The appearance of tan in the form of a pleasant golden brown ("bronze") skin color is associated with sun bathing, which was widely used in Europe practically throughout the 20th century. It should be noted that the use of sun baths is only possible in certain seasons of the year. In addition, in sanatoria, boarding houses and other resorts, as well as during the rest during the summer period, sunbathing is most often provided to the "holiday-makers" or holiday-makers, which leads to an underdosed use of UV radiation. This is due to the representation of most people about the simplicity procedures for obtaining tan, which does not require the intervention of specialists. Not the last value is the possibility of obtaining a "quick" tan with self-sustained insolation. Under these conditions, unwanted 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 expedient and favorable way for the body to get sunburn is using 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 sunspots (solar prominences) at certain Time Periods, the UV radiation of solariums is characterized by a high stability of the spectral composition and power. In addition, medical personnel or a specially trained employee who serves a solarium can monitor the exposure dose, the number of procedures and their frequency.
The staff of the solarium tentatively takes into account the photosensitivity of the client's skin to UV radiation for the purpose of prescribing the required dose of irradiation, especially at the first exposures.
According to the design, the solariums are divided into horizontal, vertical and sessile. Along with the different design of the solarium, take into account their main purpose. In this connection, personal, or so-called home, models are selected, as well as professional studio solariums.
It is known that irradiation in the wave band of 340-365 nm exerts the maximum pronounced "burn effect", which is manifested by the pigmentation of the skin of a very beautiful, "bronze" color. UV radiation of this range is the most mild, well tolerated, does not cause significant destructive changes in the skin. Therefore, this radiation is widely used in cosmetology for a sunburn, the improvements consisted of the appearance of the skin. However, the observations of recent years have shown that in the process of tanning, an important role is played by ultraviolet radiation of the "B" region (mainly in the range of 295 nm), which is a catalyst for the suntan effect. Therefore, the lamps of a suntan effect give a combined UV-radiation, areas "A" and "B". The share of the latter (UVB) relative to the total UV radiation power of the "sunshine" lamps is different - from 0.7 to 3.3%. At the same time, in "home" solariums, the UV radiation in the "B" area varies between 0.7-1.0%, in the studio - 1.4-3.0%. Relatively low content of UVB radiation in "home" solariums is compensated by longer exposure of individuals when using them.
The presence of UV radiation in the "B" area with general UV irradiation in solariums, except for the sun, has a certain therapeutic effect. It leads to the formation of vitamin D, improves the kinetics of vitamins C and A, normalizes the phosphorus-calcium metabolism, stimulates the general metabolic processes in the body, exerts a restorative and tonic effect, enhances immunity, increases the regeneration of red blood. In addition, UV radiation favorably affects the skin condition and is an effective therapeutic factor in some dermatoses.
Indications for the appointment of UV irradiation in dermatocosmetology:
- acne, seborrhea, seborrheic dermatitis;
- pustular and infiltrative skin lesions;
- herpes simplex;
- alopecia areata;
- atonic dermatitis;
- hyperhidrosis and others.
In all solariums, the source of UV radiation is UV lamps of high and low pressure, differing from one another in the way they are manufactured. In modern installations, most often low-pressure UV lamps are used, the inner surface of which is covered with a layer of phosphor. Both types of UV lamps give predominantly a selective emission spectrum of the "A" region (400-320 nm) with a certain content of the UV range "B" (320-285 nm), within the range of 0.7-3.3%. A number of manufacturers produce lamps of combined ultraviolet and multi-colored radiation in the visible region of the spectrum, which creates a visible glow. The service life of most lamps is determined by the loss of the initial power by 30-35%, which is approximately 500-600 hours of work (recently - 800 or more hours). Important parts of the solarium are cooling and air conditioning systems. The base and the cover of the solarium are covered with acrylic glass, the transparency of which is preserved by prolonged long-term exposure to UV radiation. In modern solariums, remote monitoring of the main parameters of work can be applied, as well as a device for recording individual customer data on a chip card.
Currently, with cosmetic purposes, salts of import firms are widely used. As an example, you can describe the device of the solarium solarium firm "Solatia", which often applies in Ukraine, and the method of general irradiation for obtaining tanning with its use. The solarium consists of a sun lounger and an upper part attached to it - the lid. On the upper and lower parts of the heliotherapy unit on the plexic basis are respectively 16 and 12 fluorescent UV lamps. The number of sources of UV radiation can be greater, as indicated in the plant's passport. The person is located in a sunbed in the supine position, the distance between the skin and the luminescent tubes is 15-20 cm, the exposure of each exposure is often 30 min. Swedish experts recommend also observe certain rules when conducting irradiation to form a uniform pigmentation on the front and back surfaces of the body. With a 30-minute irradiation, it is necessary to lie on your back for 20 minutes, and for the last 10 minutes after turning the body - on the stomach. With a motionless lying on the back during the whole procedure, the pressure of the body in the area of the shoulder blades and the pelvis on the couch disturbs 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 intensive tan is obtained for 5-6 irradiations, carried out at different intervals, depending on the skin reaction to DUV radiation. Subsequent irradiation is carried out 1-2 times a week with a total of 10-12 per course.
When drawing up UV-irradiation schemes according to the passport of the irradiator, the instruction of which recommends dose-response in minutes, it is necessary to determine or have an idea of the sensitivity of the client's skin to UV radiation. In this regard, use rough data on skin types, presented by T. Fitzpatrick et al. (1993, 1997).
When liquid seborrhea, as well as with acne, which affects large areas of the skin surface, it is of great importance to use a general UV-irradiation using sources that give integral or combined selective (DUV + SUF) emission spectra. These are UV-irradiators of OKP-2IM, OKB-30, UGD-3, OMU, OEP-46, EDI-10, and others models. The most common scheme of general UV radiation , starting them with 1/4 of the biodoside and adding 1/4 of the biodoside, reach up to 3.0-3.5 biodoses at the end of the treatment course. The course of treatment is 19-20 daily irradiation sessions. In relatively strong, young people, an accelerated scheme of total UV irradiation can be used, in which the effects begin with 1/2 of the biodoside, adding in the subsequent the same dose and reaching at the end of the treatment up to 4.0-4.5 biodosomes. At the same time, the course of treatment is shortened to 14-15 days.
With seborrhea and acne, affecting mainly the upper part of the chest and back, the anterior and posterior surface of the neck, they irradiate the upper half of the trunk with integral or Duof + SUF radiation. Given the different regional sensitivity to UV radiation of these parts of the body, the front surface of the neck and chest are irradiated starting with 1/4 of the bio-dose and reaching 3.0 biodosomes. Less sensitive areas of the back and back of the neck are exposed to a larger dose of radiation - from 1/2 biodose to 4.5 biodosomes. The course of treatment is 8-10-12 cei of exposure.
In the presence of acne, complicated by staphylococcal infection and inflammatory infiltration in a limited area of the skin, the effect of local UV radiation (sources of "OKN-PM" and others) on the lesion with an erythematous dose (2-3 bio-doses). 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 method has a pronounced dissolving, bacteriostatic, keratolytic action. If there is a lesion in one half of the face, the second dose (unaffected) is irradiated with the same dose, based on cosmetic considerations
With the systematic long-term occurrence of acne, inflammatory infiltrates, suppuration, the application of the usual UV-binding technique can be ineffective. In such cases, it is advisable to use photochemotherapy with photosensitizing drugs-ointments 0.1% 8-methoxypsoralenic, 0.1% puvalene 0.1-1% metoxaline or emulsions (alcohol solutions) 0.1% psoralen or 0.5% beroxane, which are applied a thin layer on the lesion in 20-30 minutes or 1 hour before irradiation. Lubricated photosensitizing medicinal products affected skin areas are irradiated with selective DUV radiation (PUVA-therapy). With acne and its complications, which affects large areas of the body, it is possible to use installations for PUVA therapy including domestic irradiators UUD-1-A for general irradiation. The first irradiation is carried out for 30 seconds, increasing through 2 procedures a dose of 30 seconds and bringing it at the end of treatment to 4-5 minutes. The course of treatment consists of a sufficiently large number of procedures (10-15), conducted every other day.
If acne, infiltrates occupy small areas of the body, it is advisable to use Duo-irradiators for local effects: models with OUN-1 "OUG-1", "OUK-1" or any imported irradiator intended for sunburn of face, neck, decollete zone. Skin areas lubricated with photosensitizing ointments or solutions are irradiated with the help of these DUV irradiators from a distance of more than 50 cm. Doses are irradiated with a biodosimeter starting from 0.5 Biodose (0.5 J / cm 2 ). Gradually increase the intensity of exposure to 4-5 biodosomes.
In the complex treatment of herpes simplex (herpes simplex), one of the main methods of therapy is UV irradiation, carried out primarily on the foci of blistering rashes. UV-irradiators of the integrated spectrum ("OKR-21M", "OKN-PM" and others) or portable Duo-irradiators ("OUN-1") are used. The centers of bubble rashes are irradiated with a dose of 2-3 bio-doses with the use of ultraviolet irradiators of the integral spectrum and 3-4 bio-doses with the use of DUF-irradiators, repeated irradiation is prescribed respectively every other day or next day after the first one. Each focus of the rashes is irradiated 3-4 times with increasing dose per 1 biodose with each subsequent exposure, after which it is possible to irradiate the foci of the lesion of the KUF irradiator (BOD-9, BOP-4) 3 ~ 4 times 2 -3 with biodosomes for bacteriostatic action.
Influences on the rash of rashes can be combined with UV irradiation of the integral spectrum of the reflex zones. In case of a bubble deprivation, the cervico-thoracic spine, including the paravertebral zones, is subjected to irradiation (1-2 biodoses); with lesions of the genital organs - the lumbosacral region (2-3 bio-doses). Irradiation of each field is carried out 3-4 times with increasing intensity of exposure to 1 biodosome.
The use of UV radiation with alopecia is most effective in non-scarring forms, which is manifested by focal, diffuse, seborrheic or androgenetic varieties. Usually, UV irradiators are used, which give the integrated radiation (400-180 nm) with the maximum of the spectrum in the "B" ("OKR-21", "OKN-P").
With single outbreaks of alopecia, hair is spread apart and only the patches of baldness are irradiated. In the presence of multiple foci or in diffuse alopecia, shave the head and irradiate the whole of the scalp, dividing into 4 fields: 2 temporal (left and right), parietal, beginning with the hair growth line on the forehead, and occipital. Two fields are irradiated daily, not exceeding 300-400 cm 2 in area . Usually, erythema doses of UV radiation (2 ~ 3 biodosises) are used, increasing the dose at each subsequent irradiation by 25-50%. Each affected area of the head is irradiated 3-4 times with intervals between procedures of 2-3 days. Erythemotherapy enlarges blood vessels, improves regional blood circulation, stimulates hair growth, reduces excessive secretion of sebaceous glands, removes 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. With focal (alimentary) alopecia, it is enough to hold 1-2 courses of treatment. With extensive damage, subtotal or total alopecia, the appointment of 4-6 courses is necessary. Repeated irradiation courses are carried out not earlier than 1.5-2 months. The therapeutic effect is often observed after the first or at the beginning of the second course of treatment, when in the centers of alopecia appear gun hair or individual long hair of dark color. If after 2 courses there are no changes in the field of the centers of baldness, then this treatment should be stopped because of its inefficiency.
In the intervals between local exchange exposures, it is advisable to carry out general UV-irradiation according to the general scheme, providing a generally strengthening, hardening effect, improving the vitamin metabolism, metabolism and immunity processes. An increase in the therapeutic effect is also achieved by irradiation of the collar zone (segments CIV-ThII) with minimal, gradually increasing erythemic doses: 1 - 1.5 BD + 1 / 2-3 / 4 BD, up to 2-3 BD. Usually acting on 4 zones: 2 fields behind in suprascapular area from the right and left side of the spine and 2 fields on the right and left in the supra- and subclavian zone. Alternately, every day, irradiate one field with the indicated doses. The treatment rate is 8-12 exposures. Irradiation of the collar zone has a pronounced neural-reflex action on the musculoskeletal structures of the head. Intensification of metabolic processes and circulation in this zone improves vascular and nerve trophism of hair follicles, activating the mitotic activity of their matrix cells and normalizing the hair growth phase.
In the treatment of vitiligo from physiotherapeutic methods, the most shown is the use of UV irradiation, stimulating melanogenesis and a decreased function of a number of endocrine glands. Effective is FHT, which is performed in several variants according to the clinical picture of the disease:
- ingestion of photosensitizing drugs and subsequent UV irradiation of the depigmentation sites;
- external application of photosensitizing agents and subsequent UV irradiation of depigmented sites;
- ingestion of photosensitizing agents and subsequent general UV irradiation.
High-intensity broadband pulsed light
As you know, light of low intensity causes stimulating effects on biological tissues, high intensity, on the contrary, causes the effects of photothermolysis. Most often in modern therapeutic cosmetology the following technologies of high-energy phototherapy are used:
- broadband pulse light;
- monochromatic (laser) light
The effects are based on the theory of selective photothermolysis. Selective photocoagulation (or photothermolysis) is based on the selective absorption by the chromophores of laser energy or a broadband pulse lamp of a certain wavelength, which results in selective resolution of one of the components of the biological tissue (target) without damaging the surrounding tissue.
The main chromophores, absorbing light, and then converted by me light energy into heat, are:
- hemoglobin (predominantly oxyhemoglobin);
The relative light permeability of the epidermis and dermis allows a beam of light by photothermolysis and photocoagulation to destroy the corresponding chromophore without damage to surrounding tissues and practically without the unharmedness of any rehabilitation. This is the clear advantage over other methods.
Each chromophore has its own spectrum of maximum absorption of light.
Oxygen-hemoglobin is characterized by large absorption peaks at 488 and 517 nm, and high absorption peaks at 550 and 585 nm. Due to hemoglobin swallowing, the blood in the lumen of the vessels is heated to a coagulation temperature of 55-70 ° C, which subsequently leads to sclerosing the vessel.
Melanin: the absorption maximum in the spectrum of the will is 450-600 nm, but in connection with the pronounced dispersion of light in this region, the optimum region is 600-900 nm. The temperature of coagulation is 60-65 ° C.
Synthesis of collagen is activated at a temperature of 55 ° C. Collagen absorbs light uniformly throughout the entire spectrum region.
At the same time, when choosing 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, the light of the spectrum with wavelengths of 400-550 nm will be absorbed to the maximum not only by oxytemoglobin but also melanin, leading to a decrease in the selectivity of the effect, and the spectrum with infrared wavelengths will be absorbed not only by melanin water, resulting in dangerous heating of tissues.
Knowing the mechanism of action, the spectrum of absorption of different wavelengths by chromophores and the critical level of photothermolysis temperature is important for a correct understanding of the choice of wavelength and the level of energy supplied to the tissue in order to achieve maximum effect during the procedure.
The radiation of broadband pulse lamps has a wavelength range of 400 to 1200 nm, so during the procedure, all the chromophores simultaneously act simultaneously to produce a multiple effect in the exposure zone. Laser radiation is monochromatic, ie, one wavelength, so its effects are strictly specific and are associated with photothermolysis of a particular chromophore.
The main medical and cosmetic effects of broadband light sources:
- Correction of manifestations of vascular pathology (couperose)
- Correction of pigment spots (freckles, chloasma, etc.).
- Correction of the texture of the skin, photoreduction of dilated pores.
- Treatment of acne.
- Treatment of psoriasis.
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