How do we keep moving on? Alma’s Vision for 2021

March 9th
Lior Dayan, CEO: CEO STATEMENT Inspirations and breakthroughs are REAL more than ever: Major advancements that take place at times of challenge, difficulty, and uncertainty. 2020 is over, but we still feel it in so many ways. And 2021 is already here – We work from the office & remotely, we work in different time zones, via ZOOM meetings and communicate in multiple languages. We find every solution we can to WORK without any excuses… Is it truly the fresh start the world was expecting for? YES! I’m filled with optimism and hope as I see our accomplishments. We faced and overcame huge challenges in a global organization and as individuals. This global pandemic period has changed our lives significantly for the short term, changes that hopefully won’t stay with us for long, yet enabled us to plan a bright future. Nowadays, when urgency and long-distance generate one hybrid concept, face-to-face meetings and events are replaced with digital interactions in the form of global webinars, live broadcasts, and on-line communication. The acceleration of digital transformation is one that I expect to last and impact our industry the most in the coming years, amplifying and resonating the voice of the customer within the corporate. Our mission at Alma for 2021 is to excel under this “new norm”: Leveraging our global reach and agile nature to bring new insights, practical knowledge and added value to our partners, customers, and consumers. Wishing us all a healthy successful 2021.
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Combating What’s Under the Mask

March 9th
Combating What’s Under the Mask Combating What’s Under the Mask As countries around the world enforce the wearing of masks to minimize the spread of COVID-19, many people are asking how to deal with what is under the mask – irritated skin, acne outbreaks and other new skin problems. When we take off our patient’s mask, we discover that their skin is affected from months of being covered. Dr Hen Ifrach, a Cosmetic surgeon from Milan, Italy, talks about “Maskne” and how to prevent it. What is Maskne? “Maskne” used to describe a skin condition caused by mask wearing although it is not a new phenomenon. It has been around for years in parts of Asia where the population wore masks as a protective measure against high levels of pollution. Medical personnel can also attest to the dermatological effects of prolonged mask wearing. Why does it happen? Face masks are occlusive and designed to block very small particles, so when we breath into the mask we create a hot and damp micro-environment. High humidity and hot temperatures have been correlated with acne flare-ups. This can be explained by the impact of temperature on sebum excretion which wasfound to be directly linked to local temperature changes and that sebum excretion increases by 10% for each 1°C rise. Studies have also found that high ambient humidity precipitates acne due to poral occlusion on skin hydration and irritation to the upper parts of the pilosebaceous duct. In addition, sweat and increased humidity might cause swelling of epidermal keratinocytes, thus affecting the keratinocytes of the pilosebaceous follicle and causing acute obstruction and acne aggravation. Other contributing factors • Repetitive rubbing while wearing and removing a mask causes the stratum corneum to peel off and deteriorating the skin’s barrier function, thereby promoting moisture transpiration, and makes the skin sensitive and prone to damage. This can also explain why acne is not the only skin condition caused by wearing a mask. • The number of hours is also an important factor to consider when wearing a mask. Prolonged duration causes occlusion leading to dry, itchy skin and other face mask skin ailments such as: allergic contact dermatitis, rosacea, seborrheic dermatitis, and folliculitis. • Stress and anxiety, which is abundant during the COVID-19 pandemic, is also known to impact skin conditions and can very well be a trigger for acne breakouts, a multifactorial inflammatory disorder . During stress cortisol is released in the body including the glands near skin hair follicles inside of the pilosebaceous unit. This hormone can escalate the production of sebum making it a favorable environment for P.acnes bacteria, initiating an immune response and leading to an inflammatory reaction . Tips on how to prevent Maskne and other mask related skin conditions These skin problems can be dealt with by starting with prevention, which is easier than you might think. ? I suggest replacing your surgical mask every 4 hours and an N95 mask every 3 days. ? Place two layers of gauze inside the mask to reduce water vapor exhaled during perspiration. ? If you already suffer from skin issues, use a hypoallergenic mask. ? If suffer from acne or sensitive skin, a cotton mask would be a better option for you. Cotton is breathable and minimizes skin irritation, but do not forget to wash it regularly and store the fresh mask in a bag to keep it clean. ? Wash your face and use a moisturizer immediately before putting the mask on and after taking it off. Not only will this keep your skin hydrated, it will also act as a barrier between your face and your mask, reducing friction. ? Make sure the mask is not too tight yet sits closely and seals. ? Those who find their face being damaged by mask related friction should consider applying reparative creams or zinc oxide before wearing the mask as it forms a barrier and helps reduce irritation and inflammation. ? If possible, avoid make-up and take a 15-minutes break from the mask every four hours. ? Avoid new skin care products as it that can irritate your skin. Products that contain benzoyl peroxide, retinols or salicylic acid will be more irritating to the skin Treating the damaged skin This unique skin condition forces us to come up with new solutions that not only treat the “maskne” phenomenon but also target any mask-related skin conditions. For most patients, there is a need for a non-invasive, painless treatment with no downtime. My favorite approach is combining two different lasers not only to kill the P.acnes bacteria but also to protect the skin barrier and prevent any acne-related hyperpigmentation and scarring. ClearSkin and ClearLift: 2-step protocol ClearSkinAs a first step, I highly recommend the vacuum assisted, cooled ClearSkin; 1540nm laser. ClearSkin targets the underlying causes of acne including the colonization of P.acnes, high levels of sebum production, altered keratinization, inflammation, and bacterial colonization of hair follicles on the face and neck. The vacuum head removes unwanted debris that clogs pores, while the cooling protects the epidermis, reduces pain, redness and swelling. This is fundamental for patients who cannot afford downtime and need to return immediately to daily routine and crucial for patients who are already in pain, suffering from inflamed acne. ClearLiftI follow with the ClearLift, a 1064nm fractional Q-switched laser, a favorite of mine, as it is non-ablative, has no downtime or side effects and is a pleasant treatment that I can offer my patients. Studies have demonstrated that Q-switched 1064 nm laser acts on the skin barrier function, increasing expression of aquaporins, procollagen, collagen type I and elastin. ClearLift is gentle enough to treat areas that are typically too sensitive to treat with any other laser, such as the delicate skin around the eyes and mouth. Parameters: ClearSkin: pixel tip, vacuum& cooling on, low fluence (400mJ), 3-5 passes. ClearLift: maximum fluence of 1800mJ using the medium depth tip, accumulating 3-5 kJ for the entire face in severe cases and over 5 kJ for the milder cases. If treating hyperpigmentation too I add on a few passes using the (+1) tip. Treatment intervals: 2-4 weeks This is a gentle treatment with low parameters – we need to remember that the mask is going back on after the treatment! In summary, wearing masks is a new feature of our daily lives which means we ALL need to start adapting our skin-care routine and giving our skin the extra care it deserves! Dr. Hen Ifrach is a graduate of the Faculty of Medicine and Surgery in Milan and holds level II Master’s degree in cosmetic surgery from the Humanitas Research Hospital. Practicing medicine for the past 7 years, she has a high interest in the use of non-invasive and innovative laser treatments, treating a spectrum of skin conditions such as acne, rosacea, melasma, hyperhidrosis and face rejuvenation.
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The ultimate guide for photofacial treatments during summertime

March 9th
The ultimate guide for photofacial treatments during summertime Many clients find summer as the ideal time for self care and aesthetic treatments. An extended vacation (for some) & more free time means they can afford some downtime and finally get that photofacial or laser skin resurfacing session they were dreaming of. Even amid the COVID19 pandemic, people are still social creatures. Maintaining their good looks during the summer when there are more events, gatherings etc. is crucial for many of them. That being said, many physicians, practitioners as well as patients have become fixated on that idea that performing laser treatments during summertime is forbidden. Why so? The reasons why not to perform laser treatments during the summer The main medical reasons that have established this taboo have to do mainly with higher sun exposure and increased risk of sun damage. The sunny season means higher amount of UV (Ultraviolet) radiation. Combine that with the fact people tend to spend more time outside during that period and you have the perfect storm. UV is the main cause for sun damage, which can lead to: Changes in skin tone Hyper pigmentation Ageing skin Wrinkles Skin lesions (sun spots) The main concern dermatologists and beauticians have is that certain treatments, such as ablative laser skin resurfacing, expose the epidermis to those UV rays and also increase the skin’s sensitivity. Moreover, the skin naturally produces more melanin during the summer (or any other time it is exposed to the sun more frequently). Therefore, more of the laser energy will be absorbed in the skin, increasing the risk for burns and further pigmentation. The risk is even higher for IPL photofacial and skin rejuvenation treatments, that use a broader light spectrum which increases the chance of hyper pigmentation. The fear of causing skin damage to a patient deters many inexperienced aesthetic providers from getting near these treatments in the summertime. However, experienced and properly trained dermatologists openly admit that with basic cautionary steps, some laser and light based treatments could be performed safely even during the summer. Which laser and photofacial treatments are safe during summertime? As mentioned earlier, IPL (Intensed Pulsed Light) photofacial which is actually supposed to treat hyper pigmentation can potentially increase it during the summer. Photofacials out, that leaves us mostly with lasers and NIR (Near Infra Red) light based treatments. NIR light therapy uses the 800nm to 2500nm light spectrum which is barely visible to the eye. Medical aesthetic devices such as our Harmony XL Pro use a LED powered applicator to emit this light which is more gentle than IPL and lasers. It has high water absorption levels (rather than melanin) which makes it safer and has minimal to no risk of causing hyper pigmentation. As an aesthetic treatment, its short term benefit is shrinkage of collagen in the skin. This gives a skin tightening and glow effect (excellent as a “red carpet” treatment option). In the long run, it stimulates neo-collagenesis which is a fancy word for skin rejuvenation. Being a gentle treatment however means that results are less visible in most cases. For patients seeking more dramatic results, lasers are the best treatment option. We’ve already ruled out ablative skin resurfacing as a safe treatment during summer. That is, unless the patient is willing to remain indoors and out of the sun for the entire healing process, which is unlikely. This leaves us with non-ablative laser treatments, which are becoming more and more advanced and popular. The Q-switched 1064nm ND: Yag laser The first option is using the ClearLift laser, which is essentially a q-switched 1064nm ND: Yag laser. This laser is very established in the industry and can be used all year long. During treatment, it creates small wounds caused by photoacoustic effect. This effect keeps the Epidermis (top layer of the dermis), intact. That means the protective layer of the skin is undamaged therefore not overly exposed to the sun’s strong UV radiation during summer. Moreover, by simply using sunscreen with 30 SPF or higher for several days post treatment – UV rays are blocked. Therefor, increased melanin production can be avoided. The advanced fractional laser treatment The second laser option is our new innovation – the ClearSkinPRO laser. The ClearSkinPRO is a 1540nm, ER: Glass fractional laser which has the remarkable ability to perform non-ablative skin resurfacing. Like the NIR spectrum, this focused wavelength is also mainly absorbed by water. The energy is transformed to heat which creates coagulation columns. This mechanism triggers the immune system to create an inflammatory reaction. The coagulated columns are eventually replaced by new, healthy tissue. The laser also heats the surrounding dermal tissue, creating a thermal reversible effect which promotes neo-collagenesis and new elastin formation. All of this occurs without creating any injury to the external skin layer. As with the ClearLift laser, standard post-treatment measures such as wearing sunscreen and avoiding activities that include extended sun exposure (like going to the beach) for a few days make this a safe treatment during summer. Combined treatments of all of the above For practitioners and patients looking to get the best possible results, various combinations of the above technologies is most recommended. There are many treatment protocols that have shown improved skin attributes by using more than one technology. That is why a multi-laser and IPL platform such as the Harmony XL Pro is so valuable. It allows both dermatologists and beauticians to combine technologies and offer safe treatments all year round. In conclusion, it comes down to taking the right safety measures and using the right technology (remember, no IPL photofacial!). Laser treatments can indeed be performed during summertime to help patients keep their youthful look all year round. To learn more about the subject from Alma’s clinical team, watch the recording of our webinar here.
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