Client’s Prerequisites to be eligible for the treatment.
In order for the client to qualify to undergo the aesthetic treatments using electrical arcing or aesthetic lasers the following prerequisites must be met first:
- The client must be in good health at the time of the treatment, with no underlining chronic health conditions. If the client displays signs of cold or flue the treatment must be postponed.
- Those with problems of keloids, skin burns or diabetes should not undergo these aesthetic procedures.
- The area to be treated should not have undergone any previous medical treatment or cosmetic laser treatment .The client must not have taken any medicine for at least 7 days before undergoing the aesthetic treatment.
- The client must not have undergone any de-pigmentation treatment in the past.
- The client should not be waiting on a doctor appointment.
- The client must not display any tanning at the time of the treatment. This is especially important for tattoo removal or permanent make-up removal.
- The client must not display herpes simplex and not have had herpes simplex in the past even if dormant at the time of the treatment. In case of clients with herpes simplex a full antiviral course should be completed before starting the aesthetic treatment.
- If the client wears a pace-maker avoid treatment with electrical arcing. Consult the pace-maker manufacturer and contact the specific electrical arcing device manufacturer for advice.
Before applying the numbing product.
Before applying the numbing product, if any, remove all make up from the face thoroughly by using normal make up removal procedures. Once you have removed all make-up, apply an appropriate non flammable antiseptic on a clean cotton pad and gently rub the area you are going to treat with the electrical arcing device. At that point you can apply the appropriate numbing product.
Patch testing should always be performed before starting most aesthetic treatment using AC voltaic arcing. This is because patch testing can demonstrate that, if the after-care is performed correctly, the skin will recover well and there are no adverse effects to the particular aesthetic treatment.
However, in case of any benign moles or skin lesions removal, including Xanthelasma, Seborrheic Keratosis, Syringoma etc, patch testing is not strictly required. This is due to the fact that the inherent nature of the treatment does not allow it. Additionally no aesthetic treatment aiming at removing any benign moles or skin lesion can guarantee scar free results.
The key to patch testing is to carry out, in a small part of the skin, the particular aesthetic procedure in the same way and using the same treatment intensity you would, when you then perform the treatment during the full aesthetic procedure. For example, if you intend to perform tattoo removal without using osmosis, using an electrical arcing device or a laser using a certain equipment configuration and in a certain way, then you only need to carry out the same procedure on a small part of a tattoo.
In the video below you can see a typical example of a patch test before carrying out a full tattoo removal procedure using electrical arcing with osmosis. The time required for the complete patch testing (including applying sterile Sodium Chloride) is less than 5 minutes.
Although the seasoned beauty practitioner can be tempted to carry out full procedures without the use of any patch testing based on one’s extensive experience, from time to time any particular client can either overlook the after-care, or accidentally contract an infection or some adverse effects could develop. At that point the experience of the patch test previously carried out provides the peace of mind of knowing that no adverse effects can be attributable to the treatment per se, provided that the treatment is carried out in a similar way as it was carried out during the patch test.
Use of numbing products before the treatments.
It is advisable to numb the area before carrying out any aesthetic treatment using electrical arcing devices for aesthetic applications. This is not always strictly required, however it is advisable for the client’s comfort. Also, because the client is at ease while the area to be treated is numb, the treatment can be carried out speedily and with ease.
Not all kinds of numbing solutions are appropriate for all the types of aesthetic treatments possible with electrical arcing. For example, injectable local anaesthetics are purposely avoided in skin tightening as they can interfere with the final results and may lead to undesirable effects. However, electrical arcing has been used for several years for the removal of all sorts of benign skin lesions leading to good results and no direct known cause for concern, even if using injectable local anaesthetics. Please note that, in many countries, only medical practitioners are usually authorised to use injectable local anaesthetics.
The preferred numbing option is the use of topical products. The advantage of using topical numbing products is that they are suitable for all kind of treatments with electrical arcing including moles and benign skin lesions removal.
The main type of numbing topical product available on the market depends on the local legislation. Different professionals are allowed to use different products in each country. (Consult local legislation for further information).
A very common topical numbing product available on the market, in most parts of Europe, including the UK is EMLA. (EMLA is available in 5% formulations from
most chemists in the UK). This is a product which can be purchased and used without a medical prescription. Because of this, EMLA is also the preferred numbing product used by tattoo artists for tattooing and performing body piercings.
EMLA is used by applying the cream on the area you intend to treat (including moles, skin lesions etc) and covering the cream with a normal cling film. The same cling film which can be purchased from any supermarket. The cling film is applied in order to cause an occlusion effect which will amplify the effects of the numbing active ingredients in the EMLA numbing cream. The area is then left to rest for approximately 40 to 45 minutes in order to achieve the desired numbing effects.
In the video above you can see the EMLA applied on the eyelids using occlusion. As you can see, although the aesthetic treatment has started on other parts of the face the product has not been removed from the orbital region because eyelid tightening would be carried out a few minutes later.
Unfortunately, although available without prescription form any chemist in the UK, EMLA requires a relative long application time in order to become effective and it is not generally very effective if a cling film is not applied on top of the cream (occlusion). If you attempt to start the aesthetic treatment before the 40 minutes required for the product to become effective, the area may not be be numb enough, in order to carry out the aesthetic treatment in ease and comfort. Additionally the topical effects of the EMLA formulation end within 5 to 10 minutes from the time the cling film is removed and the EMLA residues wiped off. Therefore the window of time while you can perform the aesthetic treatment in comfort is relatively brief.
Medical topical numbing product.
Some Medical practitioners can be authorised to use other numbing products. The formulation that has been extensively and successfully used by medical practitioners who use electrical arcing devices for aesthetic purposes is the following topical custom formulated product:
Formulation active ingredients: Lidocaine 20%, Prilocaine 5%, Tetracaine 5%.
This topical product is either made in a gel or cream formulation. In European countries like Italy and Spain this is made by most local chemists who also have an internal licensed laboratory to manufacture these types of products. In Europe, this type of topical formulation can only be sold under medical prescription (therefore under the sole responsibility of the medical practitioner who orders the product).
Due to current regulations, this is a product which can be used by medical practitioners only or under their direct supervision. The main advantage of using this type of formulation is that the desired numbing effects are achieved almost immediately and are so good that the client will only feel a tickling sensation when the electrical arc is applied. The area where this formulation is applied becomes numb within 5 to 10 minute after the application. Please note that these types of products are not meant to be completely absorbed, therefore all you have to do is applying the cream or gel, on the area you intend to treat and leave the product to work. With this formulation, there will be no need to apply a cling film because the product itself will be strong enough to achieve the desired numbing effects in a relative short time frame. Additionally the numbing effects last longer than those products available over the counter.
In the video above you can see an example of a professional custom made topical numbing product applied on the perioral area in order to numb the skin before a perioral lines attenuation treatment. As you can see occlusion is not necessary. The numbing effects start within 5 minutes from the application of the cream. The specific treatment you see in the video is atrophic scar attenuation.
In any case, whenever you start the treatment on a relatively large area, on a tattoo for instance, remember to remove the topical anaesthetic in small sections. The common mistake made by beginners is to remove all the numbing product all at once. For example, if the topical anaesthetic has been placed on both upper eyelids, the untrained beginner usually removes the cream on both eyelids before starting the treatment. The main problem is that the effect of most topical numbing products does not last long (in case of EMLA only 5 to 10 minutes at most). Therefore the effect of the topical anaesthetic could start to fade before the end of the treatment making the procedure cumbersome.
For eyelid tightening and similar skin tightening procedures, using electrical arcing, the use of local injectable anaesthetics must be avoided even if the beauty practitioner is authorised to use them.
So to summarise, the use of appropriate topical numbing products is advisable before any treatment using electrical arcing, while the use of injectable local anaesthetic are not strictly needed and sometimes must be avoided especially for eyelid tightening and skin tightening in general. Given the fact that topical numbing products are generally easy to use and are sufficient for all types of aesthetic procedures using electrical arcing, the use of injectable local anaesthetics although possible for some treatments are not generally justifiable while using electrical arcing for aesthetic applications.