USER’S MANUAL

CONTENTS 1. PRESENTATION 1.1 Introduction ........................................................................................................................................ 5 1.2 Safety Information ........................................................................................................................... 5

2. AURA Intense Pulsed Light 2.1 AURA Intense Pulsed Light ....................................................................................................... 7 2.2 BenefitsofAURA ............................................................................................................................ 7 2.3 Multi pulse ........................................................................................................................................... 8 2.4 Mono pulse y multi pulse ............................................................................................................ 9 2.5 Hand-pieces AURA ........................................................................................................................ 11 2.6 ALL TYPES Technology ................................................................................................................. 13 2.7 Differentiation AURA .................................................................................................................... 13 2.8 Technical data .................................................................................................................................... 14 2.9 Accesories included ....................................................................................................................... 15 2.10 Optional accesories ....................................................................................................................... 15

USER’S MANUAL

3. AURA TREATMENTS 3.1 Intense Pulsed Light ....................................................................................................................... 17 PHOTOEPILATION

3.2 What is photoepilation IPL ? ..................................................................................................... 18 3.3 Selective photothermolysis ........................................................................................................ 19 3.4 Photoepilation treatment process ......................................................................................... 20 3.5 Protocol of treatment: Photoepilaion step by step ...................................................... 21 3.6 Contraindications and side effects ......................................................................................... 23 3.7 Informed consent ............................................................................................................................ 24 3.8 Treatment card ................................................................................................................................ 24 PHOTOREJUVENATION

3.9 What is photorejuvenation? ...................................................................................................... 25 3.10 Photorejuvenation treatment process ................................................................................. 26 3.11 Protocol of treatment: Photorejuvenation step by step ............................................. 27 3.12 Contraindications and side effects ......................................................................................... 29 3.13 Informed consent ............................................................................................................................ 30 3.14 Treatment card ................................................................................................................................. 30 3.15 Conclusions of the clinical case studies with AURA ................................................... 31

4. TRAINING 4.1 Wavelenght ......................................................................................................................................... 33 4.2 The skin ................................................................................................................................................. 34 4.3 Fototipes ............................................................................................................................................... 36 4.4 The hair ................................................................................................................................................. 38 4.5 Considerations of photoepilation .......................................................................................... 41 4.6 Expectations of the treatment ................................................................................................. 42 4.7 Frequently asked questions ........................................................................................................ 43 4.8 Differences between IPL and laser ......................................................................................... 44

5. FUNCTIONING 5.1 Description of the console ........................................................................................................ 47 5.2 Start up ................................................................................................................................................. 48 5.3 Connecting the equipment . ....................................................................................................... 49 5.4 Starting a session ............................................................................................................................. 50 5.5 User set-up ......................................................................................................................................... 57 5.6 Safety information ......................................................................................................................... 57 5.7 Hygiene ................................................................................................................................................... 58 5.8 Maintenanceoftheequipmentandfillingthewatertank ........................................ 58

6. AFTER SALES 6.1 Officialtechnicalassistance ........................................................................................................ 61 6.2 Warrantycertificate ...................................................................................................................... 62 6.3 Recycling ............................................................................................................................................... 63 6.4 Quality and environmental policy .......................................................................................... 63

1PRESENTATION

USER’S MANUAL 5

1.1. Introduction

Termosalud SL. is a company that was formed in 1993 to design and develop equipment and

apparatus for beauty treatments.

Since it was founded the company has incorporated new technologies and has increased

its product catalogue, as well as its premises, becoming one of the leading companies on a

nationallevelinthefieldofbeautyequipment.

The Export department, deals with the international distributors and is in contact with

suppliers throughout the whole world.

The close collaboration between medical-beauty institutes and our R+D+i department,

has allowed us to develop a pioneering treatment that sets new standards in aesthetic and

cosmetic medicine.

1.2 Safety information

As the manufacturer of this product, the company TERMOSALUD S.L. is responsible for its

safety and correct functioning, provided that:

•Theelectricalinstallationoftheenclosurewheretheproductisgoingtobeusedcomplies

with IEC standards.

•Thisequipmentisonlyusedinaccordancewiththespecificationsoftheusermanual.

•Theproductsusedduringtheapplicationofthebeautytreatmentsthatcomeintocontact

with the client, are supplied exclusively by TERMOSALUD S.L. This guarantees the effecti-

veness of the session, the biocompatibility of the materials and that the regulations in force

are followed.

•Themaintenanceandrepairoftheequipmentwillbecarriedoutonlyandexclusivelyby

personnel authorised by TERMOSALUD S.L.

•Theequipmentisnotusedbytheuserwhen,becauseofknocks,deteriorationormecha-

nical wear and tear, parts of the equipment have become live.

•Thisapparatusshouldnotbeusedbypeoplewithareducedphysical,sensorialormental

capacity, nor by people who do not have the necessary experience or knowledge.

•Theinsideoftheapparatusshouldnotbehandledbypersonnelthathavenotbeenco-

rrectly trained and authorised by TERMOSALUD S.L., as the active parts may be dangerous.

USER’S MANUAL 62AURA INTENSE PULSED LIGHT

USER’S MANUAL 7

2.1. AURA INTENSE PULSED LIGHT

The results obtained from the non-invasive AURA technique guarantee a high level of cus-

tomer satisfaction, thanks to the almost painless technology.

The photoepilation and rejuvenation treatment can be applied to a wide range of hair and

skintypes,multiplyingthetreatmentsand,therefore,theprofitabilityofyourbusiness.

AURA works with energy levels of between 6 and 50 J/cm2. The exclusive adjustable multi

pulse system gives excellent results in permanently reducing the hair and rejuvenating the

skin. The innovative technology of pulsed light created by Termosalud minimises the heat in

the zone, thanks to a beam of light consisting of a sequence of micro pulses.

AURA provides effective treatment with surprising results and without any side effects.

· Safe for all skin types and colours, even on tanned skins.

· Effective on any hair colour as long as it has some pigmentation.

· Practically painless compared to other traditional Laser or IPL systems.

·Quicktreatmentappliedtolargeareas.Greaterprofitability.

· Pre-set programmes making it easier to operate the equipment.

2.2 BENEFITS OF AURA:

· ALL SKIN TONES

· ALL HAIR TYPES

· ALMOST PAINLESS TECHNOLOGY

· CAN BE APPLIED THROUGHOUT THE WHOLE YEAR

· MAXIMUM SAFETY

· EASY TO APPLY

USER’S MANUAL 8

2.3 MULTI PULSE SYSTEM

Since 1995 the Ruby laser has been used in the United Kingdom for photoepilation. With a

wavelength of 694 nm, it seemed the ideal tool for such treatments, but this technology had

two main problems:

- The high level of energy produced in too short a time led to the partial vaporisation

of the hair shaft, and did not manage to remove the smaller hairs.

- The increase in the temperature of the skin, for both lightly tanned and dark photo-

types, made the treatment too risky in both cases.

With the aim of overcoming these drawbacks, technological research in new photoepilation

systems led to the development of the MULTI PULSE systems: various pulses of light in one

single beam (see the graph on the left-hand page) making the system more effective thanks

to the control of the THERMAL RELAXATION TIMES, reaching the required temperature

(70°C) on the hair melanin, while remaining at a safe temperature for the skin (42°C).

Bear in mind that for the multi pulse to be truly effective on all hair and skin types, it needs

tohavenotonlytherightamountofenergy,butalsothespecificnumberofmicropulsesfor

each skin tone and the optimal ON and OFF times for each hair type.

In order to do this, AURA incorporates its own technology, developed to achieve up to 16

micro pulses per beam of light, compared to the 3-5 micro pulses offered by the majority

of multi pulse equipment on the market. Therefore, AURA can be used to treat very tanned

or black skin.

USER’S MANUAL 9

2.4 DIFFERENCES BETWEEN MONO PULSE AND MULTI PULSE

The following diagram shows the graphics of different pulse structures and their thermal

effects on the skin and hair, compared with the variable length multi-pulse developed by

Termosalud for AURA.

As displayed in the diagram, the big advantage of this innovative technology is that it achieves

the ideal temperature on the structures of the hair so it can destroy it while maintaining

a skin temperature of lower than 42 ºC, thereby guaranteeing maximum safety in all the

treatments regardless of skin colour.

USER’S MANUAL 10

(0,01€)

USER’S MANUAL 11

2.5 HANDPIECES AURA

Allthehand-piecesdevelopedbyTermosaludarefittedwithadvancedopticaltechnology,

which guarantees the quality of the light emitted in each beam for the whole lifespan of

the lamp.

610 nm - 1200 nm / spot 7,5 cm2

PHOTOEPILATION For all skin types. Skin Phototypes I to VI on the Fitzpatrick Scale.

550 nm - 1200 nm / spot 7,5 cm2

PHOTOEPILATION Specificallyforblonde,fineorweakhair.

FACIAL PHOTOREJUVENATION Skin Phototypes I to III on the Fitzpatrick Scale.

*TermosaludS.Lsereservaelderechoarealizarlasmodificacionesqueconsidereoportunaspormotivosdefabricación,encuantoadiseño,medidas,referenciasycaracterísticastécnicasincluidasenestemanual.

USER’S MANUAL 12

USER’S MANUAL 13

2.6 ALLTYPES TECHNOLOGY

Termosalud has developed the ALLTYPES technology achieving high levels of effectiveness,

as it generates and controls the energy in a completely customised way, making it extremely

versatile:

ALL SKIN TONES

ALL HAIR TYPES (with pigmentation, as grey hairs do not contain melanin).

ALL YEAR ROUND (even on tanned skin) avoiding the seasonal nature of the treatments

in summer months).

2.7 AURA DIFFERENTIATION

NATIONAL DEVELOPMENT AND MANUFACTURING:

based on more than 60,000 sessions of experience

(over two million pulses of experience)

MAXIMUM SAFETY:

o,oooo5 % of incidents

INTELLIGENT SOFTWARE:

Selects the optimal energy and beam structure

for each skin and hair type

CHANGE OF LAMP:

Change of lamp for “real” and effective beams

MAXIMUM EFFECTIVENESS:

On all hair types

USER’S MANUAL 14

2.8 TECHNICAL DATA:

Technical data: 220 V a.c 50/60 Hz

110 V a.c 50/60 Hz (optional)

Maximum consumption: 2.300 W

Light Source: Xenon Arc Lamp

Wavelength: hand-piece 610 nm -1200 nm:

photoepilation 7,5 cm2

hand-piece 550-1200 nm:

photorejuvenation and photoepilation 7,5 cm2

Lamp duration: 60.000 beams

LCD Touch Screen: 10,4 inches. Touch Screen

Resolution 800 x 480 pixels

Backlight Technology LED

Fluence: 6 to 50 J / cm2

Micro pulse duration: 3 to 7 ms

Micro pulse sequence : 3 to 16 micropulses

Rest between micro pulses: 2 to 24 ms

Pulse duration: 18 to 304 ms

Pulse repetition frequency: from 1 Hz

Treatment surfaces (spots): 5 x 1,5cm = 7,5 cm2

Cooling: By water

Dimensions: 114 cm (h) x 54 cm (l) x 59 cm (w)

Weight: 55 Kg

USER’S MANUAL 15

2.9 ACCESORIES INCLUDED

PHOTOEPILATION HAND-PIECE

610 nm - 1200 nm / spot 7,5 cm2

PHOTOREJUVENATION HAND-PIECE

550 nm - 1200 nm / spot 7,5 cm2

2.10 OPTIONAL ACCESORIES

CARRYING CASE (NOT INCLUDED WITH THE EQUIPMENT)

USER’S MANUAL 163AURA TREATMENTS

USER’S MANUAL 17

3.1 INTENSE PULSED LIGHT

Intense pulsed light (IPL) is an advanced technology developed to treat the widest range

of benign anti-aesthetic conditions, in a beauty salon or a medical clinic, from telangiectasias

to blemishes caused by age or the sun, rosacea and poikiloderma, congenital vascular and

pigmentation conditions, treatment for hirsutism and the removal of unwanted hair. Because

of its characteristics, it is a versatile, easy to apply technology that is extremely accessible,

providing an effective response to aesthetic problems.

The technological development of IPL systems goes beyond lasers, as it allows you to treat

a multitude of anti-aesthetic conditions on all skin types, including very dark skin. Unlike

conventionallasers,thatemitafixedwavelength,theNEWGENERATIONOFIPLEQUI-

PMENT emits a wide spectrum of light, within a range that is selected by interposing ex-

ternalfilters,andthenusestheidealsoftwareprogrammetocontroltheenergyemission

parameters,suchasthefluence,theemissiontimeandthestructureofthepulse,meaning

the treatment can be adjusted to suit each individual. The aim is to heat the chromophore

selectedfortreatmentandtoraiseittoasufficientlyhightemperaturetodestroyitwithout

damaging the surrounding area.

With IPL phototherapy the following treatments can be carried out:

•Photoepilation

•Photorejuvenation

Not all IPL systems are the same.The most modern systems, which include those manufactured by Termosalud, are

capable of generating a multitude of sub-pulses with each shot of light, which

makes the treatment more effective and gives an excellent level of safety.

USER’S MANUAL 18

PHOTOEPILATION:

3.2 What is PHOTOEPILATION IPL?

IPLphotoepilationisapermanentandlong-lastinghairremovalsystem,usingaflashoflight

emitted by a high power Xenon lamp using Intense Pulsed Light (IPL) equipment.

Each shot of light has a range of wavelengths of between 550/610 and 1200 nm, with ad-

justable intensity which is selectively absorbed by the pilous follicles that are found under

the surface of the skin.

USER’S MANUAL 19

3.3 Selective Photothermolysis

Photoepilation (Hair removal using light systems of any kind) is based on the principle of

Selective Photothermolysis: the light emitted (photo) is transformed into heat (thermo), and

selectively destroys (lysis) the germinative cells of the pilous follicle.

The melanin absorbs the light and carries it to the pilous follicle, where it is transformed into

heat, burning the germinative cells and causing the pilous bulb to be destroyed and therefore

destroying its capacity to generate a new hair, all without damaging the surrounding tissue

at all.

IPL light

The selective absorption in the chromophores (melanin) of the IPL light energy is led to the

pilous follicle where it is transformed into heat, burning the germinative cells and thereby

destroying the pilous bulb without damaging the tissue.

USER’S MANUAL 20

.3.4 Photoepilation treatment process

DURING THE TREATMENT: :

The melanin of the hair absorbs the light and produces a thermal effect that destroys the

follicle’s capacity to generate a new hair.

Part of the energy of the intense pulsed light is absorbed by the pigment of the hair raising

the temperature and driving the heat towards the follicle, but another part of the energy

passesthroughthedermisandisabsorbeddirectlybythebulb.Thisspecificandexclusive

synergy of the IPL irreversibly damages the majority of the germinative cells responsible for

hair growth.

AFTER THE TREATMENT :

The damaged hair seems to continue growing, this feeling is caused by the expulsion process

of the hair. The hair will fall out naturally through a physiological process in approximately

three weeks, resulting in long-lasting depilation.

USER’S MANUAL 21

3.5 Protocol of treatment: Photoepilation: Step by step

1 · Prepare the skin before beginning cleaning the zone with an alcohol free product that does not leave any

colour residue on the skin. Removing any dirt, sweat, creams, etc.

2 · Mark the perimeter of the zone to be treated with a white or red marker. Never use other colours to prevent

the risk of burns. It is also possible to divide the extensive zones into quadrants to keep track of which areas have

been treated and which are still left to treat. Moles should be covered up with the same pencil.

3 · Shave the zone just before starting the treatment. As it is the hair that conducts the light do not pull the hair

out, that way we can be sure that the follicles have hair in them.

4 · Set the treatment type bearing in mind:

PHOTOTYPE I, II, III, IV, V and VI (Fitzpatrick Scale, see paragraph 4.3 of this manual)

It is useful to know that for type IV and upwards utmost precautions must be taken to Prevent burns. It is also

important to say that the success of the treatment depends to a large extent of the correct selection of this pa-

rameterthereforesufficienttimeMustbetakenovertheinterviewandobservationtodeterminethisaccurately

since Sometimes, depending on the time of year the current skin tone can be confused With the phototype.

Lastly, this parameter must remain constant throughout all the Sessions because a person´s phototype does not

change over time.

PIGMENTATION OF THE SKIN

No (does not tan and no freckles)

Medium (light tan and few freckles)

Heavy (very tanned, dark freckles, birthmarks or “mother´s marks”)

HAIR (normal,thickeorfinehair)

At this point we must explain that the hair type must be considered along with the area of the body it grows on.

Inotherwords,haircanbenormalinoneareaandbefineinanother.Forexample,ifwecomparetheupperlip

with the bikini line. If there is hair of different thicknesses in one zone select the thickest one to make sure that

the most visible hairs are removed.

The two last parameters may vary from one session to another therefore it is useful to review them in detail

before programming each session.

After programming this you just have to adjust the power because all the other parameters (number of subpul-

ses, stop and start duration...) are preset when the parameters above have been selected.

In this regard it is important to say that a higher level of power does not always give the best results since for

certaintypesofhairexcessiveenergymakesitdifficultforthelighttoreachinsidethefolliclesbecausethestem

ofthehairvaporisestooquickly.That´swhy,withhairthathasbeenprogrammedas“fine”,thepowershould

not be turned up too high.

As with the previous section, this is a parameter that should be adjusted independently for each session to obtain

the best possible results.

If you are using the orange hand-piece (550nm) it is better to start with the power levels set by the machine and

if this is well tolerated progressively increase the power gradually after emitting some trial shots and waiting a

couple of minutes between them to check for any redness or oedema. This orange applicator should not be used

on phototypes of III or above or on heavy pigmentation.

Reducethepowerneartobones,becausetheosseousstructurereflectsenergyandheat.Thismakesitmore

comfortable for the client.

USER’S MANUAL 22

5 · Apply the conductor gel to cool the temperature of the skin and allow for optimal transmission of the light

fromtheapplicatortotheskin.Asufficientamountofgelshouldbeapplied,inotherwords,alayerofgelatleast

half a centimetre thick.

6 · Donotstartthetreatmentwithoutfirstprotectingtheclientandthebeautician´seyeswiththeprotective

glasses supplied by Termosalud.

7 · Place the hand-piece on the zone to be treated and apply pressure (with the aim of emptying the capilla-

ries and thereby preventing the haemoglobin in the blood from heating up) and start the light shots. Each shot

should slightly overlap the previous one (by approximately a couple of millimetres to ensure that the light cover

the whole zone)

Observe the zone to check the skin´s reaction. The energy level is correct if any of the following indicators ap-

pear: a stinging feeling, redness or swelling around the follicle.

The power level should be increased until ones of these indicators appears, if not, you run the risk of the

treatmentnotbeingeffective.Iftheenergyistoolowadjustthefluence.Ifexccesivereddeningoftheskinis

observed suspend the treatment. It is advisable to wait for another session to do more test with lower levels of

energy.

8 · To continue the treatment, move on the zone next to the one to be treated and repeat the operation. Apply

more gel whenever necessary.

9 · Whenthetreatmenthasfinished,wipethegeloffthetreatedzoneandapplyamoisturisingproduct(rosehip,

aloe vera, etc..) NEVER APPLY OILS. This is very important because oil retains temperature and this would delay

the natural cooling down of the skin. Products in gel format are very useful because as well as the properties

that contain are also very refreshing.

10 · Inform the client of the precautions she should take:

Do not use the sauna

Do not use the swimming pool

Do not have any other type of heat treatment

During the treatment sessions precautions must be taken to clean the quartz with cotton wool slightly dampe-

ned with water and/or alcohol. You could also use smooth cotton cloth (towelling cloths or knitted fabric should

not be used for this as they could leave cotton threads on the quartz surface). Take this precaution after every

patient and even with the same patient depending on the zones treated.

USER’S MANUAL 23

3.6 Photoepilation contraindications and side effects

Photoepilation contraindications

· Patients with a history of abnormal response to sunlight (poly shape rash from light, sun urticaria...)

· Patients that are taking photo sensitive medication

· Patients undertaking treatment with retinoic acid or derivatives (ROACUTAN) (treatment may begin

when use of the medication has been suspended for two months)

· Women who are pregnant or breast-feeding.

· Presence of suspect pigmentary lesions or possible skin cancer.

· Exposure to sunlight or UVA radiation without sun protection (VERY HIGH FACTOR) for the week

prior to treatment.

· Broken skin or injuries on the area to be treated

Photoepilation side effects A very common concern of the people who come for a consultation is whether Photoepilation can have nega-

tive effects on the organism.

Everyone uses the term “laser” for all the permanent hair removal treatments on the market.

This term, which is used knowing what is achieved with the technique but not knowing how it functions, often has

a slightly negative connotation and causes concerns about whether it can be harmful for the health.

As we explained at the beginning, photoepilation is an system that uses light radiation and is also used selectively

(melanin chromophore) meaning it does not affect the adjacent structures.

It is true that it has side effects, but these are minimal and normal, provided the patient follows our indications

and all the required clinical data is correct. For a correct application of the treatment the following side effects

are considered normal:

Pain: Not everyone experiences pain during the treatment. It is a subjective sensation that in most cases

is expressed as a “mild spasm” or a slight stinging feeling in the zone being treated. However, we must

bearinmindthateveryonehasaspecificpainthresholdandthepossibilityofadjustingthepowerlevel

of the machine to suit the tolerance of each person minimises discomfort.

Erythema: (Reddening of the skin or rashes caused by capillary congestion, which momentarily di-

sappears under pressure) This occurs in the large majority of people treated, as the zone treated is

subjected to various “aggressions” in a very short period of time: rubbed with a cleansing product,

shaved, the application of cold gel and heat. It is very normal of reddening to occur, but it disappears

in a few hours maximum.

Perifollicular oedema: (Accumulation of liquid under the skin and interstitial space in the cell tissue

around the follicle) We must remember that the appearance of perifollicular oedema (the same as

perifollicular erythema) is an indicator that guarantees that the power used is correct.

USER’S MANUAL 24

3.7 Informed consent Photoepilation

Below is an example of the Informed Consent form included with the AURA equipment.

This consent form should be explained to the client by the technician covering all the points.

The client should read the form carefully and understand it fully, before any treatment begins,

thentheclientshouldsigntheformanditshouldbefiledatthesalontogetherwiththe

client’s treatment card.

3.8 Treatment card Photoepilation

Additionally, it is also advisable to carry out a personalised control of the treatment to be

performed.

Below is an example of a treatment card included along with the equipment accessories

where you can record the client’s details and the monitoring of the treatment sessions. Each

professional can adapt this card to suit their work method and needs.

USER’S MANUAL 25

PHOTOREJUVENATION:

3.9 What is photorejuvenation?

As we get older the skin becomes thinner and drier. The lower levels of collagen make the

skinlesselasticandthefirstwrinklesstarttoappear.

IPLphotorejuvenationconsistsofapplyingpulsesofintenselight,withadefinedrangeof

wavelengths: 550-1200 nm, which penetrate the skin, heating it deep under the surface

andstimulatingthefibroblastscausingthemtoproducenewcollagenandelastin,thereby

improvingthequalityoftheskinandgivingitalong-lastingsmooth,firmlook.

Anotherbenefitofthisphototherapyisthatitevensoutthetoneoftheskin,reducingthe

chromatic differences that can be caused by melanin (sun spots) or can be vascular.

The latest generation of IPL combines safety and excellent results due to its capacity to

regenerate the skin in each session leaving the stratum corneum intact.

USER’S MANUAL 26

3.10 Photorejuvenation treatment process

Themethodologyconsistsoftheemissionofpointsoflightinarangeofspecificwaveleng-

ths that operate selectively on the natural chromophores of the skin (melanin, haemoglobin)

heating them until they are destroyed in the areas where they are abnormally high (super-

ficialmicro-capillariesandsunspots)therebyinitiatingtheorganism’snaturalrepairprocess

resulting in a more even skin tone.

Additionally, the papillary dermis and the upper reticular are heated, which then stimulates

thefibroblastsandincreasescellreproduction.

USER’S MANUAL 27

3.11 Protocol of treatment: Photorejuvenation Step by step

1 · Arrange a prior appointment with the client to assess the tissue lesions and the

expectations of the treatment, once the contraindications have been checked. A light

shot test should be carried out on the zone to assess the skin´s response.

2 · Before beginning the photo rejuvenation treatment the tissue must be well

exfoliated (dermo abrasion) to remove any dead cells and make it easier for the

light to transmit.

3 ·Whenthelastabrasiveexfoliatingsessionhasfinishedtheskinshouldbeleftto

rest for a week before starting the photoluminous treatment.

4 · Whentheclientarrivesthecorrespondingfileshouldbereadyandaphotogra-

ph of the client may be attached to observe the evolution and effectiveness of the

results.

5 · Before starting the treatment check that the equipment has the correct hand-

piecefitted(550nm)

6 · The work table should be prepared with all the material necessary for the pro-

cess: cleansing milk and toner, cotton wool, latex gloves, disposable face mask, bowl,

applicator brushes and spatulas, tissues, IPL conductor gel, face mask, recommended

cosmetological products.

7 · Ontheequipmentselectthespecifictreatmenttobecarriedout:Phototype:

the client should always be among phototypes I, II and III. Tanning: select medium

when the zone to be treated has freckles, treatment should not be carried out on

very tanned skin due to the depigmentation.

USER’S MANUAL 28

8 · Give the client the protective glasses which should be the ceramic ones as the pro-

cessiscarriedoutneartheeyes.Theoperatorshouldusethespecificphotoepilation

and photorejuvenation protective glasses.

9 · Put the conductor gel in the bowl and use the spatula to spread it over a part of

the treatment area. Bear in mind that the gel should be applied in stages to prevent it

from heating up.

10 · The shots of light should be applied overlapping them slightly so that no zone is left

untreated, but avoiding two points of light in the same place. Unlike the photoepilation

treatment, DO NOT APPLY PRESSURE on the skin with the hand-piece.

11 · Although the objective is to treat a localised zone, it is advisable to apply the

treatment to the whole area. For example: If you are treating the zone of the cheekbo-

nes, it is advisable to apply the treatment o the whole face, neck and cleavage, as the rest

of the tissue will taken on a fresher, younger look, also stimulating the surface collagen.

12 · Whentheprocesshasfinishedwipetheexcessgeloffandrinsethezonewith

warm water to prevent the skin from cooling down.

13 · Apply a regenerating face mask and leave it on for 15 minutes.

14 · Take the mask off with warm water and apply the depigmenting regenerating

cream with a surface massage. It is very important that the client follows the maintenan-

ce steps at home to obtain the required results.

15 · In sunny seasons or places the skin should be protected with a high protection fac-

tor cream (50-60SPF) after the nourishing cream, during the whole course of treatment.

16 · The client will notice a sensation of skin tightening and on occasions a slight redde-

ning of the skin may appear but this will disappear within a few hours.

17 · After some days the pigmentation treated will start to scab over due to the dena-

turalisation of the melanocyte that will start to come away from the skin, which is why it

is incredibly important that the client applies the recommended cosmetics to keep the

skin nourished and moisturised. We must repeat the importance of avoiding sunlight and

appliying the recommended protection factor.

USER’S MANUAL 29

3.12 Contraindications and side effects photorejuvenation.

Photorejuvenation contraindications

· Patients with a history of abnormal response to sunlight (poly shape rash from light, sun urticaria...)

· Patients that are taking photo sensitive medication

· Patients undertaking treatment with retinoic acid or derivatives (ROACUTAN) (treatment may begin

when use of the medication has been suspended for two months)

· Women who are pregnant or breast-feeding.

· Presence of suspect pigmentary lesions or possible skin cancer.

· Exposure to sunlight or UVA radiation without sun protection (VERY HIGH FACTOR) for the week

prior to treatment.

Broken skin or injuries on the area to be treated.

Photorejuvenation side effects

Despite the technique being correctly selected and carried out, a slight reddening of the skin may ap-

pearafterasessionbutitshoulddisappearwithinfifteenminutestoafewhours.

There is a small risk that the reddening may last for a few days (erythema), this is similar to mild sunburn

and disappears in 24/48 hours with no after effects. Hypopigmentation or hyperpigmentation can also

appear occasionally.

The permanent depilation of the treated zone can be considered as a collateral effect of the photore-

juvenation treatment, without any clinical consequences.

USER’S MANUAL 30

3.13 Informed consent photorejuvenation

Below is an example of the Informed Consent form included with the AURA equip-

ment. This consent form should be explained to the client by the technician covering all

the points. The client should read the form carefully and understand it fully, before any

treatmentbegins,thentheclientshouldsigntheformanditshouldbefiledatthesalon

together with the client’s treatment card

3.14 Photorejuvenation treatment card

Additionally, it is also advisable to carry out a personalised control of the treatment to be

performed. Below is an example of a treatment card included along with the equipment

accessories where you can record the client’s details and the monitoring of the treatment

sessions.

Each professional can adapt this card to suit their work method and needs.

USER’S MANUAL 31

BEFORE AFTER

PHOTOEPILATION

ARMPIT

WOMAN

3 SESSIONS

PHOTOEPILATION

CHEST

MAN

4 SESSIONS

PHOTOREJUVENATION

WOMAN

5 SESSIONS

PHOTOREJUVENATION

WOMAN

3 SESSIONS

3.15 AURA clinical results

The AURA technology guarantees excellent results in photoepilation and facial photoreju-

venation, the innovative technology means that all skin types and areas can be treated with

the different hand-pieces that come with the equipment.

Thanks to the intelligent software the therapy is very easy to apply and offers maximum

safety. The results have been clinically proved and demonstrate very high levels of effective-

ness and customer satisfaction.

USER’S MANUAL 324TRAINING

USER’S MANUAL 33

PHOTOLYTIC SYSTEMS APPLIED IN BEAUTY TREATMENTS.

4.1 WAVELENGTH

In order to understand the functioning principles of intense pulsed light it is important to

understand the physics of light.

Light is distinguished by its wavelength and it is this that determines the colour of the light.

There are many colour tones within the visible spectrum. Other wavelengths exist that are

not visible to the human eye, but which form part of the spectrum: infrareds and ultraviolets.

When we work with light we distinguish the type we are using in terms of wavelength, in

other words, the route the photon travel along.

The wavelength of a cycle is the distance between two consecutive peaks. This is what de-

termines the colour we see, and the unit of measurement is in nanometres (nm) which is

equivalent to 0.000000001 m.

The visible spectrum starts at around 400nm (BLUE) and goes up to approximately 760nm

(RED).

USER’S MANUAL 34

4.2 The skinIn this section we will study the skin, its structure and composition, its function, colour and

possible apthologies. Finding out about the skin will help us to understand how light inte-

racts with it.

The skin is one of the body´s largest organs, it has a surface area of 1.8m2 and forms nearly

16% of body weight. Among its many functions it acts as a protective barrier against harmful

external factors thereby keeping all the internal bodily systems intact. The skin is made up

of three main layers: the epidermis, the dermis and the subcutaneous layers.

The epidermisThis is the outer layer fo the skin. It is made up of dead cells that come from the lower

levels of the skin.

The body naturally and constantly gets rid of many external cells from the epidermis and

constantly makes other new ones to replace them (we lose around 30,000 or 40,000 cells

from the epidermis daily). The melanocytes that produce melanin are found in this layer

of the skin. Melanin depends on a person´s race and exposure to sunlight, it is what gives

colour to the skin, hair and iris.

Melanin protects the skin from the sun´s ultraviolet rays and is responsible for our skin

tanningwhen itcomes intocontactwith thesun.Thedeficiencyof thispigmentcauses

albinism.

Colours correspond to vibrations that have different speeds, wavelengths and rhythms.

These have a physical, mental and emotional effect that we are not aware of in general and

that allow our vital energy to enter a state that helps cells or a fragment of coding DNA,

like a plasmid, to auto-regenerate

USER’S MANUAL 35

The dermisThis is the lower layer of the skin covered by the epidermis. This layer contains:

·Thenervefibresthatmakeusfeelthings.

· The sebaceous glands, in sacs that produce sebum or grease. Sebum has the function of

lubricating and protecting the skin. Sebum and sweat combine to form a layer that protects

the skin and makes it waterproof.

· The sweat glands, in a spiral shaped tubes to protect them from the exterior, constantly

produce sweat that comes out of the dermis through the pores. Sweat eliminates toxins and

regulates body temperature.

· The adipose cells: these are in the lower part of the dermis. Their function is to cushion the

body, protecting it from knocks and providing heat.

· Pilous follicle, which tube shaped, starts at the adipose cells and carries on to the epider-

mis. Hairs are produced inside these follicles. Each pilous follicle is lubricated by a sebaceous

gland that provides grease for the corresponding hair. This grease makes it shine and protects

it from damp. It also contains blood vessels which keep the skin cells healthy providing them

with oxygen and the nutrients they need when they get rid of impurities. Collagen and elas-

tin,resistantandflexiblesubstances.

HipodermisThis is the deepest layer of the skin. It is made up of loose connective tissue and adipose

tissue. It consists of a network of collagen and fat cells, which helps to maintain body heat

and protects the body from injury as it acts as a shock absorber.

USER’S MANUAL 36

4.3 Phototypes

To ensure optimal results, you need to assess the client´s skin type following the criteria of

the FITZPATRICK SCALE

Phototype I: ALBINO

People with very fair skin, blue eyes and freckles. The skin, not usually exposed to the sun,

is milky white.

Thisskinalwaysburnsintenselywithsunexposure,practicallynevertansandflakesosten-

sibly.

Phototype II: WHITE

People with fair skin, blonde or red hair, blue or brown eyes and freckles, whose skin, not

usually exposed to the sun, is white. People whose skin burns easily and intensely, tans lightly

andflakesoften.

Phototype III: CAUCASIAN

White skin, light brown eyes and hair. Not usually exposed to the sun. People who burn

moderately at the beginning of exposure to the sun and gradually tan moderately.

Phototype IV: MEDITERRANEAN

People with white or slightly brown skin, dark hair and eyes (Mediterranean, Mongolian,

oriental races)

People who burn moderately or minimally, tan fairly easily when exposed to the sun.

Phototype V: INDIA-SOUTH AMERICAN

People with brown skin (Amerindians, Indostanics, Hispanics) and dark eyes. People who

rarely burn and tan easily and intensely. They always react immediately to pigmentation.

Phototype VI: BLACK

People who never burn. The skin may darken or not.

USER’S MANUAL 37

PHOTOTYPE I

PHOTOTYPE II

PHOTOTYPE III

PHOTOTYPE IV

PHOTOTYPE V

PHOTOTYPE VI

USER’S MANUAL 38

Composition and types of hair

The shape of the hair is determined by that of the follicle, straight hair grows in straight follicles while curly hair grows in curled follicles. Twisted hair grows in follicles distorted at the base, due to mechanical interference (tweezers, hair removal wax)

It consists of three layers:

·The cuticle: this has a layer of cells similar to scales that point to the end of the hair. The function of the cuticle is to hold and protect the cortex and give the hair elasticity.

.The cortex: this is the most abundant part of the hair structure. It is underneath the cuticle, this layer has granu-les of melanin that determine the colour of the hair.

.The medulla: This is inside the hair shaft. It can be continuous or not and may vary within the same hair shaft. It is made of loosely shaped keratinised cells. It determines the shine and colour tone of the hair due to the reflectionoflight.

Human skin has pilous follicles covering almost all of it. Each pilous follicle can generate different types of capillary structures: hair, vellus hair and terminal hair.

Bodyvellushairconsistsoffine,shortcapillaryfibres,thataregenerallynolongerthan2mm.

Because of the very low melanin content they can not be removed using photoepilation systems (laser or IPL). “Hair removal” is the common term although this is actually incorrect. We must remember that the light only destroys the hair, although the hair may have different thicknesses and colours.

In order to destroy the pilous follicle, the hair has to be in the anagen phase, in other words, the hair must be “connected” to the interior of the follicle and must also “poke through” the surface of the skin.

But not all the hairs will be in this phase, there will be other hairs that are in the catagen phase (the root of the hair starts to come away from the pilous follicle) or in the telogen phase (the papilla disappears, the bulb is ke-ratinised and the hair falls out). In these cases the light does not reach the pilous follicle and therefore it can not be removed, and a new hair is regenerated. This is why, in order to achieve our objective, various sessions must be performed to remove as much hair as possible from the required zone.

USER’S MANUAL 39

Hair growth phases

ANAGEN PHASE: This is the active phase, it gives rise to the complete restructuring

of the follicle. The pilous germ cells contained in the dermal cord begin to multiply by

mitosis. The dermal cord grows downwards, towards the dermis, while increasing in

thickness until the dermal papilla is enveloped by the bulb, which has formed on the tip

of the dermal papilla.

CATAGEN PHASE: This is the phase following on from the anagen phase, in which the

pilous bulb is formed, the dermal papilla separates from the matrix and the hair begins

to grow in the follicle, being fastened to this by the cells of the internal root shaft and

receiving nutrients from the follicle wall.

The follicle shrinks and collapses under the hair that is growing; meanwhile, the epider-

mal cord is formed by the non-separated cells. The hair becomes drier as it loses water

and glycogen.

TELOGEN PHASE: This is the next phase, the last one in the growth cycle. Known as

the resting phase, in which the follicle remains inactive or sleeping until it is stimulated

back to the anagen phase and the whole process is repeated again.

This phase lasts for a few weeks. The bulb is retained in the follicle until a new hair forms,

which then pushes the bulb out. The telogen follicle is a third of the length of the anagen

follicle.

USER’S MANUAL 40

Pilous FollicleThe dermal papilla has always been considered to be the central growth area of each hair ;

which is why the removal of the dermal papilla was the aim of many hair removal systems.

Hair contains colouring from the melanin pigment (created by the melanocytes) The inten-

sity of the colour depends on the concentration of melanin.

Skin colouring is caused by melanin, and the intensity of the colour also depends on the

amount of melanin present. The base layer holds most of the skin´s melanin, although there

is also free melanin in the melanocytes spread over the area at random.

Hair removal using light: The laser and light assisted hair removal method is based on the theory of selective pho-

tothermolysis. The selective absorption by the pilous chromophores (melanin) of the energy

coming from a laser or broadband light source is used to destroy the pilous follicles while

leaving the skin unharmed.

4.4 The hairThe laser and light assisted hair removal method is based on the theory of selective pho-

tothermolysis. The selective absorption by the pilous chromophores (melanin) of the energy

coming from a laser or broadband light source is used to destroy the pilous follicles while

leaving the skin unharmed.

USER’S MANUAL 41

4.5 Considerations of photoepilation Photoepilation is the removal of unwanted hair using a light beam either from laser equipment

or from IPL equipment.

The energy from the light is selectively absorbed by the melanin in the hair, which sends it to

the follicle and turns it into heat. The germinating root is thereby atrophied, preventing the

hair from sprouting again.

For the treatment to be effective, the hair needs to be in the anagen phase, in other words,

the root of the hair is next to the pilous follicle and has come to the surface fo the skin.

But not all the hair will be in this phase, there will be some hair in the catagen phase (the

root of the hair begins to separate from the pilous follicle) or the telogen phase (the papilla

disappears, the bulb is keratinised and the hair falls out) In these cases the light does not reach

the pilous follicle and therefore, it can not be atrophied and new hair will be regenerated.

That´s why, in order to achieve our aims, several sessions are needed to remove all the un-

wanted hair.

People with white skin and thick, black hair will need fewer sessions than people with dark

skinorwithfine,blondehair.However,asaguidelinewecansaythatforbodyphotoepilation

(armpits,bikiniline,arms)thefirstfewsessionsshouldbeaminimumoffourweeksapart.This

interval period will be increased as the treatment advances.

For facial treatments (upper lip, side whiskers, chin etc.) more sessions will be needed because

the hair is much thicker there than on any part of the body. Depending on the characteristics

of the hair, the number of sessions is usually between 8 and 10 spanning 12 to 15 months.

USER’S MANUAL 42

4.6 Expectations of the treatment.

Perhaps this is the most important and delicate section during a consultation. In fact, it is directly related to our client´s level of satisfaction. And of course, we want to achieve the highest possible levels of customer satisfaction. As the professionals we are, it is up to us to make sure that the patient receives all the information clearly and concisely. Impossible expectations will never lead to an optimal level of satisfaction.

That´s why we must make sure the client understands what to expect and what results can be achieved with photoepilation treatment. We have to be able to adapt our information to the client´s requirements. There will be people who want detailed technical and theoretical information, and there will be other people that will only become confused by so many technical terms. That´s why it is VERY IMPORTANT to adapt the consultation and make it personalised.

Bearing in mind that the results that will be obtained depend on conditioning factors, that can vary for each person, we should explain that in the majority of cases photoepilation offers:

Longtermhairremoval(neverdefinitiveinthestrictsenseoftheword),closelyconnectedtotheconditioningand hormonal factors of each person. Hair reduction after several treatments is between 75-95% (schroeter, 1998.Weissandco,1999)RoyoandMorenoMoraga1998)Thismeansthathairisdecreasedverysignificantlybut not completely.

The number of sessions will always be connected to the conditioning and hormonal factors of each person. This means that every person has a personal pattern of hair production. We must understand that each person has their own rate of hair growth (the intervals between depilation sessions are not the same: some people need sessions weekly, others monthly...) their own hair characteristics (thinner or thicker), a skin phototype (better resultsonfairerskins)andspecifichormonalfunctioning(peoplewithhirsutismandhormonallystandardisedpeople..) That´s why the number of sessions can not be closed or generalised. You must repeat that the average number of sessions (to be decided) is only a guideline and statistical data that in the best case scenario may be decreased, but may also need to be increased.It is also useful to explain that for unknown reasons there is a very small percentage of people for whom this treatment is not effective. In these cases only a couple of sessions are needed to determine this. In other words, thetreatmentoffersresults fromthefirstsession(even if itonlyaffectsthequalityof thehair)andnobodyshouldeverbegivenaninfinitenumberofsessionsifnoresultsaredetectedduringthefirstcoupleofsessions.

In short, what the treatment achieves, backed up by our professional experience, and in terms that everyone can understand,isaverysignificantreductionofhairinthetreatedzone,withthesubsequenthealthforskinandgood aesthetic effects with regards to the lack of blackheads on the skin which often appear after other types of depilation. Also, the shrinking (process of partial destruction of the structures responsible for hair growth) achieves thinner and lighter hair (better optical effect, better removal with other common depilation systems like wax, and the explanation that hair that has shrunk is no longer thick enough or has enough colour to be treated.

USER’S MANUAL 43

4.7 Frequently asked questions.

How does the AURA IPL by Termosalud work?The energy from the light source is absorbed by the pigments (melanin, haemoglobin) in the skin, hair and blood vessels. Theselectivefilteringofthelightmeansthatitisabsorbedbythemelanin(610to950nanometers)orthehaemoglobin(approx. 550 to 950 nanometers). This means that the equipment can be used for permanent hair removal and photo-rejuvenation. Permanent hair removal occurs because heat is generated (due to the hair melanin absorbing the light) up to a temperature level that is able to permanently destroy the pilous follicle.

Who can have this treatment?Dark hair is the easiest to treat, because as it has a higher level of dark melanin, it obtains maximum light absorption and alos converts this light energy into maximum heat energy. Light hair contains less melanin and therefore, it generates less heat, which is why the equipment has a pulse screen where you can select different skin phototypes and treat different typologies.The top layer of the epidermis also contains melanin, and the concentration increases when the skin is exposed to UV rays. That´s why people with dark skin should be treated applying less energy (light), to prevent excessive heat genera-tion and the subsequent pain it may cause. The AURA IPL programme includes treatment suggestions for the different types of skin and hair.

Does it hurt?As the light is absorbed by the pigments (melanin and haemoglobin), the pain depends on the concentration of melanin in both the epidermis and the hair. Therefore, it is more painful for people with dark skin and/or a high density or hair. Anaesthetic is not necessary (not even a topical one), and the majority of patients describe it as a burning or stinging sensation.

Why does hair “grow” after the treatment?Unlike other types of treatment, the hair is not vaporised by the AURA IPL, the hair follicles are killed by the heat. Howe-ver, the hair often remains in the follicle. The hair will fall out after 1 to 3 weeks as the epidermis is renewed. During this period it will seem that the hairs are growing as the epidermis pushes them out. How can I tell if the session has worked if the hair does not disappear immediately?After each treatment the hair is loose in the follicle and can easily be removed with tweezers. A little red circle can often be seen around each follicle. These two symptoms indicate that the follicles have been heated up enough. A lot of patients do not experience either of these symptoms but this does not necessarily mean that the session has not been effective.

How many treatments are necessary?Hair removal: For the treatment to be effective the hair must be in the growth phase. The number of hairs in this phase varies from 10% to 70% depending on the body site. The length of the growth phase also varies, for most patients an averageof4sessionsspreadbetweentwoandthreemonthsapartissufficienttoremovevirtuallyallhairs.

Afterthefirstsessionmostpatientsnoticeasignificantreductionintheamountofhair,alsotheremaininghairtendstobefiner.Itisimportanttoknowthatthefirstsessioncanstimulatetheanagen(growth)phaseinfolliclesthatwereinanother phase. This may cause what seems to be a sudden growth of new hair, but which is actually just the sleeping hairs ( catagen or telogen phase) starting to grow at the same time. Although this fact can seem to be a nuisance it actually makes the next session more effective.

Facial rejuvenation: a cycle of 3-10 sessions is required to stimulate collagen and elastin. The sessions can be spread out 1 per week. The number of sessions will depend on the condition of each client, the results should be assessed every 3 sessions and checked against previous photographs.

What precautions should I take before starting the treatment? Patients should avoid sunbathing for at least 1 month before the photoepilation session to avoid excessive light absorp-tion in the epidermis. After the treatment the skin is particularly sensitive to UV light and so should not be exposed to strongsunlightforfourorfivedays:

How long does a session take?This depends on the size of the zone treated: small zones (lip) take approx. 10 minutes, bigger zones (legs) take approx. 45 minutes.

It is permanent?Most authorities would agree that by using AURA it is possible to permanently remove hair. We know that 10% of the hair is externalised and that of the 90% of remaining follicles some of these can be externalised due to hormonal factors.

USER’S MANUAL 44

4.8 Differences between IPL and Laser

· Laser

Lightamplificationbythestimulatedemissionofradiation.Laserequipmentemitsapure

(coherent) light, in just one colour, in which all the photos in the light beam travel in the same

wavelength(for the Alexandrite: 755nm, for the diode: 800nm) and which moves in a straight

line.Itisalightthatisabsorbedwithgreaterprecisionbyaspecificchromophore(structure

capable of attracting one type of light) because it is pure.

· IPL Intense Pulsed Light:

Intense pulsed light equipment emits a mixed light consisting of photos that travel along

multiple wavelengths (incoherent light) in a variable range, which determines an interme-

diaryfilterbetweenthelightsource(lamp)andtheskin,dependingontheeffectyouwish

to obtain (in the case of photoepilation the ideal range goes from 590nm up to 1200 nm as

this is the type of light that melanin attracts best)

Thefirstlaserwasmanufacturedatthebeginningof1960´s,andthisequipmenthasbecome

apowerfulandessentialtoolinanymedicalandindustrialfield.

Alaserdesignedforaspecificapplicationwillhaveadeterminatewavelengthandthiscan

not be changed for the laser to emit light of another wavelength and perform another type

of application. In order to perform different treatments, you need to have a wide range of

equipment.

There are several types of laser designed for different types of treatments such as vascular

lesions on the legs and face, pigmented lesions, lentigines and facial rejuvenation.

Among others we can highlight:

USER’S MANUAL 45

· Co2 Laser: Known as the surgical laser. It has a wavelength of 10.6um (10,600 far infrared) that is absorbed by water, which is the basic component of soft tissue (approx. 80%) so its effect on the tissue is immediately visible when using the laser. That´s why this is the most commonly used laser for surgeons. Some of its uses: To make a cut like that of a scapel,togiveasuperficialablativeeffectonbenignskinlesionssuchasamolesorwarts.

· Argon laser : This is gas laser that emits a blue-green light, with a wavelength of between 488nm and 514nm. The light is highly absorbed by haemoglobin and melanin. It is mainly used in ophthalmology and otorhinolaryngology.

· Nd-YAG Laser: This emits a light with a wavelength of 1064nm (near infrared). This laser has a lot of uses due to its good pene-trationandthefibreopticdeliveryoflight.It is used in: ophthalmology, kidney surgery, otorhinolaryngology, surgery, tattoo removal, varicose veins, vascular blemishes, and it provides acceptable results for hair removal depending on the type.

· Er: YAG Laser:This emits a mid infrared light with a wavelength of 2940nm. This wavelength coincides with the peak absorption of water, which is why it is mainly used in aesthetic resurfacing and the removal or reduction of wrinkles.

· Pulsed dye laser::This emits light with a wavelength of 568nm (yellow light), which coincides with the peak absorption of the hae-moglobin in blood. It can reduce heat damage and scars thanks to its short pulses, which are lower than the heat relaxation time of blood vessels. It is very effective in treatments for vascular lesions, telangiectasias, birthmarks, collagen modelling...However, the short pulses of this type of laser combined with its high absorption usually cause bruising or haema-toma that may last around two weeks.

· Excimer laser: Emite una luz invisible ultravioleta (UV). Su longitud de onda extremadamente corta 193nm permite una alta resoluciónaptaparalacirugíamicroscópica.Aplicadoentratamientosdecorreccióndevisión.

· Copper steam laser: This emits a yellow light with a wavelength of 511nm. It takes longer to heat up and the lasser cavity has a shorter life, although it is less harmful than the dye laser it is used less often.

There are three types of laser suitable for hair removal

· Diode laser: This is the most effective, with this laser the pilous bulb that contains the follicle is destroyed by the transmission ofheattothepigment(melanin)withoutdamagingtheskin.Itemitslightwithafixedwavelengththatcanvarybetween 800nm and 900nm (near infrared. It is 40% more effective than other laser systems for hair removal; Ruby and Alexandrite lasers, although it is also more expensive and its use presents more risks to skin than the modern pulsed light equipment. It is suitable for treatments like: hair removal, varicose veins, periodontal surgery.

· Alexandrite laser:This emits light with a wavelength of 755nm (intense red colour). Although it has a longer wavelength its properties are similar to that of the ruby laser. It offers greater skin penentration and lower absorption by melanin. Suitable for hair removal and tattoo removal.

· Ruby laser:This emits light with a wavelength of 694nm (red colour). The ruby laser is only effective on black hair, phototypes

I and II. It needs a more complex epidermis cooling system than the diode or Alexandrite laser.

USER’S MANUAL 465FUNCTIONING

USER’S MANUAL 47

5.1 Description of the console

The AURA IPL is operated by means of a colour TFT LCD monitor with a touch screen that displays a graphic user interface allowing the user to browse through the software to carry out the treatments.

The user interface is divided up into different areas that display the information in an organi-sed way making it as intuitive as possible for the user, thereby making the work easier.

Additionally, there is a brief helpful text at the bottom of each screen that gives a clarifying explanation of each one of the parameters to be adjusted for the treatment set-up.

USER’S MANUAL 48

5.2. Start-up

Onthefrontpartoftheequipmentyouwillfind:

· Emergency stop button

· Safety key

· Connection to the mains. Cable included in the equipment.

Ontherearpartoftheequipmentyouwillfind:

· Once the equipment is connected to the mains, press the ON/OFF

switch found on the back of the equipment so it is set to ON.

USER’S MANUAL 49

5.3. Connecting the equipment

· Connecting the photoepilation and photorejuvenation hand-piece:

· Insert each connector into the corresponding place

· Press the ON/OFF switch found on the back of the equipment so it is set to ON.

· Turn the key on the control panel on the front to position I and turn the emergency stop button

IMPORTANT

It is very important to empty the hand-piece of any possible air bubbles that could be insi-de it. To do this, with the equipment switched on, move the hand-piece alternatively above and below the height of the equipment. This makes the air bubbles move back towards the machine where they are bled out.

After every hand-piece change, remember to bleed out any possible air bubbles.

Never perform a treatment with a hand-piece that leaks water. If a hand-piece leaks water it should be replaced immediately and sent to the TECHNICAL ASSISTANCE SERVICE.

Make sure that the temperature of the water inside the equipment is always lower than 50ºC. If the values are too high or during summer, place the AURA IPL in air conditioned rooms.

The number of pulses is calculated with the help of an individual counter situated on the actual hand-piece or with the help of the equipment controller, which adds up the amount ofpulsescarriedoutbytheequipment.Theaveragelifeofthelampsfluctuatesbetween60.000 pulses depending on the energy used. To change the lamps and inspect the hand-pieces contact the TECHNICAL ASSISTANCE SERVICE.

USER’S MANUAL 50

5.4. Starting a session

1. 1. Set the switch on the back of the machine to the ON position to access the presenta-tion screen.

After the confirmation test, theequipmentwill display themain screenwith the two

treatment options that can be selected.

USER’S MANUAL 51

2. Select the treatment type to be carried out

PHOTOEPILATION or PHOTEREJUVENATION

PHOTOEPILATION:

3. IfthePHOTOEPILATIONtreatmenthasbeenselected,firstlyyouwillneedtochoo-sethePHOTOTYPEasthefirstparameter.

At the bottom of the screen there will be a brief HELP text to ensure the correct PHOTOTYPE is selected for the treatment to be carried out.

Section 4.3 of this manual contains the FITZPATRICK SCALE giving more detailed information about the different phototypes that exist.

USER’S MANUAL 52

4. The next parameter to select is the level of TANNING, to select this you must bear in mind that in one zone there can be various types of tanning.

It is extremely important to make the appropriate adjustments on the software of the equipment so the correct energy is applied to the skin for each level of tanning, regardless of the zone, session or treatment.

5. Lastly, select the hair type. In order to do this it is necessary to carry out a prior analysis tocorrectlydefinethehairtypeexistinginthezonetobetreated.Wemustpointoutthat the three levels of hair : FINE, NORMAL and THICK can be found in different zones depending on each person.

6. When setting up the treatment parameters you can use the PREV and NEXT buttons to move between the adjustment screens.

USER’S MANUAL 53

7.The START UP screen will display the information of all the parameters selected along with the FLUENCE selected thanks to the intelligent software of AURA

INTENSE PULSED LIGHT.

The equipment will load the appropriate values for the shot (fluence andmicropulse) according to the clinical studies carried out by Termosalud. These values offer optimal performance and maximum safety for the treatment selected.

Theenergy(fluence)canbeincreasedordecreasedaccordingtothecriteriaofthespecialist technician.

The following screen will display a summary of the selected treatment options. It is important to check this information before starting to apply the photoepilation hand-piece to make sure that the treatment carried out is correct.

The treatment can be temporarily stopped at any time by pressing PAUSE and it can bedefinitivelystoppedatanytimebypressingSTOP.

8. For each shot the status bar will charge up and will emit a beep when the equipment is ready to proceed with the following shot.

USER’S MANUAL 54

9. At the end of the treatment the equipment will display the following screen with the SESSION SUMMARY. The software will display the number of pulses and the treatment time, information that will be very useful when monitoring the effects to check the results achieved.

PHOTOREJUVENATION:

10. If the PHOTOREJUVENATION treatment has been selected, firstly youwillneedtochoosethePHOTOTYPEasthefirstparameter.

At the bottom of the screen there will be a brief HELP text to ensure the correct PHOTOTYPE is selected for the treatment to be carried out.

Section 4.3 of this manual contains the FITZPATRICK SCALE giving more detai-led information about the different phototypes that exist.

USER’S MANUAL 55

11. The next parameter to select is the level of TANNING, to select this you must bear in mind that in one zone there can be various types of tanning. It is extremely impor-tant to make the appropriate adjustments on the software of the equipment so the correct energy is applied to the skin for each level of tanning, regardless of the zone, session or treatment.

12. The START UP screen will display the information of all the parameters selected along with the FLUENCE selected thanks to the intelligent software of AURA IN-TENSE PULSED LIGHT.

The equipment will load the appropriate values for the shot (fluence andmicropulse) according to the clinical studies carried out by Termosalud. These values offer optimal performance and maximum safety for the treatment selected.

The energy (fluence) can be increased or decreased according to the criteria ofthe specialist technician. The following screen will display a summary of the selected treatment options. It is important to check this information before starting to apply the photorejuvenation hand-piece to make sure that the treatment carried out is correct.

USER’S MANUAL 56

13. For each shot the status bar will charge up and will emit a beep when the equipment is ready to proceed with the following shot.

14. At the end of the treatment the equipment will display the following screen with the SESSION SUMMARY. The software will display the number of pulses and the treatment time, information that will be very useful when monitoring the effects to check the results achieved.

USER’S MANUAL 57

5.5. User set up

The set-up screen lets you adjust the different sections listed below.

To access the set-up select the initial screen on the machine and keep the START/STOP button pressed down for a few seconds. The following screen will automatically appear on the display:

To move the cursor to one of the different set-ups press the PREV/NEXT key.The selected parameter can be adjusted using the +/- cursors on the screen.

Contrast:

Adjust this parameter depending on the lighting in the room where the equipment is to improve the display of the

screen data.

Glare:

Adjust this parameter depending on the lighting in the room where the equipment is to improve the display of the

screen data.

Language:

Change the language if necessary (available depending on versions).

Alarm Time :

Thetimeindicatesthenumberofsecondsthemachinewillbeepforwhenthetreatmenthasfinished.

The cycles indicate that the machine will beep the number of times shown for the number of seconds indicated.

Advanced Menu :

This includes the different internal adjustments of the equipment. This menu will only be operative if you need to

adjust the internal parameters set carried out by authorised personnel

5.6 Safety warnings

Themultipleclinicaltrialsandhundredsofprocedurescarriedouthaveconfirmedtheeffectivenessof AURA.

Take care when using the equipment, as IPL technology can cause damage to the retina, if the eyes are not protected properly with the glasses.

It is compulsory that the operators as well as the patients wear the protective glasses throughout the whole treatment time. If you need more pairs contact the sales representative who supplied the equipment.

•DonotwearsunglassestoprotectyoureyesfromtheIPL.Sunglassesdilatethepupilwhichwouldmake it easier for the IPL to penetrate the eye.

•Closeallthewindowsinthetreatmentroom,puttheblindsdownandcoverallthemirrorsandotherreflectiveelements.

•Beforestartingthetreatment,theclientsmustputtheappropriateprotectiveglasseson,aswellasthe technician operating the machine. For your own safety and that of your clients, please check all the safety warnings before using AURA.

•Youmustwearspecificsafetyglassestopreventthewavelengthfromdamagingyoureyeswhentheapparatusisswitchedon.Thelaserworkswithaspecificwavelengthand,therefore,theprotectiveglassesmustofferprotectionforthatspecificwavelength.Werecommendyouusethemodelofglas-ses supplied with the equipment, if you need more pairs please contact TERMOSALUD.

TECHNICIAN GLASSES

CLIENT GLASSES

CERAMIC GLASSES

FACIAL TREATMENTS

USER’S MANUAL 58

5.7 Hygiene

The hand-pieces used for the selected PHOTOEPILATION / PHOTOREJUVENATION treatment should be cleaned for each new client. Use a smooth cotton cloth dampened with water and/or alco-hol to clean the wave guide (towelling cloths or knitted fabric should not be used for this as they could leave cotton threads behind)

Take this precaution after every patient and even with the same patient depending on the zones treated.

The hand-piece should always be in contact with HEALTHY SKIN (otherwise it is contraindicated.)

The glasses the client has used should also be cleaned using the same method.

ALWAYS USE DISPOSABLE RAZORS for shaving and never reusable ones.

The SPATULAS used to apply the conductor gel should also be DISPOSABLE.

IMPORTANT:Before carrying out any cleaning or maintenance task on the hand-pieces, always make sure that the machine is disconnected from the mains.

5.8 Maintenance of the equipment

AURA has been designed with top quality materials, making it a very hard-wearing machine.

Avoid knocking the console as this could cause irreparable damage to the machine.

It is advisable to examine the hand-pieces to check that they are in good working order as any defect could mean that liquid gets into the hand-piece which would affect its functioning.

USER’S MANUAL 59

FILLING THE WATER TANK The equipment has a water tank. To change the water use demineralised water.

NEVER USE TAP WATER OR MINERAL WATER OR DEIONISED WATER

The water level should be checked at least once a month.

Tofillthewatertankyouwillneed:

· A container of demineralised water (supplied with the equipment)

· A funnel (supplied with the equipment)

1 · Checkthattheequipmentisswitchedoff.Neverfillthewatertankwhentheapparatusis switched on.

2 · Inserttheadaptortofillthewatertankwiththecontainerusingthefunnel

3 · Checkthetankisfilledcorrectlyusingthelevelindicatoronthesideoftheequipment.Never exceed the maximum level.

IMPORTANTIf water leaks occur at the height of the connectors the gaskets of the male connectors need to be changed.

Loosenthe bleed screw

Remove the adaptorTightenthe bleed screw

Regularly check the water level for safety. Keep the water level between the maximum and minimum limits.

MAXIMUM

MINIMUM

Insert the adaptor to fillthetank

Fill the tank with demineralised wateruntiltheadaptoroverflows

USER’S MANUAL 606AFTER SALES

USER’S MANUAL 61

6.1Officialtechnicalassistanceservice.

Ifyouhaveanytechnicalproblem,pleasecontacttheOfficialTechnicalAssistanceService

+34 902 10 22 25

Termosalud,S.L.isnotresponsibleforequipmentthathasbeenrepairedbyanunofficialte-

chnical service.

Poligono Industrial Los Campones.

c/ Ataulfo Friera Tarfe nº 8

33211Gijón.AsturiasESPAÑA

tel. +34 902 10 22 25

www.termosalud.com

USER’S MANUAL 62

6.2.Warrantycertificate

TERMOSALUD S.L. guarantees any manufacturing and equipment material defects of the

AURA IPL for one year from the date of purchase, whenever the repair is carried out by

our TECHNICAL SERVICE.

TheOfficialTechnicalServicewillcarryouttherepairunderguarantee,uponpresentation

ofacertificate,dulyfilledinonthedateofpurchase.Thisguaranteedoesnotcoverdefects

caused by incorrect use, breakages from misuse, from the apparatus being used for things it

is not designed for and especially, any defects caused by nonobservance of the instructions

and warnings listed in this manual.

The transport costs resulting from any repair necessary due to misuse, negligence of the

user or non-observance of the instructions and warnings listed in this manual or any repair

carried out outside the period of guarantee, will always be the responsibility of the buyer.

USER’S MANUAL 63

6.3. Recycling

Never dispose of this equipment along with domestic waste, ask your council for

information on how to dispose of it correctly. The cardboard box, the plastic included

in the packaging and the parts of the machine can be recycled in accordance with

the recycling regulations in force in Spain. The crossed out wheelie bin, displayed on

the apparatus, means that when the equipment has reached the end of its useful life,

itshouldbetakentothespecificcollectionsitesandtreatedseparatelyfromurban

waste.

6.4. Quality and Environmental Policy

· Quality and its improvement is the responsibility of all members of the com-

pany, starting with the Management.

· Quality as a means of maintaining a competitive position in the market.

· Quality is obtained not through inspection, but through planning, performing,

checking and improving the General Quality System (GQS) and Environment

to prevent any possible errors.

· Quality aims to achieve customer satisfaction, through the whole company

being committed to meeting the needs and requirements of our clients, as

well as the legal requisites and regulations related to our service.

· Strict compliance with the environmental requisites applicable to our environ-

mental points and our dedication to continually improve our performance

and prevent pollution, especially with hazardous waste, to obtain an mutually

beneficialrelationshipwithoursurroundingsandourneighbours.

· To minimise the amount of waste we generate and provide our employees

with training and ways of actively collaborating on this matter. For the active

application of these principles it is completely necessary for the Management

and whole staff to support them, as well as our suppliers and clients.

Poligono Industrial Los Campones.

c/ Ataulfo Friera Tarfe nº 8

33211Gijón.AsturiasESPAÑA

tel. +34 902 10 22 25

www.termosalud.com

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