The use of total ultraviolet irradiation for tanning

The development of a tan in the form of a pleasant golden-brown ("bronze") skin color is associated with sunbathing, which was widely used in Europe throughout almost the entire 20th century. It should be noted that sunbathing is possible only in certain seasons of the year. In addition, in sanatoriums, boarding houses and other resort institutions, as well as during vacations in the summer, sunbathing is most often provided to the "resort guests" or vacationers themselves, which leads to an underdosed use of UV radiation. This is due to the idea of most people about the simplicity of the tanning procedure, which does not require the intervention of specialists. Of no small importance is the possibility of getting a "quick" tan with self-insolation. In these conditions, undesirable reactions often occur in the form of burns, general intoxication of the body, the appearance of mutations in the cells of the epidermis, which can lead to actinic keratosis and more severe skin diseases.

The most appropriate and beneficial for the body method of getting a tan is the use of artificial sources of UV radiation used in solariums. In contrast to environmental UV radiation, which is not distinguished by the constancy of physical parameters due to the appearance of solar flares (solar prominences) at certain periods of time, UV radiation from solariums is characterized by high stability of spectral composition and power. In addition, medical personnel or a specially trained employee servicing the solarium can control the radiation dose by exposure, the number of procedures and their frequency.

Solarium staff will take into account the client's skin sensitivity to UV radiation to prescribe the required dose of radiation, especially during the first exposures.

According to their design, solariums are divided into horizontal, vertical and seated. Along with the different designs of solariums, their main purpose is taken into account. In this regard, personal, or so-called home, models are distinguished, as well as professional studio solariums.

It is known that the most pronounced "tanning" effect is provided by radiation in the range of waves 340-365 nm, which is manifested by skin pigmentation of a very beautiful, "bronze" color. UV radiation of this range is the softest, well-tolerated, does not cause significant destructive changes in the skin. Therefore, this radiation is widely used in cosmetology for tanning, improving the appearance of the skin. However, observations of recent years have proven that in the process of tanning, an important role is also played by UV radiation of the "B" region (mainly the 295 nm range), which is a catalyst for the tanning effect. Therefore, tanning lamps give combined UV radiation, regions "A" and "B". The share of the latter (UVB) relative to the total power of UV radiation of "tanning" lamps is different values - from 0.7 to 3.3%. At the same time, in “home” solariums, UV radiation in the “B” region fluctuates within 0.7-1.0%, in studio solariums – 1.4-3.0%. The relatively low content of UVB radiation in “home” solariums is compensated by longer irradiation of faces during their use.

The presence of UV radiation of the "B" region during general UV irradiation in solariums, in addition to the tanning effect, gives a certain therapeutic effect. It leads to the formation of vitamin D, improves the kinetics of vitamins C and A, normalizes phosphorus-calcium metabolism, stimulates general metabolic processes in the body, has a general strengthening and tonic effect, strengthens the immune system, and increases the regeneration of red blood. In addition, UV radiation has a beneficial effect on the condition of the skin and is an effective therapeutic factor for some dermatoses.

Indications for the use of UV irradiation in dermatocosmetology:

• acne, seborrhea, seborrheic dermatitis;
• furunculosis;
• pustular and infiltrative skin lesions;
• herpes simplex;
• focal alopecia;
• atopic dermatitis;
• vitiligo;
• hyperhidrosis, etc.

In all solariums, the source of UV radiation is high-pressure and low-pressure UV lamps, which differ from each other in the way they are made. In modern installations, low-pressure UV lamps are most often used, the inner surface of which is covered with a phosphor layer. Both types of UV lamps produce a predominantly selective radiation spectrum of the "A" region (400-320 nm) with a certain content of the UV wave range "B" (320-285 nm), within 0.7-3.3%. A number of manufacturers produce lamps with combined ultraviolet and multi-colored radiation in the visible spectrum, which creates a visible glow. The service life of most lamps is determined by the loss of the original power by 30-35%, which is approximately 500-600 hours of operation (recently - 800 hours or more). Important parts of a solarium are the cooling and air conditioning systems. The base and cover of the solarium are covered with acrylic glass, the transparency of which is maintained during long-term exposure to UV radiation. Modern solariums can use remote control of the main operating parameters, as well as a device for recording individual client data on a chip card.

At present, salts from foreign companies are widely used for cosmetic purposes. As an example, we can cite the description of the device of the horizontal solarium of the Solatija company, often used in Ukraine, and the methods of general irradiation for obtaining a tan using it. The solarium consists of a lounger and an upper part mounted with it - a cover. On the upper and lower parts of the heliotherapeutic installation on a plexine base, 16 and 12 fluorescent UV lamps are located, respectively. The number of UV radiation sources can be greater, which is indicated in the passport of the installation. A person is located in a solarium in a lying position, the distance between the skin and the fluorescent tubes is 15-20 cm, the exposure of each effect is usually 30 minutes. Swedish experts also recommend following certain rules when conducting irradiation to form uniform pigmentation on the front and back surfaces of the body. With 30-minute irradiation, it is necessary to lie on your back for 20 minutes, and the last 10 minutes after turning the body - on your stomach. When lying motionless on your back during the entire procedure, the pressure of the body in the area of the shoulder blades and pelvis on the trestle bed disrupts the blood supply to the skin in these areas, as well as the free circulation of air and oxygen, which leads to an uneven tan due to the formation of lighter spots in the areas of compression. An even, intense tan is obtained after 5-6 irradiations, carried out at different intervals depending on the skin's reaction to UF radiation. Subsequent irradiations are carried out 1-2 times a week with a total of 10-12 per course.

When drawing up UV irradiation schemes according to the irradiator passport, the instructions for which recommend dosing the exposure in minutes, it is necessary to determine or have an idea of the client's skin sensitivity to UV radiation. In this regard, the approximate data on skin types presented by T. Fitzpatrick et al. (1993, 1997) are used.

In case of liquid seborrhea, as well as acne affecting large areas of the skin surface, the use of general UV irradiation using sources that provide integral or combined selective (DUV + SUV) radiation spectra is of great importance. These are UV irradiators of the OKP-2IM, OKB-30, UGD-3, OMU, OEP-46, EOD-10 models, etc. The basic scheme of general UV irradiation is most often used, starting with 1/4 of the biodose and adding 1/4 of the biodose, reaching 3.0-3.5 biodoses at the end of the treatment course. The treatment course consists of 19-20 daily irradiation sessions. In relatively strong, young people, an accelerated scheme of general UV irradiation can be used, in which the effects begin with 1/2 biodose, adding the same dose later and reaching 4.0-4.5 biodoses at the end of the treatment. In this case, the course of treatment is shortened to 14-15 days.

In case of seborrhea and acne, affecting mainly the upper chest and back, the front and back of the neck, the upper half of the body is irradiated with integral or DUV+SUV radiation. Taking into account the different regional sensitivity to UV radiation of these areas of the body, the front of the neck and chest is irradiated starting with 1/4 biodose and reaching 3.0 biodoses. Less sensitive areas of the back and back of the neck are exposed to a higher dose of radiation - from 1/2 biodose to 4.5 biodoses. The course of treatment is 8-10-12 ceaj sov irradiation.

In the presence of acne complicated by staphylococcal infection and inflammatory infiltrate on a limited area of skin, the effect of local UV irradiation (sources "OKN-PM" and others) on the lesion with an erythemal dose (2-3 biodoses). The site of the disease is irradiated 3-4 times with an interval of 2-3 days with an increase of 50% for each subsequent irradiation. This technique has a pronounced resolving, bacteriostatic, keratolytic effect. If there is a lesion on one half of the face, the second (unaffected) half is irradiated with the same dose, based on cosmetic considerations.

In case of systematic long-term occurrence of acne, inflammatory infiltrates, suppurations, the use of the conventional UV-treatment method may be ineffective. In such cases, it is advisable to use photochemotherapy with photosensitizing medicinal substances - ointments of 0.1% 8-methoxypsoralen, 0.1% puvalen, 0.1-1% methoxsalen or emulsions (alcohol solutions) of 0.1% psoralen or 0.5% beroxane, which are applied in a thin layer to the lesion 20-30 minutes or 1 hour before irradiation. Affected areas of the skin smeared with photosensitizing medicinal preparations are irradiated with selective UF-radiation (PUVA-therapy). In case of acne and its complications affecting large areas of the body, it is possible to use PUVA therapy units, including domestic irradiators "UUD-1-A" for general irradiation. The first irradiation is carried out for 30 sec, increasing the dose by 30 sec after 2 procedures and bringing it to 4-5 min at the end of the treatment. The course of treatment consists of a fairly large number of procedures (10-15), carried out every other day.

If acne and infiltrates occupy small areas of the body, it is advisable to use DUV irradiators for local effects: models with OUN-1 "OUG-1", "OUK-1" or any imported irradiator designed for tanning the face, neck, décolleté area. Skin areas smeared with photosensitizing ointments or solutions are irradiated using the specified DUV irradiators from a distance of most often 50 cm. Irradiation is dosed using a biodosimeter, starting with 0.5 biodose (0.5 J/cm ² ). Gradually increase the intensity of exposure to 4-5 biodoses.

In the complex treatment of herpes simplex, one of the main methods of therapy is UV irradiation, carried out primarily on the foci of vesicular rashes. Integral spectrum UV irradiators (OKR-21M, OKN-PM, etc.) or portable DUV irradiators (OUN-1) are used. The foci of vesicular rashes are irradiated with a dose of 2-3 biodoses when using integral spectrum UV irradiators and 3-4 biodoses when using DUV irradiators, repeated irradiation is prescribed accordingly every other day or the day after the first one. Each lesion is irradiated 3-4 times with an increase in dose by 1 biodose with each subsequent exposure, after which the lesion(s) can be additionally irradiated with an UF irradiator (“BOD-9”, “BOP-4”) 3~4 times with 2-3 biodoses to provide a bacteriostatic effect.

It is advisable to combine the effects on the foci of the rash with UV irradiation of the integral spectrum of reflex zones. In case of vesicular lichen in the facial area, the cervicothoracic spine, including the paravertebral zones, is irradiated (1-2 biodoses); in case of damage to the genitals - the lumbosacral region (2-3 biodoses). Each field is irradiated 3-4 times with an increase in the intensity of exposure per 1 biodose.

The use of UV radiation for alopecia is most effective in the non-scarring form, which manifests itself as focal, diffuse, seborrheic or androgenetic varieties. Usually, UV irradiators are used that provide integral radiation (400-180 nm) with a spectrum maximum in the "B" region ("OKR-21", "OKN-P").

In case of single foci of alopecia, the hair is parted and only the bald areas are irradiated. In case of multiple foci or diffuse alopecia, the head is shaved and the entire scalp is irradiated, dividing it into 4 fields: 2 temporal (left and right), parietal, starting from the hairline on the forehead, and occipital. 2 fields are irradiated daily, not exceeding 300-400 cm ² in area. Usually, erythemal doses of UV radiation are used (2~3 biodoses), increasing the dose by 25-50% with each subsequent irradiation. Each affected area of the head is irradiated 3-4 times with intervals of 2-3 days between procedures. Erythemotherapy dilates blood vessels, improves regional blood circulation, stimulates hair growth, reduces excess secretion of the sebaceous glands, relieves itching in the scalp, normalizes nervous and vascular trophism, vitamin and mineral metabolism, and has a general stimulating effect. When irradiating the head, it is necessary to cover the skin of the face, neck, chest and back, and protect the eyes with dark glasses.

The course of treatment for alopecia is 15-20-25 procedures. In case of focal (alopecia areata) alopecia, 1-2 courses of treatment are sufficient. In case of extensive damage, subtotal or total baldness, 4-6 courses are necessary. Repeated courses of irradiation are carried out no earlier than after 1.5-2 months. The therapeutic effect is often observed after the first or at the beginning of the second course of treatment, when vellus hair or individual long dark hairs appear in the bald spots. If after 2 courses no changes in the area of bald spots are noted, then this treatment should be stopped due to its ineffectiveness.

In the intervals between local course effects, it is advisable to carry out general UV irradiations according to the general scheme, which have a general strengthening, hardening effect, improve vitamin metabolism, metabolism and immune processes. An increase in the therapeutic effect is also achieved by irradiating the collar zone (segments CIV-ThII) with minimal, gradually increasing erythemal doses: 1 - 1.5 biodoses + 1 / 2-3 / 4 biodoses up to 2-3 biodoses. Usually affecting 4 zones: 2 fields at the back in the suprascapular region on the right and left sides of the spine and 2 fields on the right and left in the supra- and subclavian zone. One field is irradiated with the specified doses every day in turn. The course of treatment is 8-12 irradiations. Irradiation of the collar zone has a pronounced neuroreflex effect on the skin and muscle structures of the head. Intensification of metabolic processes and blood circulation in this area improves vascular and nervous trophism of hair follicles, activating the mitotic activity of their matrix cells and normalizing the hair growth phase.

In the treatment of vitiligo, the most indicated physiotherapeutic method is UV irradiation, which stimulates melanogenesis and the reduced function of a number of endocrine glands. PhCT is quite effective, and is carried out in several variants according to the clinical picture of the disease:

1. oral administration of photosensitizing drugs and subsequent UV irradiation of depigmentation foci;
2. external application of photosensitizing agents and subsequent UV irradiation of depigmented areas;
3. ingestion of photosensitizing agents and subsequent general UV irradiation.

High Intensity Broadband Pulsed Light

As is known, low-intensity light causes stimulating effects on biological tissues, while high-intensity light, on the contrary, causes photothermolysis effects. The following high-energy phototherapy technologies are most often used in modern therapeutic cosmetology:

1. broadband pulsed light;
2. monochromatic (laser) light

The effects are based on the theory of selective photothermolysis. Selective photocoagulation (or photothermolysis) is based on the selective absorption of laser or broadband pulse lamp energy of a certain wavelength by chromophores, which leads to the selective resolution of one of the components of biological tissue (target) without causing damage to the surrounding tissue.

The main chromophores that absorb light and then convert light energy into heat are:

1. melanin;
2. hemoglobin (mainly oxyhemoglobin);
3. collagen;
4. water;
5. beta-carotene.

The relative light permeability of the epidermis and dermis allows the light beam to destroy the corresponding chromophore by photothermolysis and photocoagulation without damaging the surrounding tissues and practically without any harm to any rehabilitation. This is the clear advantage over other methods.

Each chromophore has its own spectrum of maximum light absorption.

Oxyhemoglobin is characterized by large absorption peaks at 488 and 517 nm, and high absorption peaks at 550 and 585 nm. Due to the absorption of svita by hemoglobin, the blood in the lumen of the vessels is heated to the coagulation temperature of 55-70 C, which subsequently leads to sclerosis of the vessel.

Melanin: maximum absorption in the spectrum of 450-600 nm, but due to the pronounced scattering of light in this area, the optimal region is 600-900 nm. Coagulation temperature is 60-65° C.

Collagen synthesis is activated at a temperature of 55° C. Collagen absorbs light evenly across the entire spectrum.

At the same time, when selecting the optimal wavelength for treatment, it is necessary to take into account the fact of cross-absorption of light of any wavelength by other chromophores. For example, light of the spectrum with wavelengths of 400-550 nm will be maximally absorbed not only by oxythemoglobin, but also by melanin, leading to a decrease in the selectivity of the effect, and the spectrum with wavelengths of infrared radiation will be absorbed not only by melanin, but also by water, leading to dangerous heating of tissues.

Knowledge of the mechanism of action, the absorption spectrum of different wavelengths of chromophores and the critical temperature level of photothermolysis is important for a correct understanding of the choice of wavelength and the level of energy delivered to the tissue to achieve the maximum effect during the procedure.

The radiation of broadband pulse lamps has a wavelength range from 400 to 1200 nm, therefore, during the procedure, there is a simultaneous effect on all chromophores at once, obtaining a multiple effect in the area of action. Laser radiation is monochromatic, i.e. one wavelength, therefore, its effects are strictly specific and are associated with the photothermolysis of a certain chromophore.

The main therapeutic and cosmetic effects of broadband light sources:

1. Photorejuvenation.
   1. Correction of manifestations of vascular pathology (rosacea)
   2. Correction of pigment spots (freckles, chloasma, etc.).
   3. Correction of skin texture, photoreduction of enlarged pores.
2. Photoepilation.
3. Treatment of acne.
4. Treatment of psoriasis.

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