25. Treatment of a superficial skin angioma of the face with Electroporo Cosmesis
KEYWORDS: Peeling, mixed peeling, physico-chemical peeling, resorcin, microporing, de-epithelialization, epidermial permeabilization
Since she was born, this patient has had a superficial skin angioma in the zygomatic and malar regions and on the right side of the nose. The area is also slightly pigmented. Although superficial, the angioma requires the patient to correct her complexion daily with masking creams.
Electroporo Cosmesis is one of the standardized techniques of Timedsurgery.
The Timed apparatus (Capurro, Patent USA) is set to the specific pulsed current: Direct Pulsed, 0.3/5.3 hundredths of a second, Coag, 38 Watt. A rotating electrode is fitted.
Electroporo Cosmesis is one of the three mixed peeling techniques of Timedsurgery. We have called these peeling techniques "mixed" because the physical phase, which provides access to the dermis, is followed by a chemical phase. In the chemical phase, we apply resorcin. If applied in an aqueous solution to intact skin, this compound has no effect; it only exerts its effect on skin that has been micropored, permeabilized or de-epithelialized by means of the specific pulsed currents of the Timed apparatus.
Electroporo Cosmesis utilizes our patented rotating electrodes.
When the rotating electrodes brush the skin, they reduce the horny layer and create invisible micropores in the epidermis. Through these micropores, the resorcin solution reaches the dermis.
In 0.5 mixed peeling, the physical phase permeabilizes the epidermis to a greater degree. The 1.5 mm diameter EM15 electromaniple is used.
In the third mixed peeling technique, the skin is de-epithelialized with the edge of the angle of the 0.2 mm diameter EM 10 Yellow electromaniple. The electromaniples are also covered by one of our patents.
These three mixed peeling techniques use three different sets of program data and exert three different actions.
This patient's congenital superficial angioma is similar to lateral erythrosis of the neck, in which hyperpigmentation and ectatic vessels coexist. The treatment is identical.
Resorcin is the chemical compound most frequently used in mixed peeling. It is able to firm up the skin, eliminate wrinkles, and reduce or eliminate the hyperpigmentations and superficial dilated vessels with which it comes into contact. Resorcin can also be used to de-pigment the skin.
The resorcin is normally dissolved in water. However, in the treatment of superficial angiomas, it is dissolved in 3% hydrogen peroxide, in order to increase its efficacy.
The saturated solution of resorcin is applied with the glove until a uniform frost forms. It must be applied continuously; if it dries, it will no longer be able to penetrate to the dermis.
Once a uniform frost has formed, the resorcin is washed off with physiological solution.
In all these mixed peeling procedures, no products must be applied to the area treated.
After 10-15 days, the skin exfoliates.
The resorcin has eliminated the ectatic vessels and the hyperpigmentation of the superficial angioma. In the area where the angioma was, the skin now looks the same as that of the surrounding area. The patient will no longer have to use masking creams.
Capurro S. (2022): Treatment of a superficial skin angioma of the face with Electroporo Cosmesis. Timedsurgery section. https://www.crpub.org
Does this saturated solution of resorcin also act on the vessels?
Yes. We often use it in areas of permanently reddened skin, where no vessels are visible.
What are the advantages of these mixed peeling techniques?
They enable us to use resorcin. This substance has no effect on intact skin, but acts efficaciously if the epidermis has been micropored, permeabilized or de-epithelialized. The physical action of the specific currents, followed by the application of resorcin solution, is the most versatile, efficacious and safe peeling technique available today.
If we wish to apply acids after the physical phase, they must be used at low concentrations, in order to reduce the risk of iatrogenic damage.
The three mixed peeling techniques (Electroporo Cosmesis, Epidermal Permeablization and De-epithelialisation) enable us to regulate the contact of the resorcin solution with the dermis. The times of application of the solution are also different in the different procedures. These techniques enable us to improve the skin of an 18-year-old who is going to a ball, for example, or to eliminate lip wrinkles and abdominal skin folds.
In the procedure illustrated, you dissolved the resorcin in 3% hydrogen peroxide, while in most other procedures you dissolve it in water. Why?
We dissolve the resorcin in hydrogen peroxide when we want to increase its power. By means of Electroporo Cosmesis, we create micropores in the epidermis of large areas. We treat the neck, arms and abdomen. This technique is also used on skin that is visibly reddened by micro-ectatic capillaries, as in this patient. Melasmas also lighten and disappear. To treat these extensive hyperpigmentations, the operator needs to know that Electroporo Cosmesis is inflammatory at higher powers; by contrast, the application of resorcin in water for long times is not inflammatory. It is therefore necessary to increase the time during which the rotating electrode brushes the skin at a power of 14 Watt, 20 Watt or 27 Watt, and to increase the time of application of the resorcin.
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