Advancements in Skin Resurfacing Techniques

Introduction

Medical technology has advanced and undoubtedly underwent several phases of change. The merging of expertise in dermatology and medical technology brought about several skin resurfacing techniques which are used in therapies which provoke the rejuvenation of the skin. Some of the techniques used include laser resurfacing treatment therapies, PSR micro-needling, radiofrequency ablation, and other microdermabrasion techniques which are crystal-free. Throughout the previous decade, these aesthetic and medical techniques have experienced a steady surge, and this stems from the high numbers of diagnoses of skin cancer and increasing demand for practices for skin rejuvenation. In the United States alone, in 2013, dermatology treatments increased by 22% from the preceding year. This rate translates to 9.5 million treatments made during that period (Loesch, et al., 2014). This reflects the increasing use of skin resurfacing treatments such as laser-based procedures, microdermabrasion, and chemical peels. Regardless of the variety of skin rejuvenation treatments which exist at the present day it still remains a challenge and extremely critical to make a selection of the most appropriate modality of treatment for a patient’s skin condition and type. The growth of dermatology treatment and the diverse challenges that are still being faced in picking the correct treatment modality to promote further exploration and research to better address the phenomenon. Advanced knowledge will aid in uncovering of skin rejuvenation treatments which will best suit the next generation of therapy engineering (Loesch, et al., 2014). With regard to this knowledge, this report targets to discuss how research is being conducted in skin resurfacing treatment industry, how existing research has been analyzed to support the development of the aesthetic industry, and my own professional development. This shall be done by considering various research designs being used, the effective ways of collecting research, the correct terminology used in research designs, the characteristics of the social science, the ethics involved and the impact of several case studies, theories, data quality and research methodologies on the aesthetic industry.

The Conduct of Research

The use of laser in skin resurfacing treatment is a popular modality due to its several benefits. These benefits include; a) making the skin to appear more youthful; b) removing and reducing fine wrinkles and lines, acne scarring, birthmarks, blotchy patches, and age spots on the skin; c) treating of damage caused by the sun by improving the overall skin texture; d) stopping the growth of warts and moles; e) producing new collagen which rejuvenates the skin; and, f) it is effective in the early stages of cancer. Some of the risks which deem the necessity of extended research on skin rejuvenation include infection after treatment, hypo- or hyperpigmentation, and abnormal healing (Chakrasthitha, 2019). The benefits and risks of laser resurfacing treatment have spearheaded research, and, indeed, one of the outcomes of extended research is the development of the percutaneous collagen indicator. The Percutaneous collagen indicator (PCI) is a treatment modality for skin resurfacing that was advanced by Dr. Des Fernandes who is based in Cape Town, South Africa. The PCI is one of the alternatives to laser resurfacing, and it involves giving several punctures on the skin using a device which is drum-shaped that consists fine needles which are protruding so as to promote the production of elastin and collagen. In a highlight, some of the advantages of the PCI include the thicker skin, a preserved epidermis, the use of a local anesthetic only, and a short phase of healing.

Research Design

In order to carry out research that reveals alternatives such as the PCI in skin resurfacing, researchers face the task of picking the appropriate research design (USCLibraries, 2019). A research design is a general strategy which is used in the integration of different components of a research study in a manner that is logical and coherent. Eventually, it addresses the research problem effectively. It is like a blueprint for collecting, measuring, and analyzing data. A research design functions to make sure that the acquired results can be used to address a research problem logically and effectively while avoiding any kind of ambiguity. In many cases, a research problem is the determinant of the kind of design which will be used to carry out the study (USCLibraries, 2019). In the research by Dr. Des Fernandes, the research design evident in his study, which is titled “Percutaneous Collagen Induction: An Alternative to Laser Resurfacing” is a comparative design. Comparative methods are used in making constructive explanations and building of theory and applying them to the real world. Comparative research designs are also known as quasi-experimental methods which describe the differences and similarities in variables present in more than one group in natural settings. This means that it is similar to an experiment because it involves some manipulation, but random assignment is not done on individual subjects (USCLibraries, 2019).

Dr. Fernandes’ study showcases the building of the new theory of PCI and applying it as an appropriate alternative to laser resurfacing, which is considered as the most effective treatment method for rejuvenation facial skin. The PCI is a build-up from the principles which are used in other skin resurfacing treatments. Some of the principles which Dr. Fernandes uses to develop his treatment modality are subcision and needle abrasion. Subcision is an alternative technique to the laser skin resurfacing treatment which stimulates collagen deposition while preserving the epidermis. Subcision is a mode of constructing connective tissue under winkles and scars which are retracted. This treatment modality, though, can only be applied in skin resurfacing treatment on certain parts of the face as well as other areas of the human anatomical body (Fernandes, 2002). Needle abrasion involves the use of a tattoo gun in the treatment of scars – a technique which can be applied in many areas for skin resurfacing, though it tends to be laborious, slow and results in closely-spaced holes which are shallow on the skin. Both techniques result in collagen strands which tether the bottom of the scar to the upper layer of the dermis being broken by the needles as the injury triggers the removal of the collagen which is damaged and induces the deposition of collagen immediately below the epidermis. The principles of subcision and needle abrasion inspire Dr. Fernandes’ advancement of the percutaneous collagen induction modality of treatment (Fernandes, 2002). Apart from the comparative research design, other research designs, such as case study design, longitudinal design, and cross-sectional research design are used in carrying out extra research on the alternatives for laser skin resurfacing treatment.

Effective Ways of Collecting Research/Measuring Research

Avoiding construct bias

Before collecting and measuring research in the aesthetics industry, it is worthy to identify whether the construct selected is relevant and has the same dimensions in more than one culture (Esser & Vliegenthart, 2017). This will determine whether identical tools of collecting and measuring research data will be used. In the case where preliminary analyses of the appropriate research design which are based on expert testimonies, triangulation, and pretests of alternative research methods, and literature research show that there are different indicators required to the same meaning of the underlying concept, researchers still use an emic approach in undertaking their studies. Am emic procedure works by measuring professionalization in a national context and construct an instrument which is culture-specific and country-sensitive. An etic approach, which is similar to that used by Dr. Fernandes, is preferable for studies where scholars target to apply rigorous tests for any construct bias that is likely to occur. Doing so requires two alternatives. The first alternative is the determination of the extent at which construct equivalence has actually been achieved, and this is mainly through statistical analysis techniques. The second option, which is used by Dr. Fernandes, is the development of the primary concepts in a collaborative manner by the incorporation of the international researchers’ collective expertise at the beginning of the comparative study (Esser & Vliegenthart, 2017).

Avoiding measurement bias

In cases where an etic approach is used, such as in the study by Dr. Fernandes, the making of comparisons could be a challenge due to measurement bias. Measurement bias happens where the terminology of the survey questions in the analysis of contents have not been adequately translated for the various versions in different countries. As a consequence, people who hail from different cultural backgrounds that take a common standing on a specific construct could possibly have different results on certain question items. This will be either due to inconsistent use of words across different cultures or the triggering of inappropriate connotations in any culture. One of the precautionary measures which research ought to make at the beginning of the comparative study in order to avoid measurement bias across different cultures prior to using the techniques which actually check the existence of such inconsistencies after the collection of data is the back-translation or translation process (Esser & Vliegenthart, 2017). The back-translation process takes into consideration the paramount significance of the reliability of measurement and equivalence of language — this process aids in ensuring that survey questions bear the same meaning and instructions to coding. Eventually, the result of the back-translation is compared to the original version as a way of evaluating the translation quality. Conceptually, back-translation is usually repeated until the match between the two versions reaches a reliable point of matching. One essential motivation for a procedure such as back-translation is the removal of concepts, phrases, or words that are specific to culture – an activity known as cultural decentering (Esser & Vliegenthart, 2017).

Avoiding Instrument bias

Bias on instruments primarily refers to the equal modes of a survey, such as face-to-face, telephone, mail, and habits which are culture specific that relates to the modes on the part of interviewees and interviewers. One of the problems for researchers using the comparative study design is response bias from participants. Response bias refers to the systematic likelihood of participants from certain cultures to select answers which are either modest or extreme or portray strange mannerisms which attest to social desirability. These differences in styles of communication could offer substantial reasons which are embedded in a specific culture, and they make it hard to compare data in a cross-cultural perspective in the absence of additional sets of data (Esser & Vliegenthart, 2017). In the perspective of content analysis, instrument bias represents the instructions for coding in a codebook and factoring in that instructions are interpreted or understood by coders differently, coders can have different degrees of knowledge concerning the instructions, and they could fail to apply the codes consistently. The measurement of complex frames of news, evaluations which are subject to change and meanings which are ambiguous does not stop to pose a huge challenge and problems that are linked to this measurement are reinforced by ambiguous meanings. In ideal circumstances, the coders are taken through repetitive and intense training until the reliability of interceding is satisfactory and sufficient. In the optimal circumstance, coders are supervised closely and frequently retested to assess the quality of their work throughout the running-time of the project (Esser & Vliegenthart, 2017).

Avoiding sampling bias

There are two contexts of ensuring sampling equivalence, and these are the context of analysis of media content and the context of surveys. In the context of media analysis, sampling equivalence refers to the selection of news outlets equally. In the context of survey, sampling equivalence refers to selecting respondents equally. As surveys aim at the probability of samples, content analyses in the cross-national perspective commonly rely on samples which are systematic and not representative. In addition, they examine the media that is distributed most broadly in a market or the news outlets which are most influential in the processes of setting agendas among different media. Therefore, manuals which are well-written, instructions which are clear and having participating researchers who are fully committed at the most preliminary stage of the comparative study is very crucial in establishing a method equivalence. While the cultural expertise and the ability to analytically develop a framework which is unified by collaborators is the main determinant of sampling equivalence, administrative and methodological equivalence largely entails the capacities of management (Esser & Vliegenthart, 2017).

How research contributes to the development of the aesthetic industry

Characteristics of Social Science

The social science that forms the basis if this report is skin resurfacing. Skin resurfacing is a medical term that is used in reference to a collection of methods that are used in the improvement of facial imperfections through the removal of skin layers to provoke the growth and appearance of new skin which is far more healthier-looking. A variety if skin resurfacing techniques are used apart from laser techniques and the PCI. Skin resurfacing has become so popular to the extent that it is offered in settings which are not medically approved and from people who have not received any proper kind of medical training or certification from any boards for facial plastic surgery. Some of the treatments facilitated by skin resurfacing include treatment of; a) facial skin damaged by the sun or that is wrinkled; b) the lines of Crow’s feet around the eyes; c) skin that is loose on the area of the lower eyelid; d) fine wrinkles on the upper eyelid; e) specific precancerous growths, and; e) chicken pox scare or acne (The Regents of The University of California, 2019). More precisely, the use of PCI is important to avoid facial skin treatment using a laser beam, and it gives more flesh to ‘white’ scars. One of the results of PCI is that is results in thicker skin – a result which is far better than dermabrasion (Fernandes, 2002). The PCI is very useful in the aesthetic industry particularly because it involves short phases of healing and it can be used after the implementation of the laser skin resurfacing technique for skins which are very thin. PCI has the unique ability to eliminate telangiectasia, and it is easy to master considering that a drum shaped tool with needles is specially designed for its application. It is due to its easy-to-master characteristic that PCI is being used widely and it bears the risk of being used by medical operators who lack any professional certifications or qualifications for facial skin surgery. To add, the PCI can be performed using topical anesthesia. On the down side, the PCI results in exposure to and of blood and the resulting deposition of collagen are less intense compared to the laser skin resurfacing treatment. Although, with repeated treatments, the collagen deposition could last as long. There is also the risk of over-aggressive needling when PCI is done using a tattoo gun. A rare complication which is an outcome of PCI is hyperpigmentation. Seldom do tattoos result in hyperpigmentation, especially when used in people of a darker skin complexion (Fernandes, 2002).

Ethical considerations

Considering that Dr. Fernandes used a comparative design to present his findings, ethical considerations will have to be observed with regard to the research method he used. One of the ethical considerations is that Dr. Fernandes and any other researchers using the same design ought to remain aware and sensitive towards the social and cultural differences that exist between other researchers and the participants. If the research was done across different nations, Dr. Fernandes’ research team out to have conducted themselves in a manner which recognizes the borders of every research team member (Grand Canyon University, 2019). Of great significance is confidentiality and this ethical consideration requires that Dr. Fernandes handled data with extra planning and care to consider that every member in his research team treats data with the same degree of confidentiality and respect. The standards of national research are different in every country while some nations lack laws for data protection. In addition, the findings of the research ought to be generalizable, and this is in the case where more than one country is used in the study. Also, the research presented ought to have complied with the regulations and laws that relate to the particular research in every nation that was part of the study (Grand Canyon University, 2019) . Ethical considerations brought about by Dr. Fernandes’ study affect the aesthetic industry. Building up the theory and application of the PCI as an alternative to laser skin resurfacing treatment is a significant contribution made by Dr. Fernandes. Although, this poses a risk where educational efforts lead not to the production of surgeons, a pool of technicians who sell their skills in the medical aesthetic market place (Gupta, 2012). Also, there is the need for medical ethics to reconcile deontology and teleology, and neither have the controversies in each theory been settled. Deontology is a school of thought where behaviour is judged by their moral driving force apart from consequences alone. Teleology judges behaviour or actions according to their wrongness or rightness in the context of their consequences. Therefore, carrying out the study should make an effort to reconcile deontology and teleology by observing principlsim. Principlism contains four modern medical ethical principles which Dr. Fernandes ought to have considered, and they are beneficence, non-maleficence, autonomy, and justice. Beneficence refers to the researcher’s moral obligation to act in the interests which are in favor of patients. Non-maleficence is the researchers’ moral obligation to keep patients away from negligence and harm. Autonomy entails the recognition of every person as having the unconditional right to choose their own destiny. Justice is the principle where the researcher recognizes the fair distribution of goods and services among every citizen (Gupta, 2012).

Conclusion

To conclude, this research has impacted my experience as a foundation degree student by getting to know that the aesthetic industry is growing. As it grows, on-going research on the current medical procedures stimulates the development and advancement of new and already existing theories respectively. The results from studies serve to provide more information that increases the understanding and simplify the complex information regarding certain phenomena. In this case, Dr. Fernandes suggests an alternative to laser skin resurfacing treatment by PCI. The PCI uses a customized and simple medical device to make multiple punctures on the skin using needles for skin rejuvenation therapy. Since it is simple, there is the need for ethical considerations to be observed in the use of PCI because, being a simple procedure, it can be carried out by anyone who knows how to do so but lacks professional certification. Eventually, this could result in risks posed to patients due to negligence.

Bibliography

Esser, F. & Vliegenthart, R., 2017. Comparative Research Methods. In: The International Encyclopedia of Communication Research Methods. s.l.:John Wiley & Sons, Inc.

Fernandes, D., 2002. Percutaneous Collagen Induction: An Alternative to Laser Resurfacing. Aesthetic Surgery Journal, 22(3), pp. 307-310.

Gupta, S., 2012. Ethical and legal issues in aesthetic surgery. Indian Journal of Platic Surgery, 45(3), pp. 547-549.

Loesch, M., Somani, A.-K., Kingsley, M. & Travers, J. B., 2014. Skin resurfacing procedures: new and emerging options. Clinical, Cosmetic and Investigational Dermatology, Volume 7, pp. 231-241.