but you will also need to feel the skin’s texture,
warmth and contours. This will be done when carrying out the superficial and deep
cleansing routine – your fingertips will alert you to rough patches of skin, moles and

INTRODUCTION TO COSMETIC-DERMATOLOGY
Cosmetology is study of art in cosmetics and their use.
Cosmetology is defined as serving to beautify the body and improve the appearance of physical features
Cosmetology broadly divided into
1 Medical cosmetology
2 Non-medical cosmetology
Medical cosmetology: medical cosmetology deals with beauty of the body with the help of medication (drugs) and
different clinical procedures.
Non medical cosmetology: non medical cosmetology deals with beautification of the body without any use of
medications , The same includes beauty parlour, spa , makeup. saloon etc
As doctors only deal with medical cosmetology so we discuss about medical cosmetology in details
Approach towards cosmetological patients:
People demanding aesthetic correction do not fall into the category of Patients, and thus need to be considered
differently. The counselling and proper history talking has an important role in initial approach to them .
Sometimes ,It is also important to Nullify the High expectations of the clients looking for higher end cosmetic
correction. It is important to develop an Aesthetic sense to properly Guide your clients through to proper
outcome.
Cosmetic problems can have multiple presentation depending on the nature of skin , Environment , Climate and
the behaviour of our skin can be different in different individuals.
Skin types vary depending upon factors such as:

 Water content, which affects your skin's comfort and elasticity
 Oil (lipid) content, which affects your skin's softness
 Sensitivity level
Skin can be divided into 5 types on the basis of prospective purpose of cosmetology:
 NORMAL
 COMBINATION
 OILY
 DRY
 SENSITIVE
Normal Skin Type:

Normal skin is not too dry and not too oily. It has:
 No or few imperfections
 No severe sensitivity
 Barely visible pores

 Exposure to heat or too much humidity
To take care of oily skin:
 Wash your skin no more than twice a day and after you perspire heavily.
 Use a gentle cleanser and don't scrub.
 Don't pick, pop, or squeeze pimples. This prolongs healing time.
 Use products labeled as "noncomedogenic." They tend not to clog pores.
Sensitive Skin Type:

If your skin is sensitive, try to find out what your triggers are so you can avoid them. You may have sensitive skin
for a variety of reasons, but often it's in response to particular skin care products.
Sensitive skin can show up as:
 Redness
 Itching
 Burning
 Dryness
Importance of identification of skin type in cosmetology: The treatment, changes in different skin types of the
patients eg : Avoiding Salicylic Peel in patients with Dry skin.
In cosmetology, history taking is different than routine patients : eg hyperpigmentation with a sun exposure, Use
of systemic & topical medication like retinoids hydoxyquinines ,hypersensitive skin etc giving a different clinical
picture and as a result altering the treatment.
Cosmoceuticals:
Cosmeceuticals are divided into categories based on their active ingredient
Antioxidants can reduce the harmful effects of free radicals, which are molecules that injure the skin's cells and
cause inflammation, increase sun damage and contribute to the development of skin cancer
Peptides are smaller proteins that stimulate the production of collagen and thicken the skin.
Growth factors are compounds that act as chemical messengers between cells and play a role in cell division, new
cell and blood vessel growth, and in the production and distribution of collagen and elastin
Cosmeceutical Research
There is limited research being done on cosmeceuticals in academic dermatology, and there have been no NIH
grants available for cosmeceutical research to date. As a result, the best research comes from industry sponsored
studies.
Some Common Types of Cosmeceutical Ingredients
 Alpha Hydroxy Acids  Moisturizers

 Antioxidants  Peptides

L-Ascorbic Acid (Vitamin C)
There is clinical data to support the use of topical vitamin C to improve fine lines and reduce both pigmentation
and inflammation and many cosmeceutical formulations contain this antioxidant. However, many of these
formulations are not effective on the skin because:
 the concentration of L-ascorbic acid is too low.

 exposure of the product to air and light compromises the stability of the product.
 the L-ascorbic acid molecule (in the form of an ester or a mixture of isomers) cannot be absorbed or metabolized
effectively by the skin.
In high enough concentrations (i.e., at least 10%) of the nonesterified, optimal isomer, this antioxidant does inhibit
UV damage.9 It is important to note that stabilizing ascorbic acid presents many formulary challenges; however, a
formulation that has an acid pH of approximately 3. may optimize vitamin C absorption. Newer formulations of
stabilized ascorbic acid derivatives may prove to be more efficacious.
Niacinamide (Vitamin B3)
Niacinamide is a potent antioxidant that is generally well tolerated. It improves the lipid barrier component of the
epidermis, thus reducing transepidermal water loss, and acts as an inhibitor of melanosome transfer, resulting in
reduced hyperpigmentation. Studies have revealed significant reduction in fine lines and wrinkles, hyperpigmented
spots, red blotchiness, and skin sallowness, as well as improved skin elasticity.
N-Acetyl-Glucosamine (NAG)
NAG is a more stable form of glucosamine, and may prevent new signs of photodamage from occurring, and fade
existing imperfections by interrupting the chemical signals that promote melanin production. A placebo-controlled
study comparing 3.5% NAG with the combination of 3.5% NAG plus 3.5% niacinamide on hyperpigmented spots
showed a superior reduction in pigmentation in the combination treatment group vs. both the placebo and NAG
only groups. When combined they produced synergistic effects.
á-Tocopherol (Vitamin E)
When taken orally, á-tocopherol protects membrane lipids from peroxidation. It has been shown to reduce
sunburn cells after UV exposure, neutralize free radicals, and act as a humectant.13 Its activity can be renewed by
combining it with a vitamin C preparation. As a component in topical formulations, it, like unmodified L-ascorbic
acid, has shown some limited efficacy; however, when a stable formulation delivers a high concentration of the
nonesterified, optimal isomer of this antioxidant, vitamin E does inhibit the acute UV damage of erythema,
sunburn, and tanning, as well as chronic UV photoaging and skin cancer.9 Because vitamin C regenerates oxidized
vitamin E, the combination in a cosmeceutical formulation is synergistic - particularly with regard to UV
protection.
Ubiquinone (CoQ10)
Ubiquinone is a naturally occurring, fat-soluble antioxidant and there is good in vitro evidence that it can suppress
fibroblast production of UVA-induced collagenase, thereby reducing collagen breakdown.14 It has been shown to
be effective against UVA mediated oxidative stress in human keratinocytes. Ubiquinone was also able to
significantly suppress the expression of collagenase in human dermal fibroblasts following UVA irradiation.15

Several studies on melasma have shown good efficacy with only mild irritation that disappeared with
discontinuation.
Moisturizers
Moisturizers restore water content to the epidermis, and provide a soothing protective film. They improve the
appearance and tactile properties of dry and aging skin, restore the normal barrier function of the skin, and reduce
the release of inflammatory cytokines. Moisturizers comprise an important therapeutic component in the
management of various skin conditions (e.g., eczema, psoriasis, pruritus, and aged skin)
Topical Peptides
Topical peptides are regarded as cellular messengers that are formed from amino acids and are designed to mimic
peptide fragments with endogenous biologic activity. These pentapeptides (e.g., KTTKS) are comprised of a
subfragment of type I collagen propeptide, and play a role in signalling fibroblasts to produce collagen in the
skin, which can improve the appearance of wrinkles.
One variation, the palmitoyl pentapeptide known as Pal-KKTKS (Matrixyl™, Sederma) was tested in a controlled,
double-blind, left-right randomized, split-face study of 93 women between 35 and 55 years of age who had
Fitzpatrick I-III type skin. Pal-KTTKS concentration was 3ppm; both groups were treated twice daily for 12 weeks.
Improvements in wrinkle appearance and length were observed.
Sunscreens
Sunscreens are the single most important cosmeceutical, because they protect skin against solar radiation, which is
the most important damaging environmental agent. As a result, they help to prevent the signs of aging. To be
effective, sunscreens should provide broad spectrum coverage that includes both UVA and UVB blocking agents to
inhibit photo aging and be part of a daily skin care regimen. Sunscreens contain active ingredients that act as
ultraviolet filters. The recommended application is 2mg/cm2, though this is rarely achieved in real-life practice.
Labeling changes proposed by the US FDA on sunscreen products are forthcoming.

• Skin with ecxess oil, pigmentation or acne scaring
SUGGESTED FREQUENCY OF TREATMENT: 1 x week for 6 treatments. 1 x month for maintenance.
CLIENT PREPARATION:
Remove all jewellry and protect client’s hair with a cap orheadband.
Wash your hands and put gloves on.
CLEANSING PROCEDURE:
Remove eye and lip make-up with an appropriate product
Cleanse the face thoroughly with a foaming or gel style
cleanser. Remove cleanser with sponges or a warm, aromatic
STEP 1CLEANSE & ANALYSE

Cleanse the skin
Analyse the skin. Make sure you look for the following:
How thick or thin, how sensitive, how vascular the skin is, if the skin is lax or loose, if it needs an intense
or gentle treatment
Put on clean gloves to start the streatment.
STEP 2 DIAMOND MICRODERMABRASION
Select a fresh (clean) tip, put it on the handpiece in front of the client
• Select the level of abrasion based on the skin qualities.
• The finest (lowest abrasion) tip is numbered 250, and the most coarse (most abrasive) is 75.
• Use the larger size tips for the broader, fleshy areas of the face and the small size for smaller or curved
areas eg around the nose, crease of the chin etc.
Choose a low level of suction to start with

Start at the centre area of the chin & work outwards in slow sweeping movements
Support the skin with your other hand as you go
Adjust suction as required, and use multiple tips if needed
• Higher level of suction and more coarse (more abrasive) tip for thicker or congested skins, acne scarring
or more intense treatment
• Lower level of suction and finer (less abrasive) tip for thinner, sensitive, vascular skins or less intense
treatment Cover each section of the face, working upwards and with
outwards strokes where possible (encourages lymph drainage)
• Make sure each sweep joins onto the last – don’t miss
patches
• Don’t treat inside the orbital rim (inside the area of the
eye bones or under the brow)
Commence with a second pass if required (sweep the strokes
in opposite direction to first pass)
STEP 3 DIAMOND REMOVAL & EXTRACTIONS

MICRODERMABRASION
CLEANING & MAINTENANCE
Microdermabrasion is an extremely popular skin treatment. People undergo this procedure to remove
impurities and fine lines and wrinkles from facial skin. The treatment is particularly effective on skin that
has small bumps or blackheads. The process works by applying vacuum suction and abrasive particles
(Diamond or Crystal) over the skin, which serve to remove some of the upper layers of the epidermis.
The dead skin cells, which end up inside the different parts of the microdermabrasion machine, make
the hygiene of these gadgets extremely critical. The most important element that requires cleaning is
the dermabrasion tip, as the dead cells usually accumulate inside this tiny component. All skin-care
professionals and casual home users need to learn how to properly clean and sterilize dermabrasion
applicators before re-using them.
DIAMOND TIPS
Once the treatment is completed and before the next client.
While wearing gloves, carry out the following:
1. Remove used tip/s from handpiece
2. Wash and scrub the tips with warm water, antibacterial detergent and a toothbrush to remove skin
debris from them
3. Rinse thoroughly
4. Dry tips with paper towel
5. Soak in approved chemical sterilising solution - follow manufacturer directions for dilution and
soaking time
6. Remove tips from sterilising solution, rinse with hot running water
7. Allow to air dry in a clean location
8. Store dry tips in a covered storage container or sealed bag until required for next use
OR
9. Tips may be sterilised in an Autoclave after step 4 is completed, if preferred.
Dr Gaurav Dhanduke
Director
Ayuaesthetics Pvt Ltd
Contact : 08856860463
E mail : ayuaesthetics@gmail.com

CONTACT 08856860463 EMAIL : ayuaesthetics@gmail.com Page 19
b. Postburn scar
3. Stretchmarks
4. Mesotherapy – Microneedling when used to puncture skin will bypass the stratum corneum and
create transient aqueous transport pathways of micron dimensions and enhance the transdermal
permeability. These microspore are orders of magnitude larger than molecules dimensions and
therefore readily permit the transport of hydrophilic macromolecules . In androgenetic alopecia and
alopecia areata, 1 ml of 5% minoxidil is applied and roller is rolled over the scalp. It enhances upto 40
times more absorption of substance compared to topical creams.
5. Cellulite-With thickening of skin epidermal layer will become tighter and firmer giving younger and
healthier look .
6. Lax skin on arms, abdomen, neck, thighs, areas between breast and buttocks .
7. To tighten skin after liposuction
CONTRAINDICATIONS
1. Active acne, herpes labialis.

2. Chronic skin disease like eczema and psoriasis
3. Blood clotting disorders and patient on any anticoagulant therapy like warfarin, heparin or other oral
anticoagulants, as it can cause uncontrolled bleeding.
4. Rosacea
5. Skin malignancy, Moles or warts and Solar keratosis: as the needles may disseminate abnormal cells
by implantation.
6. Patients who have not pretreated their skin with vitaminA.
7. Patients on Aspirin should discontinue it atleast three days before the treatment.
PATHOPHYSIOLOGY OF COLLAGEN INDUCTION THERAPY
Needles pierce the stratum corneum, create holes without damaging epidermis. Each pass of rolling
produce 16 micro punctures/cm . Rolling with dermaroller over an area for 15 times results in
approximately 250 holes/cm . Microneedling aims to stimulate collagen production (Figure 1), by
producing microwounds and initiating the normal post-inflammatory chemical cascade. There are 3
phases in the bodies wound healing process which follow each other in predictable fashion described

differentiation of all major cells in epidermis and dermis. Vitamin A may control the release of TGFβ3 n
preference to TGFβ1 andTGF β2.
Vitamin C is essential for production of normal collagen.

Percutaneous collagen induction and vitamin A switch on the fibroblast to produce collagen and
therefore increases the need for vitamin C.
PROCEDURE
Area to be treated is anesthetised with topical anaesthesia i.e LA and covered with cellophane tape for
45 minutes to 1 hour. EMLA removed using normal saline. The skin of face is stretched by one hand
while the
other is used to roll the instrument over in a direction perpendicular to that of stretching force.
Roller is rolled 15-20 times in horizontal vertical and both oblique directions. In deep seated scar base of
the scar is to be treated till pin point bleeding occurs, which should be from the base of scar .
Saline pads are kept over treated area.
Topical antibiotic cream is applied
Whole procedure takes 15-20 minutes
Treatment is to be repeated after 4-6 weeks.
POSTOPERATIVE CARE
Treated area is swollen and superficially bruised. To absorb the bleeding and serous discharge, it should
be covered with cool, damp swabs that are replaced for 2 hours.
Topical antibiotic cream (mupirocin) is applied for few days to minimize the chance of bacterial
infection.
Avoid sun exposure & harsh chemicals or any cosmetic procedure over the face for atleast for one week.
SIDE EFFECTS OR RISK FACTORS

They are almost neglible
1. Pain.
2. Reactivation of herpes simplex.
3. Impetigo.
4. Allergic contact dermatitis to the material used in needles.
5. Exposure to blood.
6. Poor quality needles of the roller device often result in bending at needle tips after repeated
treatments, which results in more tissue damages and haemorrhage with linear hypertrophic scars or
post inflammatory hyperpigmentation. Over aggressive needling may also cause scarring using a tattoo
gun but not with special barrel of needles.
ADVANTAGES
1. It has a short healing time.
2. It can be used in any type of skin and on all area of body where lasers and deep peels cannot be
performed
3. It is a convenient office procedure and cost effective than other alternative therapy
4. Well tolerated and accepted by patients.
5. No risk of post –inflammatory hyperpigmentation Interleukin10 was increased after PCI therapy while
expression of MCIR(Melanocortin l receptor) gene coding for a melanocyte stimulating hormones

What is Dermapen?
Dermapen is a fractional micro-needling device that works to tighten, lift and rejuvenate the
skin. It’s effective in reducing fine lines and wrinkles, stretch marks, surgical and acne scars.
Fractional micro-needling or collagen induction therapy (CIT) uses needles to pierce the skin in
a controlled and precise pattern. Compared to other skin rejuvenation treatments, Dermapen is
safe on any skin type, has short treatment time and minimal discomfort with virtually no
downtime. Dermapen: a revolutionary breakthrough for beautiful skin.
How Dermapen Works?
The Dermapen is an automated microneedling device, with a disposable tip cartridge, that
uses 11 micro-needles to vertically stamp the skin at high speed. The stamping action of the
Dermapen’s vertical tip creates micro-injuries to the skin, stimulating new collagen production.
In doing so, these micro- injuries encourage and harness the body’s innate ability to regrow and
repair the skin through normal physiological processes.
Benefits of Dermapen
ent time
What Dermapen Treats
ch marks
Dermapen indications are general dermabrasion, scar revision, acne scar revision and tattoo
removal.
Dr Gaurav Dhanduke
Director
Contact : 08856860463

General Mesotherapy Applications
The various injection techniques within classical mesotherapy are described based on their depth of
injection, from the surface or epidermis to the deep dermis and subcutaneous tissues.
• Intra-epidermal
• Papular
• Nappage
• Point-by-point
Hair Mesotherapy
Hair mesotherapy can also be called “mesoplasty” or “mesohair”. It represents a variety of minimally
invasive techniques in which medications are directly injected into the scalp in order to improve
alopecia and hair growth. Mesotherapy acts on the epidermis, dermal connective tissue, the circulation,
the immune system and the neurosensory system. This therapy is effective at some certain forms of
alopecia. Acute diffuse alopecias such as telogen effluvium and stress alopecias androgenetic alopecias,
alopecia areata are the forms that mesotherapy can be used with good results. It is not effective at hair
shaft dystrophies or scarring alopecias. In the hair mesotherapy, there is lack of mixture and application
scheme whose effectiveness has been proved scientifically. Content of cocktails changes due to
physician’s practice and experience. The effects of treatments are to restore and increase local
microcirculation, provide nutritional input, slow down the programmed process of follicular involution,
stimulate the hair’s environment through neddling and complement other treatments. The chemicals
that are claimed to stimulate hair growth and new hair production are buflomedil, minoxidil, finasteride,
dutasteride, biotin, vitamins and organic silicium.
Vasodilators
In the treatment of alopecia; procaine, buflomedil, pentoxifylline, ginkgo biloba, minoxidil can be
used as vasodilator. By the vasodilatation, local microcirculation is restored and get stronger. Buflomedil
is an alpha-adrenoceptor antagonist and a weak calcium channel blocker. Ginkgo biloba also has
antiedema effect. Minoxidil is very important and effective drug for hair loss. It is shown that minoxidil
enhances hair growth by prolonging the anagen phase and induces new hair growth in androgenetic
alopecia. We do not use minoxidil over than 1-2 cc within the mesotherapy cocktail because it may be
painful for the patient. Hypotension can be seen due to excess vasodilatation.
Procaine: It is best known for its anesthetic property. Procaine is used in mesotherapy in the form of
chlorhydrate of procaine, 1% to 2%. It is antiarrhythmic and vasodilator.
Conjoctyl (organic silicium, salicylate of monometilsilanotriol): It is anti-oxidant effective drug. Silicon is
an element in the structure of elastic connective tissue. It acts as a coenzyme in the synthesis of the

By this modality of treatment, hair loss reduces, regrowth can be seen. A test trichogram should be
carried out after one year to be visible and meaningful. Injections can cause pain. An anesthetic cream
could be applied 30 minutes before the operation to reduce the pain. Rarely local reactions such as
edema, bruising, pruritus and pain may happen. Treatments has never had to be stopped and may be
conducted indefinitely, as long as the patient tolerates. No adverse effects develop. There are also some
cases of alopecia that are seen as a complication after mesotherapy treatment. In one case report, there
were two cases of acute patchy alopecia after mesotherapy for the treatment of androgenetic alopecia.
Histopathologic features showed an almost complete absence of terminal anagen hair follicles and a
marked increase in the number of telogen germinal units and catagen follicles suggested an acute
noncicatricial alopecia similar to anagen effluvium. There are certain case reports seen mycobacterial
cutaneous infections after mesotherapy in the literature .
Hair mesotherapy is a non-surgical, relatively painless injection technique. Despite the fact that there is
very little scientific evidence sustaining its widespread use, the field of hair mesotherapy have grown
enormously in the past few years, becoming a common method in cosmetic medicine. Its use in
cosmetic medicine to eliminate hair loss is gaining in popularity. To ensure a satisfying cosmetic result, it
is critical to use the correct cocktail and injection technique. No long term side effects have been seen in
thousands of patients.
Dr Gaurav Dhanduke
Director,
Contact : 08856860463

physiological product, eliminates donor transmissible infections, and is a biological glue for
tissue adhesion, especially in skin flaps, bone grafts, and trauma.
Alhough PRP is a promising therapy for most patients, the practitioner must take into account
some considerations during the initial assessment before suggesting this treatment.
Contraindications include the following: sepsis, cancer, chemotherapy, platelet dysfunction
syndrome, critical thrombocytopenia, hypofibrinogenemia, hemodynamic instability,
anticoagulation therapy, acute and chronic infections, chronic pathological conditions of the
liver, severe metabolic and systemic disorders, and skin disease (systemic lupus erythematosus,
porphyria, and allergies), as well as heavy nicotine, drug, and alcohol consumption. Adverse
effects of PRP treatment may occur, some of which are significant. The most common adverse
effects are infection, skin discoloration and bruising, pain in the injected area, allergic reaction
(a rare occurrence), and blood clot (because PRP therapy uses a needle, a vein could be
damaged). Certain factors (eg, smoking and alcohol intake) diminish stem cell release. Avoiding
these will increase the success of the PRP procedure. The platelets work by causing an
inflammatory reaction. If this inflammatory reaction is diminished, the clinical outcome is
significantly compromised. For this reason, the use of anti-inflammatory drugs is not
recommended. This restriction should be in place for about 1 to 2 weeks.
Platelet concentration is a rich source of various cytokines and growth factors, which are
activated after its injection into the target tissue. Platelets are activated endogenously by
coagulation factors (in some methods of preparing PRP, the activated PRP is injected to the
tissue). Following their attachment to special receptors on the cell surfaces, some intracellular
processes are activated, that facilitate extracellular matrix (ECM) accumulation and improve cell
proliferation and differentiation. Tissue regeneration is resulted from cell proliferation,
angiogenesis and cell migration.
Matrix metaloproteinas proteins (MMP) are involved in aging process by degradation of

collagen and other extracellular matrix (ECM) proteins, this characteristic can be used to benefit
rejuvenation. They can help regeneration of dermis through omission of collagen fragments
that are harmful to the dermal connective tissue, and so, provide an appropriate foundation for
new collagen deposition. In some studies Aprp (activated PRP) increases the expression of
MMP-1 and MMP-3 protein. Thus, aPRP may cause ECM remodeling through stimulating the
removal of photodamaged ECM components and inducing the synthesis of new collagen by
fibroblasts, which are in turn proliferated by their stimulation. Another mechanism of PRP for
skin rejuvenization, is through acceleration of hyaluronic acid production. Hyaluronic acid
absorbs water and makes hyaluronic acid matrix swelled which increases skin volume and
turgor. It also promotes cell proliferation, extracellular matrix synthesis and helps to the
adjustment of the collagen fibers diameter. Overall, it could enhance skin elasticity. All these
processes and some other unknown ones contribute to tissue rejuvenation through PRP.
Platelet Rich Plasma (PRP) is used for stimulation of both superficial and deep dermis layers. For
superficial stimulation, the injection must be done in the superficial dermis. The PRP must be
injected into the deep dermis or subdermal tissues when using as filler. The superficial injection

experience, surgical scars respond well cosmetically. The PRP treatments can be used on
all skin types and tones. Minimal swelling, bruising, and redness for the initial 12 to 24
hours are expected. A bruise at the needlestick site may be visible for 2 to 3 days.
Swelling from the fluid is what the patient will notice first. During several weeks, the
platelets stimulate growth factors, which assists in more collagen stimulation.
Treatment results vary but last up to 18 months in most patients. Biannual touch-up
treatments will maintain the results. As an initial treatment strategy, up to 3 injections
may be given within a 6-month time frame. These are usually performed 2 to 3 weeks
apart. Certain factors (eg, smoking and alcohol intake) diminish stem cell release.
Avoiding these will increase the success of the PRP procedure. The platelets work by
causing an inflammatory reaction. If this inflammatory reaction is diminished, the
clinical outcome is significantly compromised. For this reason, the use of anti-
inflammatory drugs is not recommended. This restriction should be in place for about 1
to 2 weeks. Proponents of PRP therapy argue that negative clinical results are associated
with poor-quality PRP harvest or concentration by inadequate devices. The specification
that gathering devices capture a percentage of a given thrombocyte count is a
marketing bias because significant individual variability exists in the platelet
concentration of human plasma. More is not necessarily better in this case. Variability in
platelet concentrating techniques may alter platelet degranulation characteristics,
which could affect clinical results.
There are various uses of PRP in aesthetic medicine:

• PRP has made the most significant progress in the facial area. Platelet Rich Plasma (PRP) with
fat transfer is the surgical combination of injecting a patient’s own plasma containing growth
factors along with their own purified fat to augment areas of lost volume and wrinkles on
the face.
• Containing beneficial growth factors, PRP may additionally be used with fat transfer or
subcision to re-plump areas of lost volume or depressed scarring from acne or trauma.
Advantages of PRP Rejuvenation
• Uses bodys own natural platelets so there is no risk of allergic reaction

• Natural collagen is formed in response to the presence of the activated platelets
• PRP is ideal for the patient who does not want any synthetic fillers
• There is little to no swelling, bruising or lumping as the fluid assimilates in the natural skin
environment
• PRP can be used to enhance Laser procedures for faster and improved healing
• PRP Therapy is equally as effective in men as in women
• Can provide outstanding results either with or without the use of underlying fillers.
As with all therapies, adequate training and experience are paramount. The beauty of the PRP
technique, especially in dermatology and as an adjunctive tool in practice, is that it can be used
as part of a multifaceted or layered approach. Significant clinical outcomes can be obtained
with concomitant use of light therapies, fillers, and mesotherapy. Due to limited studies on
clinical efficacy and safety, further studies are required to investigate the mechanism of action
behind the therapeutic effects of these products and their long term safety.Still,the PRP has
certain limitations as there is no standardisation in PRP preparation and specific quality
parameters in PRP preparation are still lacking.
Dr Gaurav Dhanduke
Director
Contact : 08856860463

A laser is a device that generates an intense beam of light. The term "LASER"
denotes Light Amplification by Stimulated Emission of Radiation.
Light is part of the spectrum of the electromagnetic radiation. Under certain conditions light
exhibits the characteristics of a wave.
All effects of light including laser light on skin begin with the absorption of electromagnetic
radiation (EMR). EMR is an important form of energy that exhibits both wave and practical
properties because the energy of light is carried through the photons.
Whenever a photon is absorbed some movement or separation of charged matter occurs in the
cells and the energy carried in the photon is invested in excitation of the charges. Excitation and
absorption of the energy is the basic of photobiological effects and laser application in
treatment.
There are important data concerning light used in laser treatment. These include the following:
The wavelength : is defined as the distance between the crests of each wave and that
determines the functional properties of the laser energy. Electromagnetic radiation with long
wavelengths, measured in meters, is commonly used for radio and television broadcasting.
Wavelengths in the 0.4-0.7um range form the visible light of the spectrum. Ultraviolet rays, X-
rays and gamma are forms of electromagnetic radiation with the wavelengths shorter than the
visible light.
Amplitude
Is the height of the wave with the maximum displacement from the zero position.
Frequency
Is the number of waves passing in a given point per second and is expressed in cycles per
second. The shorter the wavelength, the higher the frequency, and the higher is the energy.
Velocity
This is a constant and is equal to 186000 miles per second.

Fluence: is the energy density and calculated as the total energy divided by the cross sectional
area of the beam. It is expressed as joules per square centimeter. It is calculated as the laser
power multiplied by time of exposure over an area of spot size in cm2. If the heat is deposited
at a rate faster than the thermal relaxation time, there will be minimal conduction of heat to
the surrounding structure.
Spot size: Large spot size allows for smoother, more uniform vaporization of tissues.The spot
size is controlled by focusing or defocusing of the lenses. Simply by moving the hand piece
towards and near the skin decreases the spot size, or away from the target increases the spot
size. The smaller the spot size the greater tendency to create uneven ridges, furrows and
bleeding. Larger spot size causes decrease in peripheral thermal damage.
Thermal relaxation time:
This is the time required for the heated tissues to loose some of its heat through diffusion. It is
the time needed for adjacent tissue to cool during laser surgery. This is very important which
has a direct relation to tissue destruction.
PROPERTIES OF LASER LIGHT
Laser light has three special qualities that distinguish, it from the conventional light source .
1. Collimated: means that laser light travels parallel in a single direction with very little
divergence even for a long distance and therefore there is minimal loss of power along
the beam . A laser beam is a 1000 times brighter than the daylight and is brighter than
the sunlight.
2. Monochromatic: consists of one color or wavelength and thus the laser beam is very
pure. In contrast, white light from a regular light bulb involves the spontaneous
emission of photons of many wavelengths or colors, traveling in various directions and
emitting diffuse light.
3. Coherent: means all of the light waves move parallel in phase together in both time and
space. Ordinary light from a lamp consists of a mixture of wavelengths radiating in
different directions and out of phase . It is in a laser term considered as incoherent.
MODES OF ACTION OF LASER LIGHT

HUMAN SKIN AND LASER INTERACTION
The nature of interaction of all laser light with biological tissue can be described in terms of:
Reflection: There is always a degree of reflection of laser light from the epidermis.
Transmission: The laser light is transmitted through tissues to their target.
Scattering: This occurs after the laser light is transmitted and passing the epidermis to deeper
tissues.
Absorption: This occurs by the target tissue of the specific type of laser. Absorbed laser light
may cause tissue coagulation or vaporization. Characteristically, laser light searches for its
target such as pigment, hemoglobin or water.
Tissue coagulation: is related to the thermal effect .The conversion of laser energy into heat
causes coagulation, sealing or cautary with minimal necrosis occurs with temperature above 45
degree centigrade.
Tissue vaporization: This occurs with temperature over 100 degree centigrade , particularly
with rapid heat transfer from the laser light to the tissues. This will lead to boiling of cellular
fluid and complete destruction of cellular protein and the cell itself. The fume of this vaporized
tissue causes small particles which is about one micron . It is of prime importance to use special
laser mask during skin resurfacing especially viral lesions such as warts where inhalation of
these fumes containing the viral elements may cause serious complications .The laser mask
should have special specification to filter particles less than one micron .
Temperature is directly related to the average kinetic excitation molecules. As
temperatures are raised ranging from 40-100 degree centigrade most proteins,
DNA, RNA, membranes and their integral structures start to melt denature and
Laser
absorption
and Tissue
penetration

Scattered light is ultimately absorbed with the subsequent release of heat. Scattering is one
mechanism whereby, heat is lost from the lesion being treated to be deposited in non-target
tissue. Scattering is also the reason that the outline of bones cannot be seen when the hand is
trans- illuminated.
These three factors, melanin, hemoglobin and scattering are the basics in laser application in
dermatology and cosmetology.
EFFECT OF LASER LIGHT ON THE SKIN LESIONS
The epidermis is 100 um thick and is very susceptible to laser energy. It is almost universally
damaged during laser surgery with visible light wavelengths unless adequately pre-cooled. The
upper dermis is 400um thick and contains c'llary loops in the pegs supplied by the superficial
arteriolar plexus. which is supplied from arteries in the lower dermis. The normal superficial
plexus consists of 50um vessels and is a principle factor in skin coloration. The lower dermis is
400um consists of the supporting structures of the sweat glands, follicular structures and larger
vessels.
When laser is directed to skin, light may penetrate the skin surface, absorbed by the target
tissue, reflected or scattered.
There are three major factors, all-important in laser therapy, which keep tissue from being
more transparent than it is. These are the targets for laser. Different lasers are principally
depend on these factors, which are: the pigment melanin, hemoglobin and water.
Pigmented lesions
When treating a pigmented lesion, the light absorption characteristics of melanin are most
important. Melanin is the target pigment or chromophore and is heated by absorption of the
laser light to the point where the lesion is destroyed. The surgeon chooses a wavelength that is
well absorbed by melanin. Generally a wavelength in the Blue/Green range is needed. Blue has

beam of C02 laser is invisible and therefore a lowpower visible beam is used to provide an
aiming dot for the surgeon to guide and direct the beam to the desired target .
Laser energy passes through an articulated arm and focusing lens or through a hollow wave
guided . The tissue target for this type of laser is water, where light is absorbed by biologic
tissues causing destruction by rapidly heating and vaporization of the intercellular water. The
strong absorption of the laser light by water causes tissue destruction "What you see during
operation is what you get of the effect on human tissue ."
The output power may exceed 100 watts in the continuous operation and 50 watts when using
the pulsed operation .
The factors affecting tissue destruction by laser is the power reaching the tissue , spot size and
the thermal relaxation time ( which is the time between heating of tissues by the laser beam
and the time of cooling of tissues). C O 2 lasers are now provided by computerized devices that
make their use safer and much easier for the users . These computerized devices are
programmed in a more simple way for use either for skin resurfacing, surgical cutting or simple
ablation of the skin surface. The surgeon just uses the parameters according to the case he has
to treat. The laser power and spot sizes are all adjusted automatically.
Q-SWITCHED RUBY LASER
This is the first laser used by Dr. Goldman in 1965 for treatment of pigmented skin lesions and
tattoos.
Ruby laser (694 nm) of the Q-switched type can remove blue and black tattoo pigment. This
type of laser can remove tattoos with minimal scarring and without anesthesia. Several sessions
may be needed to remove pigmented lesions by the Qswitched Ruby laser. Different successful
results depend also on the type of laser used.
NEODYMIUM :YAG LASER
Nd:YAG is another type of Q-switched laser with longer wavelength (1064 nm) and can be used
to remove tattoos and pigmented skin lesions.

LASER SAFETY
Laser emits an intense beam of electro-magnetic radiation that can easily cause irreversible
damage to tissues, particularly ophthalmic tissue. therefore strict precautions should be taken
into consideration when using lasers . Protection of the patient , the surgeon , the assistant is of
prime importance.
1. The operating room
LASER safety door sign should be applied for warning of unauthorized persons not to
step into the laser area whenever the laser is working .
It is recommended to hang eye goggles on the door to remind each one entering the
laser room during operation to put on goggles before entering the laser room
Windows : must be covered with materials of sufficient optical density.
Instruments used should be of special type not reflecting laser light.
The room should not contain volatile substances such as ether, alcohol .
Water basin should be available.
Gauze used should be moistened with water to prevent inflammation by the laser light.
2. Safety measures for the patient:
Special glasses should be used . It should be noted that different lasers have different
glasses, which is special for that type of laser and can't protect from other laser light.
Eye shields: applied and cover the eyes by moist gauze before applying the glasses.
Patient's lips: can be protected by moist gauze. When operating in the oral cavity, care
should be taken to protect teeth and bone by using wet gauze or other nonflammable,
heat absorbing protective material.

NEVER place hands or other objects in the path of the carbon dioxide beam. Severe
burn may occur.
NEVER discharge the laser without a target to absorb it and without consideration giving
to what lies behind the target. Saline soaked gauze sponges or saline moist gauze or
water soaked clean gauze can be used to protect tissues.
LASER FOOT SWITCH :only the surgeon should have access to the laser Footswitch.
NEVER press the foot paddles unless you are starting treatment and all safety
precautions should be considered.
NEVER attempt any preventive maintenance on the laser.
NEVER use the laser in inflammable situation.
STAND BY position: keep the laser in the standby position when you want to shift to
other area or you stopped working temporarily for any reason to prevent accidental
exposure to laser surgery.
MASKS: Special masks should be used especially when removing viral lesions to prevent
inhalation of the viral particles .
POLLUTION HAZARDS
Smoke evacuator: The laser plume obscures the operative field and is noxious to those
who come into direct contact with it . The plume should be effectively evacuated by
repeated suction by special vacuum system.
ELECTRICAL HAZARDS
NEVER remove the laser protective covers.
NEVER operate the laser if there is any leakage of water from the console. (Certain types
of lasers contain water inside)
NEVER operate the laser if the power cable is faulty or the indication of the calibrating
device is showing "NO GO"(Ruby laser).

nearer to the area .Spot size of 2-5 mm is typically used for vaporization and the power output
is decreased to get the best surgical results when doing vaporization .
Uses of Co2 Laser
Co2 laser can be used successfully to treat the following lesions:
Skin resurfacing: removal acne scars, skin wrinkles, hypertrophic lesions
of lichen planus, xanthelasma. seborrheic keratoses, psoriasis patches with excellent results by
an experienced surgeon.
Actinic cheilitis :C02 laser is the treatment of choice for treatment of actinic cheilitis.
Fig. 447. Nevus of Ota

Fig. 446. Nevus of
Fig452. Angiofibroma of lips (treated by Q-Switched Ruby
Ota (Before Treatment)
laser)
Fig. 448. Acne Scar Fig.453. Angiofibroma

Fig. 448b. Skin Resurfacing by
treated by Co2 laser removed by CO2 laser
Co2 laser
Fig.454 Acne scar

Fig.449a. Hirsuitism Fig.456warts of the knee

Vascular lesions: such as telengectasia, port-wine stains, angiomas.
Epidermal pigmented lesions: Epidermal nevi, lentigines , ephelides, tattoo and pigmented
labial macules.
Tattoos: can be removed by vaporization the area with a bloodless fields. This method usually
leaves scar. Other types of lasers such as Q-switched lasers are more efficient in removing
tattoos without skin scarring .
Benign dermal tumors: neurofibromas, myxoid cysts, and granuloma faciale.
Actinic keratosis and squamous cell carcinoma.
Debridement of burns.
Control of bleeding.
Cosmetic surgery: Rhinophyma, blepharoplasty, and mammoplasty.
General Instructions.
Patient Consent.
The patient should sign a special form to agree about laser surgery and that he had information
about that. The patient also understands that he has to abide with instruction of the surgeon
and he accepts any complications, which may result after the surgery.
The patient is instructed that there is an erythema resulting after the operation, which may
extend for one month or more and he should keep away from direct exposure to sun light and
use exactly the medications as prescribed.
The patient should have information about the type of the skin lesion to be treated.
The type of laser surgery to be applied.
Result of Laser Surgery:
It is very important that the surgeon should discuss to the patient be informed that "No human
being by any device can return the treated area exactly the same to its previous condition." The

The patient should be instructed to abide strictly with the following:
1. Do not rub, scratch or put pressure on the treated area until skin changes like erythema
and crusting clears.
1. Do not apply make-up if there is severe reaction like oozing and blistering of the treated
areas.
2. Washing of the face gently by water may be allowed, while swimming is postponed for
2-4 weeks.
3. The treated area should be kept away from exposure to sunlight and sun blocks should
be used two weeks before and four weeks after surgery.
4. Post laser hyperpigmentation and scarring are the main problems of laser surgery. To
minimize post laser hyperpigmentation the following formula can be used by the patient
two weeks before and eight weeks after laser surgery.
0.2% Retin A
2% Hydrocortisone
4% Hyroxyquinone
5. This formula should be prepared in a special base cream and should be kept in
refrigerator in order not to become darker in color.
6. It can be used gently twice daily. The concentrations of the ingredients can be modified
according to the type of skin , condition of the treated area and age of the patient.
7. Acyclovir tablets used 5 days before the operation in patients having history of herpes
lesions.
8. Oral antibiotic such as Cephalosporin can be given as a prophylactic measure.
Postoperative measures.
Apply polysporin ointment.
We rise in our medical center combination of Pufexamac and Muperacin cream ( Droxaryl &
Bactropan) that proved to have an excellent post-operative healing and minimizing er ythema
arid hyper pigmentation .
The resurfaced area can be covered by Vaseline or vigilion dressing. The dressing is left in site
for 48 hours and then removed using only the medication without covering .

Intensity: the power transmitted by a light wave across a unit area perpendicular to the wave.
Power: the time rate of doing work (watt)
Power density: the power of the laser beam per unit area (watts/cm2).
Excitation: The addition of energy to a particle or system.
Fiberoptics: a system of flexible quartz or glass fibers with internal reflective surfaces that pass
light through thousands of glancing reflexes.
Aiming beam: HeNe of low density beam used to guide the invisible laser light to the treatment
area.
Laser medium: (active medium) material used to emit the laser light.
tem00: The lowest order mode possible , a gaussian or bell-shaped distribution of light intensity
across the laser beam cross-section.
tem:Transverse electromagnetic mode.
Argon: gas used as a laser medium.
Coagulation: destruction of tissues by heat without physically removing it.
Vaporization: conversion of a solid or liquid into a vapor.
Collimation: all rays coming from laser are parallel to each other.
Coherent radiation:same wavelengths move together to different points.
Thermal relaxation time: The time it takes heat to diffuse out of a structure and into
surrounding structures by thermal conduction. When pulsed duration of a laser is shorter than
the time required for heat to spread out of a target, the heat damage will be confined to the
target.
Target site: tissue that is aimed or fired with the laser beam.
Gaussian curve: Normal statistical curve showing a peak with even distribution on either sides.

400.1100 nm plus can hit the melanin. We are also aware that many laser systems function in
this visible and the infrared range of the electromagnetic spectrum. Though all these lasers
would have some effect on melanin, three wavelength bands are most useful for treating
pigmented lesions . green, red, and infrared.[1] Its not only about the wavelength, it is more
about the right pulse duration and at sufficient fluence. Since green and blue light lasers are
long pulsed continuous waves, they cause a lot of damage to surrounding skin. However, in the
last decade, the Q-switching technique has given birth to Q-switched ruby, Q-switched
alexandrite, and in the infrared category, Q-switched NdYAG laser.
Figure 1: Absorption spectrum of melanin and hemoglobin
WHAT IS Q SWITCHING?
In addition to their categorization by wavelength, lasers can be divided into continuous wave
(CW) or pulsed. A CW laser delivers a steady stream of light that is measured as average
power in watts or kilowatts. A pulsed laser delivers a very short but intense light emission
followed by a period of no light. If the laser is repetitively pulsed, the pulse repeats itself
on a regular basis. The time between the pulses is referred to as the interpulse period and the
length of each pulse is called the pulse duration. The number of hertz (Hz) represents the
number of pulses emitted per second. The length of the pulse duration is an important
characteristic of any pulsed laser/light device. Pulses lasting a few milliseconds (10-3) are
generally characterized as long pulses. Nanosecond (10-9) pulses are considered short. Q-
switched NdYAG laser pulses are typically 3.7 nanoseconds in length. [2]
What is the advantage of Q switching?

Figure 3a: Postinflammatory hyperpigmentation Figure 3b: After treatment with Q-

switched
with hypertrichosis before treatment NdYAG laser
Medium depth nonablative skin resurfacing[6]

Frequency doubled 532 nm Q switched is a well-established technology for treating photoaging.
When used at lower fluences with a larger spot size, it is a medium depth laser peel, with less
downtime and high patient satisfaction. However, due to the risk of postinflammatory
pigmentary
changes in Indian skins, it should be used only after a test patch and adequate sun protection
advised to the patient.
Melasma[7]
High-energy pigmented selective laser, for example, 694 nm, Q-switched ruby laser, 755 nm Q-
switched alexandrite laser, 532 nm frequency doubled Q-switched NdYAG laser,and 1064 nm Q-
switched NdYAG laser had been studied for treatment of melasma with poor results. Normal
skin color was rarely achieved. Epidermal melasma responds better and faster than
dermal/mixed melasma. Complete clearing of lesions may be expected in more than 50% of
cases of epidermal melasma. Complete clearing of dermal/ mixed melasma may be seen in
about 30.50% cases, while the remaining cases will show moderate improvement.
Postinflammatory hyperpigmentation and rebound melisma are dreaded complications that
may occur in the individual with sensitive skin. Lower energy and fewer repetitions are
adequate to produce marked improvement. Improvement will need to be maintained by
repeated treatments. However, recurrence is common in melasma.

done at monthly intervals, wrinkles soften and skin gets toned. Hence it is also referred to as
laser skin toning. This is a good option for improving acne scars, wrinkles, and stretch marks
without complicated procedures and long recovery times.
Laser-assisted hair reduction[9]

Though the long-pulsed lasers are gold standards for the removal of terminal hair, Q-switched
laser has been tried with and without topical carbon suspension. Q-switched pulses produce a
photomechanical impact on the tissue and also on hair shaft and hair follicle, causing reduction
as well as delay in hair growth cycle. Since it is not color dependent, it can be suited for all skin
types, even on tanned skins without fear of pigmentary changes.
Vascular lesions[2]
Medlite. laser from Hoya ConBio has been shown to be effective in treating vascular lesions like
telangiectasia, cherry angiomas, and small spider nevi. More than one treatment could be
required. However, it can cause purpura which could take up to a week to clear.
Dark lips[10]
Dark lips are a common cosmetic concern in India. Two to four sessions of Q-switched 532 nm is
an effective treatment for lip lightening.
COMPLICATIONS
The following complications are transient reactions and do not require termination of
treatment.
. Immediate erythema
. Physical urticaria
. Acneiform eruption
. Minute petechiae
. Whitening of fine hair
. Rebound hyperpigmentation
The following complications need either stopping the laser therapy or modification of laser
parameters:
. Mottled hypo and hyperpigmentation
. Leukoderma
. Severe urticaria
. Severe acneiform eruption
. Herpes simplex activation
Ghost shadows and scarring can occur with tattoo treatment

. Chemical peels (Glycolic acid, Jessner.s peels)

. Microdermabrasion
. Long pulsed lasers/Intense pulsed light
. Microneedling/Dermaroller
CONCLUSION
The search for an ideal laser for pigmented lesions has been long and continuing. We started
with the ruby and carbon dioxide in continuous mode with heavy and bulky lasers systems
which were not practical to use. Moreover, the complications/side effects far outweighed the
benefits. Today, we stand tall with new Q-switched technology which delivers a flat top beam
to utmost perfection and at the same time sparing the surrounding skin. But does that end our
quest for ideal laser for pigmented lesions? We still can.t treat melasma effectively. We still
have problems like scarring, ghost shadows, etc. with tattoos. We are still apprehensive of using
frequency doubled Q-switched laser 532 nm in Indian skins due to fear of hyperpigmentation.
Hence, there is definitely still a long learning curve ahead of us to overcome these lacunae in
the application of the existing technology to common skin problems. However, in Q-switched
technology we certainly have found answers to some of the previously untreatable conditions.
Nevertheless, newer future developments overcoming the shortcomings of the existing ones
would certainly be welcome.
Dr Gaurav Dhanduke,
Director,
Contact : 08856860463

CHEMICAL PEELING
Chemical peel procedure steps
Chemical solutions are carefully applied to patients skin to improve the texture by removing
damaged outer layers.
The formula used should be adjusted to meet patients particular needs.
There are three types of chemical peels:
Light chemical peel - Subtle improvements at first, but that healthy glow will increase with more
treatments
Medium chemical peel - Patients skin will be noticeably smoother and fresher-looking
Deep chemical peel - Results are dramatic, but recovery takes the longest
Light chemical peel

A light chemical peel might be the right choice if patient have uneven pigmentation, dryness,
acne or fine wrinkling.
This kind of peel removes just the outer layer of skin (epidermis) in a light exfoliation and can
result in a healthier glow.
Common agents used in light peels may include combinations of alphahydroxy acids and beta
hydroxy acids, such as glycolic acid, lactic acid, salicylic acid and maleic acid. All of these
chemicals are the milder choices than those used for deeper peels. You can repeat these
treatments at regular intervals to achieve patients desired results.
Light chemical peel procedure steps
Cleanse Patients face.
The chemical solution is brushed onto patients skin and left on for a few minutes. Patient may
feel some mild stinging.
The chemical peel is then washed off and neutralized.
Light chemical peel risks and recovery

Although these chemicals won't bleach patients skin, patient may see some color changes.
Patient're advised to avoid the sun and to use sunblock for several months to protect that fresh
new layer of skin.
Other medium chemical peel risks include:
Hyperpigmentation (when too much pigment occurs, causing brown blotches) may result even
if patient use sunscreen.
Permanent scarring is another infrequent risk.
Redness, which occurs in everyone after the peel, may last longer than a few months for some
people.
Deep chemical peel

If patient have deeper facial wrinkles, skin that's damaged by the sun, scars, areas that appear
blotchy or even pre-cancerous growths, deep facial chemical peels might be the right choice for
patient. You need to carefully determine if patient is a good candidate for this treatment.
Here you will use the strongest chemical called phenol to penetrate down to the lower dermal
layer of patients skin. For this type of peel, patient may need a local anesthetic and a sedative
to manage any discomfort.
A deep chemical peel usually involves some sort of pretreatment for up to eight weeks. This will
prepare patients skin for the peel and speed the healing process.
Pretreatment may include use of a retinoic acid cream or gel – a prescription medication that's
derived from vitamin A. This works to thin out the skin's surface layer, allowing the chemical
solution to penetrate more evenly and deeply.
Deep chemical peel procedure steps
Patient will be given a sedative to relax along with a local anesthetic to numb patients face.
Patients face will go through a stepwise cleansing process.
Phenol is brushed onto the area after an appropriate time interval.
The chemical is neutralized with water.
A thick coat of ointment is smoothed over patients skin, to prevent dryness and pain. The
ointment must stay in place. Sometimes you can cover patients skin with strips of tape or
medicated gauze rather than ointment.

Chemical Peels
A chemical peel is a technique used to improve the appearance of the skin on the face, neck or
hands. A chemical solution is applied to the skin that causes it to exfoliate and eventually peel
off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new
skin is also temporarily more sensitive to the sun. There are three basic types of chemical peels:
Superficial or lunchtime peel: Alpha-hydroxy acid or another mild acid is used to penetrate
only the outer layer of skin to gently exfoliate it. The treatment is used to improve the
appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest
or hands.
Medium peel: Glycolic or trichloroacetic acid is applied to penetrate the out and middle layers
of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and
wrinkles, freckles and moderate skin discoloration. It also can be used to smooth rough skin and
treat some precancerous skin growths, i.e. actinic keratosis.
Deep peel: Tricholoracetic acid or phenol is applied to deeply penetrate the middle layer of
skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles
and shallow scars. Patients will see a dramatic improvement in skin appearance. The procedure
is used on the face and only can be performed once.
INDICATIONS
Chemical peels are used to treat a number of conditions including:
Acne scars, Aging skin, Crow's feet, Hyperpigmentation, Melasma, Scars, Sun damaged skin,
Sagging skin, Wrinkles
CONTRA INDICATIONS
Generally light-haired and fair skinned people are the best candidates for chemical peel. The
procedure does not work as well on dark-skinned patients. The procedure is not recommended
for individuals with infections, active skin disease, cut or broken skin, sunburns or active Herpes
simplex 1 sores. Other counter-indications include patients who are:
Nursing or pregnant., Have taken Accutane in last six months.
Have psoriasis, eczema, dermatitis or rosacea.
Have used Retin-A, Renova, prescription skin care products, products that contain ascorbic acid,
bleaching or skin-lightening agents or other acid-based products in the last 48 hours.
Sun exposure and smoking after a chemical peel must be avoided because they can cause
unwanted side effects, including infection and scarring.
DR GAURAV DHANDUKE
DIRECTOR,
AYUAESTHETICS PVT LTD
CONTACT : 08856860463
E MAIL : ayuaesthetics@gmail.com

Type of current Description

Galvanic Constant and direct (DC) – has no break in the flow of electrons
Used for:
• iontophoresis
• desincrustation
• epilation
Faradic Surged and interrupted –: alternating and low frequency. The current and wave formations
exercise can be adjusted on the machine to suit the client’s needs.
Used for:
• muscle toning
• passive
High frequency Oscillating, high in frequency, : higher in voltage with lower amps.
Alternates rapidly at more than 50 times per second. Can be applied directly or indirectly to the body.
Used for
• direct application
• indirect application
Microcurrent Modified direct currents (DC) – a galvanic current which can be altered on the machine for
the client’s needs and differing stages of treatment
Used for:
• uplifting facial contours
• uplifting body contours
Types of electrical facial treatments
Infrared lamp
An infrared light bulb is fixed into a fitting with a swivel arm on a stand, making it easy to place the lamp
into a suitable position.
• Used to create extra blood flow, which generates heat for the skin and underlying tissue. Muscle fibres
will soften and it can be used effectively on any part of the body. But can only treat small areas at a
time, due to the limited arc of light from the lamp. Can be used on the face, chest or upper back – time
the treatment, as if an erythema occurs too strongly, it may contra-indicate other treatments.
• Can also be used on the face with a hot oil mask.

• Desincrustation – removes the incrustation, i.e. the excess sebum, and gives a deep cleansing to the
skin.
• Iontophoresis – introduces beneficial substances into the skin, to rebalance and rehydrate the skin, or
to get active substances to stimulate the body’s systems, which aids lymphatic drainage.
Most skin types, except where contra indications present. Desincrustation – for oily skins or skins in
need of a deep cleanse; iontophoresis – for a dry skin or to rebalance the skin or just to improve the skin
texture.
Microcurrent
A modified direct, low-frequency current which is used on its own for lifting of the facial contours and in
conjunction with a galvanic current for skin improvement. Can help with fine line reduction, stretch
mark minimising and scar reduction, and deep cleansing.
Most skin types, except where contra-indications are present.
Faradic
Using a surged and interrupted current, a faradic machine can stimulate muscular contractions on both
the face and body. It is often referred to as passive exercise, and you can actually see the muscles
contracting under the pads, with no effort on behalf of the client – the client is lying still on the couch.
The pads for the face are smaller than those used in body work, so it is possible to target specific muscle
groups for improvement in tone and suppleness. Treatment is ideal for double chins, dropped jaw line
and cheekbone definition.
Most skin types, except where contra-indications are present.
Dr Gaurav Dhanduke
Director
Contact : 08856860463

HIGH FREQUENCY
The Benefits Of High Frequency Skin Care Treatment
High frequency facial treatment is a safe and gentle alternative to dramatic plastic surgery
procedures, laser resurfacing, chemical peels, Collagen and Botox injections and other invasive
treatments.
When applying high frequency for anti-aging purposes, results can vary by individual
and skin type, are gradual, and do not occur overnight. Although high frequency has been
shown to produce an immediate and temporary lifting effect, continued daily application can
provide more cumulative long-term, lasting results. Interestingly, many acne sufferers have
found improvements in their complexions after only a few days of use.
Acne: Sometimes the body can become immune to certain acne medications if used
over an extended period of time. When combined with an effective acne treatment lotion,
regular application of high frequency keeps the acne away long after other expensive
medications and treatments can fail. High frequency gently cleanses the skin of acne-causing
bacteria and unwanted toxins while making the skin more receptive to acne lotions, creams and
other skin treatment products. The results can be extremely dramatic - even after only a few
treatments!
Enlarged Pores: With regular use, high frequency skin care treatment can be very
effective at reducing the size of enlarged pores, softening skin and controlling excess sebum
production. The gentle spray of oxygen molecules produced by the high frequency current
diminish enlarged pores by penetrating deep down into the root of the affected area and
cleaning out unwanted debris and toxins allowing the pore to quickly regain its natural size
once again.
Fine Lines, Wrinkles, and Sagging Skin: The oscillating action of high frequency can
increase blood circulation, which in turn nourishes the skin's surface and renews underlying
cells. It also produces an enriched form of oxygen, which can provide the skin with a firm,
youthful, vibrant glow. It can diminish the appearance of fine lines and wrinkles, tighten double
chins and jowls and improve overall skin texture and tone by promoting increased collagen
production.
Puffy Eyes: The pulsating "oxygenation" action produced by high frequency current aids
in lymphatic drainage and disperses excess fluid while increasing blood circulation. The result is
a reduction in the appearance of congested, tired, puffy eyes. High frequency also helps the
skin more efficiently absorb skin care products thereby extending their effectiveness.

EMS slimming treatment

Electrotherapy for Weight Loss
For years, physical therapists, chiropractors and sports injury specialists have been performing
electrotherapy using electrical muscle stimulation, or EMS, machines to treat neuromuscular
issues. Now you can find the device in health spas as a treatment for fat loss and body
contouring. Spa treatments using EMS, may be packaged as "Slimming Machine" sessions,
which promise to rid your body of cellulite, puffiness and toxins, as well as help you lose weight
and inches.
FEATURES
The EMS device is a lightweight, portable machine designed to deliver electrical signals through
adhesive electrode pads that are placed over specific areas of the body. The electrical impulses
stimulate the nerves and cause the muscles to contract. The device is computerized with
different programs that deliver varying strengths of stimulation. The number of electrodes vary
with manufacturers, but your body will have anywhere from 16 to 24 pads placed over strategic
areas—like hips and thighs—at one time.
TREATMENTS
Like other health spa treatments, electrotherapy takes place in a comfortable, quiet
environment while you relax on a massage table. Before your first treatment, you may undergo
a total body assessment that includes weighing, measuring and body fat analysis in order to
track your progress. A single session lasts anywhere from 45 to 60 minutes. In order to get the
results you want, spas may recommend two to three sessions a week for up to sixweeks.
According to SlimmingMachine.com, the treatment is safe, noninvasive and pain-free.
HOW IT WORKS
According to manufacturers of body contouring electrotherapy machines, the stimulation of the
muscle by the electrical current creates a significant energy demand on the muscles so
surrounding fat cells are burned for energy. They also claim that the stimulation agitates the fat
cells causing release of toxins and reduction of cellulite. In addition, the deep muscle
stimulation may help tighten and tone the skin and improve circulation.
EXPERT ADVICE

*For optimal and long term results we recommend a complete series of 10 sessions (2-3 sessions/week)
and a sensible eating plan.
EMS treatments can be used alone or alongside an exercise program
Infratherapy & Diathermy
Both of these therapies use radiant heat to stimulate the body. They promote perspiration, while
increasing the heart rate and circulation of the blood & lymphatic system. These technologies are used
to treat stress, chronic pain, repair damaged tissues, eliminate toxins, minimize fat cells and create
calorie loss. The therapeutic heat promotes deep relaxation, boosts the immune system and restores
restful sleep.
EMS, IFC AND TENS

EMS, Electronic Muscle Stimulation: Also known as Neuromuscular Stimulation Therapy, (NMS or
NMES, Neuromuscular Electronic Stimulation), this type of stimulation is characterized by a low
volt stimulation of motor nerves to cause a muscle contraction. Functional Electrical
Stimulation (FES) is a type of EMS, and helps to create movement in muscles for people with
neuromuscular disorders. Contraction and relaxation of muscles has been found to effectively
treat a variety of vascular and musculoskeletal conditions. EMS has the potential to strengthen
healthy muscle and rehabilitate damaged muscle fibres. It is a top choice for athletes.
EMS differs from TENS in that it is designed to stimulate muscle motor nerves for movement
and strengthening, while TENS is designed to stimulate sensory nerve endings to help decrease
pain.
Common uses: Prevent or delay disuse atrophy, strengthening programs, re-educate muscles,
post Op orthopaedic surgery, joint replacement, gait training, shoulder subluxation and
reduction of muscle spasms.
IFC, Interferential Current Stimulation: This type of stimulation is characterised by alternating two
medium frequency electrical pulses, with paired electrodes, that work together to penetrate deep
muscle fibres. These frequencies block pain signals at the spinal cord. IFC Stimulation helps to reduce
swelling and increase blood flow to the area to naturally promote healing and repair.
Interferential Current Stimulation is different from TENS because it allows a deeper penetration of the
tissue, with more comfort and increased circulation.

Ultrasound Rf cavitation
The procedure starts with circumference measurement of the target body area, applies the
ultrasonic device directly to specific areas of the skin after a gel is applied, continues with
circular movements of the applicator over the treatment site, for a Combo session a Radio
Frequency hand piece is used which is slowly rotated over the targeted area, transmitting radio
waves to the skin heating it 40 to 50 degrees Celsius without burning the skin surface. The heat
causes contraction of the collagen fibers to immediately tighten the skin. Then finalized with
another circumference measurement. The duration of treatment session normally takes around
15-20 minutes each depending on the size of the area and the thickness of the fat layer Results
can sometimes be noticed after the first treatment with more improvement noticed within a
few days. 6 - 10 sessions at 3 days intervals are recommended in order to achieve an ideal
result, but further treatments may be needed to attain your desired figure.
Most people feel the treatment is painless and comfortable. Some people may feel slight
discomfort due to the specific noise spreading inside the body, but causes no, harm and
disappears as soon as the applicator is moved away from body. You may also experience
warmth during the treatment. If on the slim chance it gets too warm you can request,
immediately some extra ultrasound gel to be applied.
INDICATIONS :
Fat & Cellulite reduction
Skin tightening and fat melting (combined with Radio Frequency)
Body Sculpting
RF is a effective way to improve skin tightness and elasticity, reduce wrinkles and cellulite,
boosting the overall condition on areas of the body such as the face, chin, upper arm,
abdomen, thighs, bra line or buttocks.
People who are generally healthy are safe to have the treatment
CONTRAINDICATINS :
People with cardiac and vascular diseases, diabetes, acute illness, comprised liver function,
severe bleeding tendencies, pacemaker carriers and women who are pregnant or
breastfeeding should avoid undergoing the procedure.
PATIENT COUNSELING Ultrasound Cavitation & RF

PRE AND POST PROCEDURE CARE

Try to avoid doing anything that will irritate your skin immediately before treatment. This
includes tanning (natural or artificial). It would be more likely to suffer pain from the addition of
heat to the already damaged skin; however an established tan would be fine.
Do not have hot shower , bath or sauna right after the Ultrasound treatment
Recommend a low calorie diet with protein in each meal and drink at least a glass of warm
water (not carbonated, sparkling water, pop, coffee) before and after the session. Drinking
plenty of water and having exercise such as brisk walk, biking or other aerobic activities for at
least 3 days after the treatment to stimulate the lymphatic activity as elimination of the fat
continues through the Lymphatic System for 72hrs. Follow by a suitable exercise routine.
Cavitation will be best performed under high hydration conditions, avoid taking any caffeine or
diuretics 2 days before therapy. Drink a lot of water will help to improve your metabolism and
increase urine output -- lipid metabolites release out of your body.
A lymph-draining massage is also encouraged to improve the circulation and lymphatic system,
which helps to drain fluids.
For best results refrain from any alcohol consumption for 48 hours after the treatment. Alcohol
consumption during this period may prevent your liver from removing the deactivated fat cells
from your body (as the liver will assign priority to removing the alcohol from your blood).
Maintain an un-stressful life style also helps the body flush out the fat more efficiently.
TREATMENT SESSSIONS
Ultrasound Cavitation: 6-10 sessions spaced 3 days apart for the first 3 sessions, then once a
week.
Skin Tightening: 6-10 sessions spaced 3 days apart for the first 3 sessions, then once a week.
After the initial treatments are completed, maintenance treatments consist of one session each
month for 4 months followed by one treatment every 4 months.
Dr Gaurav Dhanduke
Contact : 08856860463
E MAIL : ayuaesthetics@gmail.com

INDICATIONS
PDO THREADS:
 Forehead (Brow Lifting)
 Jawline
 Upper and lower cheeks
 Neck
 Naso-labial folds (Mouth to nose)
 Marionette lines (Sagging mouth)
FACIAL CONTOURING
PDO Threads can very effectively strengthen the contour of the face, reduce roundness, lift
sagging skin in the cheeks, jowls, neck and also produce an excellent eye brow lift.
SKIN REJUVENATION
 Enhances skin tone, tightening pores.
 Ideal to combine with microneedling, PRP, laser, chemical peel
 100% bio-compatible, no scarring and minimal risk
 Collagen induction + tightened and lifted skin
PROCEDURE
Local anaesthetic is injected into the treatment area. The PDO Thread will then be introduced
using a cannula or micro-needle in the required area. The procedure takes around 45-60
minutes, depending on what treatment you will require. You will normally be able to fully
resume your everyday routine and social commitments within a couple of days. When you
combine PDO Therapy with PRP, Fillers and Botox great results can be achieved.
CASE SELECTION
The best candidates are men and women who are beginning to experience the appearance of
wrinkles on the forehead, drooping of the brow, sagging of the mid and lower face, visible jowls
and loose skin on the neck.
For the face, these would be lifting of the eye brows, naso‐labial folds, marionette lines, cheeks,
jaw line and double chins.
PDO Threads
These threads are 100% Polydioxanone which is a clinically proven bio‐compatible and bio‐
absorbable material that is already widely used medical suturing.
COMBINATION WITH OTHER PROCEDURES

PDO Threads Therapy can be used alone or can be combined with other treatments to deliver
optimal results e.g.: Fillers, Anti‐wrinkle injections, Sculptra, PRP, Micro‐needling, Peels,
Radiofrequency and Fractional Laser Treatments



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2017 CERTIFICATE IN AESTHETIC MEDICINE

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

➡ EMS for face

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

You need to examine following points in patient:

NVQ 3 BEAUTY THERAPY: Facial treatments – theory and consultation

Manual examination of the face

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

Cosmetology broadly divided into

Approach towards cosmetological patients:

Skin types vary depending upon factors such as:

Normal Skin Type:

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

Sensitive Skin Type:

Cosmeceuticals are divided into categories based on their active ingredient

Some Common Types of Cosmeceutical Ingredients

 Alpha Hydroxy Acids  Moisturizers

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

 the concentration of L-ascorbic acid is too low.

Niacinamide (Vitamin B3)

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

SUGGESTED FREQUENCY OF TREATMENT: 1 x week for 6 treatments. 1 x month for maintenance.

STEP 1CLEANSE & ANALYSE

Choose a low level of suction to start with

STEP 3 DIAMOND REMOVAL & EXTRACTIONS

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

1. Active acne, herpes labialis.

PATHOPHYSIOLOGY OF COLLAGEN INDUCTION THERAPY

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

Vitamin C is essential for production of normal collagen.

SIDE EFFECTS OR RISK FACTORS

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

What Dermapen Treats

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

General Mesotherapy Applications

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

Matrix metaloproteinas proteins (MMP) are involved in aging process by degradation of

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

There are various uses of PRP in aesthetic medicine:

Advantages of PRP Rejuvenation

• Uses bodys own natural platelets so there is no risk of allergic reaction

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

This is a constant and is equal to 186000 miles per second.

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

Thermal relaxation time:

PROPERTIES OF LASER LIGHT

MODES OF ACTION OF LASER LIGHT

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

HUMAN SKIN AND LASER INTERACTION

Transmission: The laser light is transmitted through tissues to their target.

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

EFFECT OF LASER LIGHT ON THE SKIN LESIONS

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

Q-SWITCHED RUBY LASER

NEODYMIUM :YAG LASER

AYUAESTHETICS PVT LTD, TALEGAON DABHADE, PUNE 410506

1. The operating room

Windows : must be covered with materials of sufficient optical density.

Instruments used should be of special type not reflecting laser light.

Water basin should be available.

2. Safety measures for the patient: