Different Photoelectric Treat Measures’ Skin Barrier Repair

Human skin is the most direct contact with the external organs for the human immune system’s first physiological barrier.To some extent, it can prevent external adverse factors (physical, chemical, biological, etc.) from entering the body and causing damage to the body, and at the same time, it can avoid the loss of water and lipids in human epidermis and dermis, so as to maintain the stability of its skin barrier function.

Photoelectricity is produced by the action of light, based on optoelectronics, the comprehensive use of optics, precision machinery, electronics and computer technology to solve various engineering applications of the technical subject.The main applications in the field of optoelectronics focus on precision detection and optical imaging.The photoelectric industry has been developing rapidly in recent years, and the application of laser in the field of dermatology and venereal diseases has been developing towards the direction of more precise instrument and wider application space.Under the irradiation of light, the phenomenon that causes the electron to emerge in the object is the photoelectric effect, which can be divided into external photoelectric effect and internal photoelectric effect. The human body itself is a powerful ionizer.However, intense pulsed light and various kinds of lasers act on the skin based on external photoelectric effect and internal photoelectric effect. After the skin barrier is affected by these different photoelectric technologies, the physiological parameters of skin barrier function such as cuticle moisture content, percutaneous water loss (TEWL), sebum and p H value have different changes.The damage mechanism and repair effect of photoelectric therapy on skin barrier should be further studied.

1.Intense pulsed light(IPL) of photoelectric treat measures

The intense pulsed light treatment instrument can emit wide spectrum light with a wavelength range of 500 ~ 1200nm. Selecting the wavelength range through the filter can be absorbed simultaneously by the skin’s three main color group hemoglobin, melanin and water in one treatment.As a result, the clinical improvement of pigment and erythema, increase of extracellular matrix protein synthesis and new collagen synthesis can be achieved to achieve clinically visible “facial rejuvenation” effect.Vogl et al. reported that the skin moisture content 1 month after 4 treatments was not statistically different from that before treatment, which may be caused by the thermal effect generated by the photothermal effect and slight thermal damage of the epidermis.But after 1 month, with the natural replacement and repair of the epidermis, the skin moisture content recovered and even increased.Follow-up after 1 month of treatment showed that the content of sebum was decreased, suggesting that IPL intense pulsed light treatment has therapeutic effect on patients with excessive oil secretion, while the skin care products containing oil should be used during and after treatment in patients with dry skin. Intense pulsed light therapy can increase skin moisture content and enhance skin barrier function, which may cause loss of sebum and have little effect on skin color.Goldberg et al. reported the clinical effects and ultrastructural changes of the photoaging skin after combined irradiation with 633nm and 830nm LED. The results showed that the wrinkles were improved significantly after biopsy in 5 subjects.Russell et al. performed 633nm and 830nm LED irradiation on 31 patients with facial wrinkles using Omnilux LED system, and significantly improved the wrinkles in the photoaging area after 9 times of treatment.In a clinical study, 93 patients with photoaging were treated with 590nm LED, and the results showed that 90% of the patients had improved symptoms of photoaging.In most patients, periorbital wrinkles, overall skin texture and skin flushing, pigment spots, etc. were significantly improved.Various studies have shown that intense pulsed light with the light of heat and penetration to promote metabolism, accelerate blood circulation, beautify skin, make skin more smooth effect is significant, but due to the sensitive state of patients, operating personnel’s technical level, treatment parameter setting, the influence of such factors as temporary erythema, edema, inevitably some adverse reactions, such as through a simple cold, cold compresses and repair facial mask is used can be quick fixes.Of course, before treatment, it is urgent to improve the degree of skin barrier damage, strengthen the training of technicians and rationally select treatment parameters.

2.Erbium laser(Er-YAG) of photoelectric treat measures

Han et al. observed that the cuticle of erbium laser treatment had high water content, and the cuticle became scarring after 1 week, and the cuticle was thickened and low water content.As the wound recuperates, the water content rises back to normal.However, after irradiation by the YAG laser, the water content was only 1.2% higher than that of the non-laser irradiation group, and there was no significant difference after 1 week.Subsequently, the water content began to rise and was higher than that of the non-laser irradiation group. Therefore, laser skin rejuvenation can improve the barrier effect of skin.TEWL mainly includes perspiration and water evaporation, and is mainly related to the functional state of the cuticle.Immediately after the erbium laser irradiation, the percutaneous water loss increased significantly, while the TEWL increased by 159/m2·h after the irradiation with the long pulse width of 1064nm Nd: YAG laser, which may be related to the changes in horny layer edema and function caused by laser irradiation.After that, TEWL gradually decreased and was finally lower than the control area, and the TEWL in the long pulse width of 1064nm Nd:YAG irradiation area reached the normal value earlier than the erbium laser irradiation area. It can be seen that the influence of erbium laser irradiation on the skin barrier lasts longer, recovers slowly, and the influence is also greater.The skin barrier function was better in the YAG laser irradiation group.

Brightman et al. found that the amount of dermal hydroxyproline in the baited laser and the long pulse width of 1064nmNd: the YAG laser irradiated region was much higher than in the respective control group, suggesting that both laser treatments strongly stimulate the synthesis of new collagen.Erbium laser is effective in promoting collagen by 1064nm Nd:YAG laser.The thickness of the dermis changes with age. Before the age of 20, the thickness of the dermis gradually thickens. After the age of 20, the dermis gradually shrinks.Both erbium laser and long pulse width of 1064nm Nd:YAG laser can safely and effectively improve skin elasticity, dermal thickness, collagen content and skin barrier function.Erbium laser produces more collagen, increases more in elasticity, and increases more in dermal thickness, but the 1064nm Nd:YAG long pulse-width laser increases the water content more, and the improvement degree of water loss in the epidermis of the two lasers is similar.

3.Lattice laserof photoelectric treat measures

As a result of the remarkable curative effect, and at the same time with the advantages of light, rapid recovery of laser adverse reactions, such as the need for treatment methods, lattice laser came into being. The raster laser splits the tissue apart by forming a columnar micro-injury zone, making the skin at a specific depth uniformly heated, producing collagen during the repair process, regenerating the epidermis, increasing the thickness and elasticity of the skin.Due to normal skin surrounding the micro-injury area, the repair process is rapid and efficient, and the incidence of adverse reactions is significantly reduced. At present, dot-matrix laser has gradually become the gold standard for treatment of acne scars.The CO2 dot-matrix laser not only retains the advantages of CO2 laser penetration depth and high efficiency, but also greatly shortens the recovery time and minimizes the occurrence of adverse reactions such as pigmentation. Lene et al. Application of the lattice CO2 laser for patients with depression in 13 cases of acne scar control study, randomly select a side face with CO lattice laser therapy (12 ~ 14 w, 48 ~ 56 mj/energy per pulse, the density of 13%), by contrast, on the other side of the face is not treated interval in January, a total of three treatment, respectively, in the treatment of 1,3,6 months follow-up.The results showed that the sag scar was improved, and the effect was better with the increase of treatment times, and no obvious adverse reactions occurred.At the same time, they proposed that CO2 dot-matrix laser treatment with higher energy, the effect is significant, but the adverse reactions may be obvious. Lattice 2940nm Er: YAG has a relatively shallow gasification depth compared with CO2 lattice laser, but it has a more accurate grinding effect and has less damage to surrounding tissues.The healing time is shortened and adverse reactions such as pigmentation are alleviated through the lattice model.Sindy on 34 cases of skin type is Ⅲ ~ type Ⅳ pitting scar after acne patients using lattice 2 940 nmer: YAG laser treatment, follow-up of 3 months, about 75.0% of patients considered significant improvement of scar, patient satisfaction is high, short downtime, low incidence of pigmentation after inflammation (3.0%).Rein-holz et al. conducted self-controlled study on 14 patients, and the results showed that both sides of the dot-matrix 2940nm Er: YAG laser treatment and side of the CO2 dot-matrix laser treatment were improved, and the effect of CO2 dot-matrix laser on improving skin texture and scar was more obvious than that of 2940nm Er: YAG laser, and the effect of scar was more obvious than that of 2940nm Er: YAG laser.With a wavelength of 2790nm, YSGG is a new kind of dot-matrix laser. The absorption of water to this laser is between the baited laser and the CO2 laser. Therefore, this laser has both significant efficacy of CO2 laser and mild adverse reactions similar to the baited laser.Compared with baited laser and CO2 laser, bleeding and pigmentation are not easy to occur after treatment.Through the study, Kimura et al. found that: YSGG laser treatment of acne sag scar on the face after 1 time was improved to a certain extent, and skin elasticity increased by at least 30% after 1 month of treatment, suggesting that Er: YSGG laser treatment has a certain effect on acne scar.At the same time, they found that epidermal moisture was significantly lost on the third day after treatment, and skin hydration was significantly reduced. After one week, the hydration was restored to normal, and after four weeks, epidermal moisture reached normal level. Therefore, Er: YSGG laser treatment was performed at least 1 month interval, so that the skin had enough time to restore its normal barrier function.

4.Q-switched laserof photoelectric treat measures

595 nm tuning QNd: YAG laser tender skin is not damage by inflammation, launched the tissue repair mechanisms, macrophages, neutrophils, and T lymphocyte transforming growth factor – beta (TGF – beta), epidermal cell growth factor (EGF) and platelet derived factor (PDGF) and other cytokines, these cytokine and receptors on the surface of the fibroblasts, biological signals, stimulate fibroblast cells mitosis, proliferation and migration, and promote Ⅰ and Ⅲ collagen gene expression.Amot et al. demonstrated that the activity of JNK and p38 kinase was improved in the aging skin, while that of ERP kinase was decreased.The high activity of JNK kinase can increase the expression of c-jun, thus leading to the activation of ap-1 protein, leading to increased expression of matrix metalloproteinase (MMPs) and the inhibition of precollagen expression. The result of their combined action is reduced collagen and increased wrinkles.In some cell types, JNK and p38 kinases induce apoptosis, while ERP kinases inhibit apoptosis.In addition, heat shock protein (HSP) is also thought to be involved in regulating collagen synthesis, increasing the gene expression of procollagen I, but the exact mechanism is unclear.Hsp47 can effectively regulate Ⅰ type collagen synthesis.Hsp70 has been induced by near-infrared light in animal experiments, and is involved in the synthesis regulation of dermal structures, promoting wound healing and collagen regeneration.

Pulsed dye laser of 595 nm and 1064 nm of Q Nd: YAG laser and 1320 nm Nd: YAG laser to visible light and infrared light, it belongs to the physical pressure and ultraviolet light, but the effect on the contrary, so they may not damage the delicate skin by stimulating the ERP kinase activity increases, the JNK and p38 lightning kinase activity, inhibit the expression of MMP, increase Ⅰ, the expression of collagen type Ⅲ before, achieve the goal of collagen protein synthesis and reshaping.

5.Superpulse laserof photoelectric treat measures

The ultrashort pulsed laser is mainly characterized by plasma-induced erosion, which is caused by the action of the plasma’s own ions.Because the process is so fast, there is little energy transferred to the surrounding tissues, and thus little heat damage to the surrounding tissues.When Wanner et al. studied the Q switching ruby laser for treatment of secondary pigments, they found that melanosis was visible near the hair follicle 1 week after irradiation, and the pigment cells were redistributed around the basal layer cells and spinous cells 5 weeks after irradiation.But the increased pigment after inflammation is considered transient, and the pigment fades two months after laser treatment.

6.Epilogueof photoelectric treat measures

With the development of medical photoelectric technology, photoelectric technology has been widely used in the field of medicine. Many refractory skin diseases have been well treated, but the skin barrier function is also damaged in different degrees during the treatment.The effects of photoelectric therapy on skin barrier function and repair are affected by the skin condition of the patient before treatment, the parameters of photoelectric therapy and the application of postoperative repair products.Therefore, the skin barrier function can be repaired faster and better by timely and objective assessment of skin barrier function, selection of reasonable treatment parameters and correct use of repair products.

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