Issue link: https://www.ascpskindeepdigital.com/i/1278890
52 ascp skin deep september/october 2020 Cost Cordless handheld units begin at the $500 range, with tabletop units beginning at $2,500 and trolley- mounted versions costing $5,000 and up. HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) If you do an internet search for "HIFU" you are likely to find references to the use of the treatment for tumors and diseases including prostate cancer.4 While relatively new as an esthetic treatment, HIFU is a treatment that has a body of peer-reviewed research to support its effectiveness.5 HIFU technology uses intense ultrasound energy to target skin layers below the epidermis. Rapid heating of the tissue causes cellular damage, which then triggers the production of collagen. It is being promoted as an alternative to a surgical facelift.6 Helen Rapoza, owner of Helen's Haven Integrative Medical Spa in Honolulu, Hawaii, has added HIFU to the menu after research and trial treatments. Recording before and after photographs over a series of three sessions, she reports, "While improvements were only minimally noticeable after the first treatment, the complete sequence produced significant skin improvement, especially in tightening the jaw area."7 We will have to wait and see whether this treatment can indeed replace facelifts.8 What to Ask 1. Does my state consider this an esthetic or a medical treatment? 2. What FDA classification is the device? 3. What is the cost of replacement parts? 4. How many treatments will the device provide? Cost The marketplace offers units for esthetic use in the $1,500–$2,000 range, making this advanced technology affordable. Replacement tips run $250–$300. FIBROBLAST PLASMA THERAPY/PLASMA PEN In the last year, the number of vendors offering fibroblast devices and training programs has exploded in the skin care market. Hailed as a revolutionary skin-tightening treatment, the pen-like device delivers a tiny arc of plasma via an electrical charge.9 The device singes the skin, causing small burns or holes that scab and then drop off. The theory is that the device triggers skin tightening by activating fibroblast production. Fibroblast plasma therapy has caused a great deal of discussion regarding scope of practice. 10 California specifically prohibits estheticians from using any device that causes scabbing, but other states are not as clear. 11 This gray area of regulatory clarity has caused much confusion for providers and consumers. As of today, only one device carries FDA classification and approval despite numerous vendors declaring that they are FDA registered. 12 It is important to note that the device registered with the FDA is a Class II device that requires purchase by a physician. If you really want to scare yourself regarding what this device does, watch Kim Pratt's YouTube video "Fibroblast Plasma Pen Treatment: I Did it Myself . . . Should You?" and then evaluate whether this is a device you would be comfortable using on your clients. 13 What to Ask 1. What level of medical practitioner can perform or delegate this treatment? 2. What special precautions for wound control and blood-borne pathogens are required? 3. Is this treatment covered under my (or my medical director's) liability insurance? Cost Plasma pen devices can be easily purchased for under $1,000, with additional batteries costing approximately $400 and needles as little as $20 for a three-pack. This low entry price has undoubtedly fueled the introduction of the treatment into the skin care arena. CAUTIONS AND CONCERNS Some of the latest devices and tools available for your skin care practice can be both effective and affordable. Before you are wooed into making a purchase, though, be sure to investigate whether both the device and treatment are covered by your liability insurance. You'll also want to identify any limitations on either purchasing or using the device by your state's scope-of-practice guidelines. In some states, merely owning a device that is considered out of scope can result in a fine. Notes 1. Chloe Metzger, "7 Best LED Masks for Acne, Wrinkles, Redness, and Really Good Skin," Cosmopolitan, December 2, 2019, accessed August 2020, www.cosmopolitan.com/ style-beauty/beauty/g29964112/best-led-masks. 2. Ana Gotter, "What You Should Know About Carboxy Therapy," Healthline, reviewed September 18, 2018, accessed August 2020, www.healthline.com/health/carboxytherapy. 3. Hana Zelenkova, "Carboxytherapy—A Non-Invasive Method in Aesthetic Medicine and Dermatology, and the Combined Usage of Carboxytherapy and PRP in the Periorbital Area," Global Dermatology 4 (January 2017), https://doi.org/10.15761/GOD.1000202.