Aesthetic Physiotherapy - AUTOMATIC VITALTERM
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 Cutaneous
rejuvenation treatment
The ageing of the tissues is an unstoppable process of our Biology. It
is produced in a progressive way from 25 years of age and is prolonged
until our death. Physical ageing is the manifestation of a physiological
process of slowing down of cellular regeneration of the cutaneous,
bone, nervous, muscular cartilaginous tissues......
It is probably one of the most complex treatments to which the
beauty professional is confronted. The modifications affect distinct
structures and in distinct grade, with the added aggravation that
the manifestations of the alterations of the tissues are produced
in a gradual way. For this reason it is necessary to treat the zones
where the deterioration is most visible.
The type of antiageing treatment can be a preventative treatment
or a paliative treatment. To know the different fields of acting
of the currents of AUTOMATIC VITALTERM in cutaneous rejuvenation,
the physiology of the ageing is analysed, the cosmetics that must
be used and what physiological effect is given off from the action
of the combined action of the diathermic electrotherapy and of the
active principles.
The visible signs of ageing of the skin are essentially represented
by the appearance of wrinkles and folds sunk in the face and neck,
as well as other parts of the body. Joined to them other changes
are observed that can be summarized in cutaneous drying, senile
atrophy, the elastosis senile actinico (loss or degeneration of
elastic fibres of the dermis), pigmentary stains, alterations of
vascularization, tumoral formations and the alteration, loss or
degeneration of the elastic fibres of the dermis), the pigmentary
stains, the alterations of the vascularization, the tumoral formations
and the alteration of the cutaneous annexes.
As an example of formation of the wrinkles we can take the face.
In it throughout time, lines begin to appear, folds, stretch marks
or wrinkles due to the loss of muscular tone amongst other things.
These facial lines can be of three types: static or orthostatic
lines (those that are marked from birth and correspond to the natural
folds of flexion and extension- elbow, wrist, neck, etc--), the
dynamic lines of expression (those that begin to appear around the
age of 25) and the gravitatory lines (those that appear from the
age of 40).
Within the dynamic lines or the lines of expression, the muscular
tone is of vital importance. The cutaneous muscles, according to
the orientation of its fibres, establish lines of force that indicate
the direction of the cutaneous sliding. The wrinkles of expression
that stand out most are the wrinkles of the external angle of the
orbicular of the eyes, called “crows feet” (that are
accentuated when you laugh), the horizontal wrinkles of the forehead,
the vertical interciliar wrinkles that form the folds of the area
between the eyebrows, the circunmoral wrinkles (perioral, around
the mouth) or periorals and the marked lines of the “rictus”
(that are marked more when talking).
The graviatory lines are due to a real ageing of the tissues. From
the age of 40, the boney atrophy is manifested more intensely, the
loss of teeth, muscular degeneration, reduction of the adipose layer
(that is displaced and is accumulated in the low parts of the face),
the deep dehydration, esclerosis of the dermis.... the skin becomes
flabbier, loses its usual support and falls because of the action
of gravity together with the dynamic folds. These lines are more
accused together with boney prominences (orbit, cheek bone, jaw),
in the upper and lower eyelids, with formation of bags and deposits
of fat.
The AUTOMATIC VITALTERM is shown in these cases in all its splendour.
The most direct effects of gravity as are the falling of the cheekbone,
the superciliar arc and the chin on resituating the musculature
in its place again, stabilizing the muscular degeneration. The layers
of the dermis are deeply rehydrated and the lines of expression
are disimulated. The tone of the skin acqires a greater texture
and the oxygenation is visibly increased. The client can herself
check the changes developped in a short period of time of only ten
minutes.
It also incides directly on the histological and biological modifications
of the cutaneous senescence. These variations can be produced in
the slimming of the epidrmis, the flattening of the dermoepidermic
union and the alterations of the structure of the dermis, especially
of the elastic fibres and collagen.
The modifications of the epidermis are the most visible in the
process of ageing. This layer, by being in direct contact with the
environment, is seen especially exposed to external factors (sun,
cold, wind, contaminants, etc.). The most significant histological
changes are the progressive slimming of the epidermis, the reduction
of the number of melanocites, and the reduction of the number of
cells of Langherans..
The DNA system incides positively over the increase of the epidermic
renovation. As the slimming is greater in the spiny layer due to
the process of ageing, the effect of the application of the current
with a cosmetic product is felt quickly because the cutaneous desquamation
derived from the increase of the stratum corneum is stopped. The
number of the melancites decreases, for which a reduction of protection
to the sun is produced. An increase of the cohesion of the corneocites
is observed. The cellular trophic improvement also has a bearing
on the improvement of the capacity of immune response of the skin,
which improves considerably its response to exterior agressions.
These effects produce some changes in the properties of the epidermis.
In the first place, the barrier function of the epidermis is stabilized.
In spite of conserving its main function of primary protection of
the body, the permeability of the epidermis increases with the process
of ageing, for which the penetration is easier. Cellular strengthening
and cutaneous hydration normalize the normal resistance of the skin
in front of external agents.
In second place, the immunitory capacity is reforced that brings
with it a stabilization of the inflammatory response and a reduction
of the sensitivity to certain stimuli.
Thirdly, it reduces the time of scarring, since there is an acceleration
in cellular renovation. This effect is easily checked if you carefully
follow the evolution of another injury in any other zone. This observation
shows how the ageing process produces a normal slowing down in the
cellular renovation in the zone which is not treated, in front of
a rapid mitotic division and the resulting scarring of the treated
injury with current of AUTOMATIC VITALTERM.
In fourth place, the pH is liberated from the epidermis, limiting
its tendancy towards acidity and its lower resistance to the alkalis
and of the capacity to neutralize acids.
It is well-known that the cellular renovation of the epidermis
requires a control of the rhythm of proliferation of the basal cells.
This control allows you to maintain an adequate population of queratinocites
in the process of differentiation and a stratum corneum of a sufficient
quality so that it acts as an effective cutaneous barrier.
Recent investigations confirm the existence of a very precise mechanism
that allows the physiological destruction of a variable number of
queratinocites that have abandoned the proliferant stratum. In this
way the “disappearance” of queratinocites in the kinetic
epidermis is explained.
The term apoptosis, for its etimology, could be related to the
phenomenon of reduction or fall of the leaves or petals of a plant
or a flower. The apoptosis can be considered as a physiological
cellular death, with the mission of eliminating unnecessary, damaged
or harmful cells. It is differentiated, therefore, from the necrosis
in the measure in which the necrosis is a pathological cellular
death. At the level of the epidermis the queratinocites that experience
apoptosis disconnect their desmosomes with the neighbouring cells,
they fragment first their nucleus, and afterwards the whole cell,
without rupture of the lisosomes and the mitochondria. This fragmentation
gives rise to apopoptic bodies (membranous vesicles that contain
cellular fragments) that are phagocytosed the neighbouring cells
or macrophages, without producing any inflammatory reaction.
The necrosis (or pathological cellular death) cannot be included
within the denominated programmed cellular death, although it is
admitted that both the physiological death by apoptosis and death
linked to a complete differentiation (formation of desquaming corneocites),
require in an adequate programming.
The process of ageing also has a bearing on the dermoepidermic
union. This union doesn’t apparently suffer changes in its
histological structure, but with age it tends to level out. The
cohesion between the epidermis and the dermis is deficient, in a
way that the skin makes us more vulnerable to the traumas, as well
as developing a greater ease to the formation of phials. The AUTOMATIC
VITALTERM favours the cohesion between the different levels of the
skin, due to the important trophic and circulatory effect that it
generates, limiting the reactions in front of the traumatic effects.
The modifications of the dermis in the process of ageing are not
as visible as those manifested in the epidermis, but they don’t
stop being less important for this. These modifications are the
cellular alterations, the alterations of the fibres, the alterations
of the fundamental substance, the vascular and lymphatic modifications
and the alterations in the dermic nervous system.
The cellular alterations are intensified. With age, the dermic
fibres, and the proteic components of the fundamental substance
stop producing their secretions. The number of fibroplasts reduces,
producing a reduction of the mitotic capacity and the number of
mastocites (very fat cells, a type of leucocite). The response to
the inflammations is also reduced. The AUTOMATIC VITALTERM acts
positively increasing the number of fibroblasts and, as a result,
increasing the mitotic capacity, the number of mastocites and it
regulates the natural response to inflammations.
In the fibres, ageing is manifested in disorganisation of the bundles
of collagen. These bundles are slimmed, fragmented, disorientated
and with a frayed appearance. The degeneration and reduction of
the elastic fibres is produced. In the papilary dermis the fibres
are less numerous and lose their verticality. In the mid dermis
they tend to enlarge, and in the deep dermis an elastosis is produced
with increase of the density of the elastic network. The combination
of these alterations of the fibres causes a loss of the turgidity
and elasticity of the dermis. An amorphous material at the level
of the papilary dermis is originated, also denominated elastosic
material, that keeps increasing with the passage of age, eventually
occupying the whole reticular dermis.
The alterations in the fundamental substance are the reduction
of the fundamental substance in proportion to the fibrous tissue,
with alteration of their structural glucoproteins and of their proteoglycan
constituents. It is less rich in hialuronic acid and it becomes
less permeable, less hydrated and less fluid. The nutritive exchanges
reduce, since the fundamental substance loses in great part its
capacity to attract and conserve the circulating liquids, with which
a deep dehydration is produced. The AUTOMATIC VITALTERM increases
the intercellular drainage, for which the circulating liquids are
seen newly attracted towards it, intensifying the processes of cellular
respiration.
The vascular and lymphatic modifications are manifested in the
reduction of the vascularisation by rarificacion of the terminal
capillaries, with reduction of the blood flow. The functioning of
the lymphatic capillaries is tightly linked to the circulating tissues
that with age are mobilized less, slowing down the lymphatic drainage.
In this aspect, the AUTOMATIC VITALTERM restitutes the deficient
vascularization, considerably increasing the blood flow. This effect
is manifested by the important hyperaemia that is created in the
application zone. The greatest speed with which the blood circulates
increases the speed of the process of disintoxication of the lymph
and accelerates the lymphatic drainage. The increase of the process
of elimination of the toxins and the important haemolymphatic movement
that it creates over the organism is evidenced by the elimination
of liquid through the urine that is produced after the application
of the equipment.
The vascular modifications are the cause of hypothermia characteristic
of the senile age, as well as the appearance of senile purple (for
rupture of the capillaries). It is also related to the reduction
of arrival of nutritive substances, the alteration of the inflammatory
response (the necessary elements for the inflammation that procede
from the circulatory torrent arrive in less number and more slowly),
and a slow and anomalous scarring. Thanks to the improvement of
respiration and to the processes of metabolic nutrition, the oxygenation
is improved in a high percentage and the rhythm of scarring is accelerated.
This effect is the response of the organism to the electrical circuit
of high frequency to which it is submitted.
The alterations in the dermic nervous network are the increase
of the lintel of painful tactile and dermic sensitivity, manifesting
itself with a lesser perception to pain.
The process of ageing also affects other tissues, as are the adipose
tissue and the muscular tissue. The modifications that are produced
are various. At the level of the subcutaneous tissue a reduction
of the fat accumulated in the adipocites, that together with the
disorganisation of the fibres leads to an atrophy of the adipose
panicule, and the resulting “slackening” by the loss
of support of the dermic fibres. At the level of the muscular tissue
a reduction of the volume is observed with loss of tone. As a result,
the muscles that serve as support to the skin lose part of their
mass, and stop causing certain reliefs. The treatment of the facial
tissues with AUTOMATIC VITALTERM compensates these effects of ageing.
The dermic fibres are reinforced, increasing their support, and
then muscular tissue is stimulated, returning to it the place before
suffering the loss of volume and tone.
Within the alterations caused by ageing, you must pay attention
to those that are caused in the cutaneous annexes. These alterations
are:
*Greying (aproximately half of the population has grey hair at
the end of the fifth decade).
*the reduction of the quantity of hair (The scalp is predominantly
affected, since its anagen/telogen coefficient is greater than the
rest of the body hair).
*the reduction of the number of ecrine glands (approximately 15%).
Likewise the production of sweat is less in old people both at rest
and exercise. The size and number of sebaceous glands does not diminish,
but the production of sebum decreases by 60%, mainly due to the
decrease in androgenic activity.
*Adenomas (benign epithelial tumors, generally of structure similar
to a gland) and sebacious quists by hiperplasia (abnormal multiplication
of the elements of a tissue) of the sebaceous cells.
Ageing brings with it other modifications. There is a series of
important functions that deteriorate with age. These are the physiological
functions. Ageing is a sum of time lived and the way of living it.
From the time lived some endogenous causes give rise to the genetic
theory of ageing. Of the way of living, some exogenous causes are
derived, that give rise to some external factors that influence
in ageing. This process is, therefore, the sum of the genetic theory
and of the external factors.
It is necessary to take into account that many of the inherent phenomena
to ageing are interrelated or overlap. At the aesthetic level stand
out:
Reduction of the proliferation and reparation of the queratinocites:
the epidermis slims, and desquamates; the barrier function, therefore,
is also altered. The AUTOMATIC VITALTERM activates cellular renovation
and attenuates the wear and tear and reduction of the epidermis.
The aesthetic treatments complimentary to the therapy will go directed
to improve the epidermic renovation and to the protection to external
agents.
Reduction of the immunitary response: ageing can cause a greater
sensitivity to the external agents. It will be cared that the cosmetics
of cleaning are not detergents, to avoid sensitizing substances,
and use hipoalergenic products. The AUTOMATIC VITALTERM will alleviate
inflammatory processes in order to limit the sensitivity of the
skin and return it to normality.
Reduction of the vascular response: The AUTOMATIC VITALTERM stimulates
the vascularization, in a way that also favours the cellular metabolism.
The complementary treatments applied will have to be orientated
to improve the trophism and cellular respiration.
Reduction of the secretions: The protective function of the hydrolipidic
emulsion is almost null. We will try to repair the epidermic lipids,
and improve the protective function with cosmetic emolients. The
improvement of the fixation of the water molecule in the deepest
layers of the skin contributes to stabilize the reticula of ceramides
that the water retains in its interior. In this way the grade of
nutrition and hydration is improved.
Reduction of solar protection: It is important the protection with
filters and solar screens that besides prevent the appearance of
stains and dehydration.
The causes of cutaneous ageing have continually worried scientists
and continue at present under study. In the cutaneous ageing different
factors both genetic and internal have a bearing that it is necessary
to know and investigate through a careful questioning, and note
in the personal file of the clientelle. These will orientate us
in the aesthetic treatment to perform and in the preventive measures
that must be taken into account. The last causes of ageing are still
an enigma for science, although the most current theories can be
grouped into two large generic divisions: Those that are based on
the etiology of the genetics and in those which are founded in others
of environmental type.
According to the genetic theory, the mechanisms that control ageing
would be “written” in the DNA of our cells, with which
the proliferative capacity of the cells would be limited by the
human genome. The changes produced by age would be nothing other
than a continuation of the normal genetic signals that regulate
the development of every living being. With respect to these theories
of programmed senescence, although they haven’t been able
to be confirmed experimentally, existence of genes of the longevity
and that these are very directly influenced by environmental conditions,
these acquiring a vital importance in the processes of ageing.
If we admit that the process of ageing is determined by a physiological
mechanism, by a family predisposition and by influences that incide
on the skin, the environmental stress would be an unchaining and
aggravating effect of this process. Between the environmental factors
that cause surface dehydration and deprive the skin of protection
favouring the ageing, we can cite the exaggerated, and to dry and
contaminated atmospheres (including air conditioning).
In the paliative and preventive treatment against ageing, several
steps must be followed. Given that the modifications that ocur in
ageing affect different structures, an integral treatment will be
performed that contemplates all the alterations and cutaneous manifestations,
besides other medical, dietic treatments of life habits etc., that
can be recommended. Generally a treatment of preventive type is
established, to which later will be introduced modifications according
to needs of the client, with special incidence in the zones most
sensitive to the passage of time.
The specific treatments will be able to be general or for zones,
making greater emphasis in the body areas that before manifest the
ageing: orbiculars of the eyes and lips, necks, hands, face and
body in general (arms and internal parts of the thighs, abdomen
and breasts). The work protocol of this type of complex treatment
is the sum of the different individual treatments. It is advised
to read carefully the specific treatments desired.
With the arrival of menopause all the manifestations fundamenrtally
due to hormonal changes, but also to a greater susceptibility to
climatic effects (especially the sun), for which preventive measures
will be taken.
It is also necessary to contemplate the shock treatment, or rather
ultrarapid treatments of immediate beauty. For this reason, the
protocol will be followed of work of the non-surgical lifting treatment
and it will be proceded to a making up that allows you to emphasize
to the maximum the spectacularity of the treatment. The substances
that must be ionized are regenerating substances, rich in elastine
and collagen, and with all the active principles that stimulate
the cellular renovation and recovery of firmness. Many of these
substances are specified in the section of “Activation of
all types of substances”.
The effects that are obtained with multiples. In the first place,
the important penetration of substances stands out (hydration, stimulation
of epidermic renovation) especially in cases of atrophy. In second
place, the peripheral circulatory stimulus, visually identifiable
through the redenning of the treated zone. In third place, the trophic
effect, that corrects the circulatory defecit and of metabolic respiration
for the process of ageing. In fourth place, the circulatory stimulus
that acts against the lack of vascular tone. In fifth place, the
scarring action. In ninth place, the stimlus of the metabolism for
which a circulatory increase is produced, draining and calming.
In tenth place, it stimulates microcirculation, favouring the penetration
of substances and improving cutaneous toning. Finally, it also stands
out for improvement in the processes of elimination of liquid excedents
and toxins, for which the circulatory lymphatic defecit is regulated.
The scientific bases established through the study of the main
manifestations of the ageing, of its causes, of the cosmetics and
techniques that can be used allow you to plan a general treatment
protocol of the wrinkles, and devitalized skins. The treatment of
the redenning also includes other aesthetic treatments like alterations
of the grade of hydration, of the pigmentation, neck and eyes, etc.,
through which a brief reference to these will be made, which is
ampliable through the individual files of each treatment.
The cutaneous needs depend a lot on the age of the client and her
individual characteristics. These are determined with the deep study
of the skin, from which the personalized treatment is designed.
In general lines it can be affirmed that the objectives are correcting
the dehydration and desquamation, to paliate or reduce the cutaneous
stains, regenerate the epidermis, reduce the elastosis and flabiness,
improve the nutrition and the cellular metabolism and the muscular
tone.
In preventive and paliative treatments, the modifications in all
the cutaneous structures must be studied: epidermis, dermis, muscular
tissue, nails and hair. You must pay special attention to sensitive
zones like the contour of eyes and mouth, using the techniques of
palpation and observation. Other media such as
photographs of the cutaneous relief that can be revealing at the
moment of determining the grade of ageing.
In cases as complex as the treatment of cutaneous ageing it is
very important to perform a design of the treatment that we are
going to perform at short or medium term, depending on the grade
of ageing. For this we are going to base on the modifications that
the skin presents in three levels: In the epidermis, in the dermis
and in muscular tissue. The technical media necessary according
to the priorities that are established.
The demaking up and cleaning of the skin must be performed with
emolient emulsions, not detergents, not to alter the pH of the skin,
and procede to the exfoliation of the epidermis.
The acting on the epidermis of the AUTOMATIC VITALTERM improves
the penetration of substances. The skin is dehydrated because of
lack of hydrolipidic emulsion, therefore the treatments will be
of hydration. As, besides the cellular renovation is reduced, it
is convenient to stimulate it through exfoliants like the AHA that
favour the hydration, the synthesis of mucopolysaccharides and the
quality of elastic fibres and collagens. The manual or mechanical
massage exerts a stimulating and queratoplastic action.
The acting on the dermis of the AUTOMATIC VITALTERM is the improvement
of the elasticity and of the circulation, the hydration in depth
and the stimulation of the fibroblasts. The main modification in
the dermis is produced in the fibres that are disorganized, elastosis
is produced and the fundamental substance loses its capacity to
retain water. The trophic effect and of stimulus of the circulation
that the AUTOMATIC VITALTERM exerts, applied in a punctual way in
the points of acupuncture or along the wrinkles, as well as favouring
the metabolism and the circulation at a deep level. The manual massage
with the appliance of cosmetics rich in amino acids, oligoelements,
vegetal embrionary extracts , marine extracts, derivates of organic
silicon etc., will complement the actions of the previous techniques.
You can combine with lymphatic drainage, shiatsu and digitopuncture.
The action at muscular level of Diathermia is also very significant.
With age, atony appears in the muscles, that are lengthened and
lose tone in a progressive form. As a consequence the wrinkles of
expression are exaggerated, other new ones appear and the oval form
of the face is lost. In order to improve the muscular tone you must
apply AUTOMATIC VITALTERM against the direction of the fall of the
muscle to stimulate its resituation in its original places. If the
flabiness is very manifest (especially from the age of 50) motor
stimulating currents of low frequency can also be applied to stimulate
together the different muscular groups of the face. You can combine
with galvanization, since it possesses trophic effect and improvement
of the muscular contraction due to its effects at ionic level.
You must end with a face mask according to the type of the skin.
The pulverizations must be performed with stimulating tonics. Next
the base cream is applied. You must not forget the fixing of the
hair and face (make up).
The complexity of the process of ageing means that we have to personalize
in each case the protocol of standard treatment. Generally and depending
on the age and of the characteristics of the skin, it is necessary
to perform specific treatments of certain alterations associated
to ageing. The treatments will therefore be integral, since the
alterations are not presented isolated.
Amongst these we will mention:
• Treatments of contour of eyes and mouth: It is the first
zone that manifests symptoms of ageing, therefore we must begin
with them, if necessary. They are also combined with treatments
of hydration or firming.
• Treatments of the neck: there are people in which the ageing
is exaggerated in the zone of the neck with presence of double chin,
wrinkles etc. You must combine with any other facial treatment.
• Treatment for wrinkles: The stopping of the surface tension
causes the fall of the skin within the muscle, with the consecutive
appearance of wrinkles or lines of expression. An antiwrinkle product
or a hydronutritive cream must be used.
• Treatment for devitalized skins: environmental contamination
and stress reduce the vitality of mature skins, that are converted
into unstressed and can even acquire a yellowish tone. The internal
oxygenation that is produced with the use of the AUTOMATIC VITALTERM
and a specific product to bring vitality to the skin exerts a visible
effect already at the end of the first session.
• Treatments for sensitive skins: Many of the clients that
have reached maturity complain that their skin becomes sensitive
and irritable with time. It is a more exaggerated manifestation
of the lack of protection that exists in ageing, together with the
reduction of the defences. This indefension means that cosmetics
are not tolerated well and that it reacts in a special way to the
external agents. In these cases the protection is very important,
the same as the use of hypoalergenic substances.
• Treatment for facial flabiness (Non-surgical lifting):
the muscular fall can be prevented and can be compensated once manifested.
The treatment of this disorder is performed in a non-aggressive
way through the work protocol of the Non Surgical Facial Lifting
(NSFL). It concerns a very deep muscular treatment that stimulates
the reaction of the muscular fibres.
• Treatment of the hyperchromias: the cutaneous stains are
very frequent in mature ages. A previous diagnostic must be performed
that discards the existence of queratosis solares, epidermic tumours,
etc. The depigmentating treatments can be combined with hydration.
• Body treatments and of arms, hands and feet: They must
be combined with the previous. The treatments of hands and feet
can be performed during the waiting time of the face masks.
These treatments are widely developped in the next pages, dedicating
individual sections to them.
The work standard of the treatment of ageing is of two or three
weekly sessions in alternate days during 10-15 sessions. One maintenance
session per month is recommended once the treatment has been concluded.
However, this standard is orientative and must be personalized by
the beauty professional at all times.
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