Laser cosmetology

Main article: Hardware cosmetology

The basic principle of the use of lasers in cosmetology is that light acts only on the object or substance that absorbs it. In the skin, light is absorbed by special substances - chromophores. Each chromophore absorbs in a certain wavelength range, for example, for the orange and green spectrum it is blood hemoglobin, for the red spectrum it is hair melanin, and for the infrared spectrum it is cell water.

When absorbing radiation, the energy of the laser beam is converted into heat in the area of ​ ​ the skin that contains the chromophore. With sufficient laser beam power, this leads to thermal destruction of the target.

The processes of heat absorption and transfer depend on the physical properties of the target, the depth of occurrence and its size. Therefore, in laser cosmetology, it is important to carefully select not only the wavelength, but also the energy and duration of laser pulses.

The depth of penetration of laser radiation depends on the wavelength of the laser.

Глубина проникновения в кожу излучения лазеров различного типа

The first lasers used for skin operations were continuous radiation lasers, such as a carbon dioxide laser and an argon laser. They have been widely used to treat birthmarks such as hemangioma. Although the birthmarks were removed, the side effect of scarring was unacceptably high in these lasers. The new lasers, which were created during the 1990s and 2000s, have become comparatively safer and much more efficient compared to older versions.

Lasers in medicine have allowed precise local exposure. At the same time, it turned out to be possible to treat scars with minimal damage to healthy tissues. High accuracy, selectivity, repeatability of parameters and absolute sterility, both under non-contact and contact exposure, are the main advantages of lasers in modern medicine.

Types of medical lasers

Lasers are classified depending on the active medium used. Characteristics of wavelength, pulse duration and absorption of different skin chromophores determine possibility of clinical application of different types of lasers in dermatology.

Lasers can be classified by the type of active medium used to generate photons. The following main types of medical lasers are distinguished:

1. Gas lasers: CO2 laser, argon laser, copper vapor laser, etc. These are the first lasers to emit a continuous beam of light.

2. Solid-state lasers: ruby, Nd: YAG (neodymium laser), Er: YAG (erbium laser), KTP (neodymium laser), alexandrite, etc. These lasers operate in pulsed mode.

3. Liquid lasers: dye lasers. Pulse dye lasers are lasers with very short pulse durations and long intervals between each pulse. The laser energy of these lasers is quite high.

4. Diode lasers: have several wavelengths suitable for soft tissue procedures.

Lasers used in dermatology

1. CO2 lasers: Laser beams from these lasers are absorbed by the water contained in the skin, hence are used to rejuvenate the skin, remove benign skin tumors such as warts, xanthelasms, mucous cysts, angioma cherries, leukoplakia, and are used for surgical cutting.

2. Nd: YAG lasers: The active medium is neodymium in yttrium-aluminum garnet, wavelength 1064 nm. Nd: YAG lasers have little uptake in melanin and hemoglobin and are used for laser hair removal, laser vein treatment, laser photo rejuvenation, laser acne treatment and are used in laser skin surgery.

3. Q Switched Nd: YAG Lasers have strong absorption in dark ink pigments, hence are used in laser tattoo removal.

4. Er: YAG lasers have a wavelength of 2940 nm their working medium is erbium in yttrium-aluminum grenade. It is absorbed by water in the skin and is used for skin resurfacing, laser photographic rejuvenation and to remove skin formations.

5. Ruby lasers have a wavelength of 694 nm and contain chromium ions in alumina as a working medium. Ruby laser light has a very strong absorption in melanin and black and blue ink pigments. This is particularly useful for tattoo removal. Laser hair removal and removal of pigment (dark) skin lesions.

6. Potassium titanyl phosphate (KTP) laser: Nd: YAG laser on second harmonic radiation and wavelength 532 nm, laser with absorption in hemoglobin and melanin, is used to remove vascular and pigment skin lesions^[1]

7. Alexandrite lasers: 755 nm wavelength, a pulsed laser used to remove blue, black and green tattoos, epidermis and dermis of pigmentation, such as in melasma.

8. Diode lasers: with different wavelengths. Absorbing chromophores are melanin and hemoglobin in the skin. Diode lasers are used for laser epilation, treatment of varicose veins, and laser photoresolution.

9. Dye lasers as an active medium contain organic compounds in solution (often rhodamine) and have a valid wavelength between 400-800 nm. Absorbing chromophores are hemoglobin and melanin pigment. Dye lasers are useful in the treatment of vascular lesions and nonablative skin rejuvenation.

10. Excimer lasers contain compounds of xenon, krypton and argon, their target are protein and water molecules, have wavelengths between 190-350 nm. Excimer lasers are useful in the treatment of psoriasis and vitiligo.

11. Fractional lasers are the last lasers that produce microscopic zones of exposure and affect a specific depth in the skin. This is particularly useful for treating acne, wrinkles, sun-damaged skin, melanosis of the skin, etc. The wavelength is in the range of 1550 nm, and the absorbing chromophores are water in the tissue.

It is important to know which laser is right for your skin type and specifically for which cosmetic procedure. The effect of laser radiation on different areas of the skin depends on the wavelength, power density and temperature characteristics of the laser. It is also important to know how lasers work in dermatology before choosing the most appropriate one.

2023: Market growth of 0.8% to 36.2 million procedures

In 2023, approximately 36.2 million laser hair removal procedures were performed in Russia. The growth compared to the previous year, when the figure was 35.9 million, amounted to 0.8%. The industry began to recover from the decline recorded due to the deteriorating geopolitical situation. This is stated in the BusinesStat study, the results of which are presented in mid-February 2024.

The laser hair removal service is noted to have gained popularity due to its high efficiency and painless nature. In addition, compared to alternative methods, this method of hair removal retains the result much longer. Advertising by beauty bloggers on social networks also contributes to the popularization of laser technology.

Against this background, in 2019 the number of laser hair removal procedures rose by 24.1% compared to 2018 - to 36.6 million. However, a substantial decline followed. The introduction of restrictions during the COVID-19 pandemic has led to a reduction in customers in beauty salons and clinics. At the end of 2020, the number of laser hair removal procedures in Russia fell by 10.7%, amounting to 32.7 million. But already in 2021, an increase of 13.3% was demonstrated - up to 37 million procedures. As quarantine restrictions eased, beauty salons and clinics began to offer more flexible conditions for customers to stimulate demand.

In 2022, there was another drop: the number of procedures decreased by 3.1% - to 35.9 million. Due to the deterioration of solvency, some customers who had previously planned to perform laser epilation postponed it for a more favorable time or preferred cheaper methods of hair removal. In 2023, the demand for laser hair removal procedures was supported by an expansion of the geography of service provision and an increase in the number of clients applying for the processing of new zones.^[2]

2022: World's first picosecond laser released to remove wrinkles, scars and eels

In early June 2022, Cynosure announced the release of the PicoSure Pro, which is positioned as the world's first picosecond laser to remove wrinkles, scars and eels. The machine delivers energy in one trillionth of a second, using pressure instead of heat to provide safe and effective treatment for unwanted pigmentation and skin revitalization for all skin types. Read more here.

Procedures

Laser resurfacing, rejuvenation

In cosmetology, the most popular procedure is skin rejuvenation, which can be achieved by laser skin resurfacing. For this procedure, two types of lasers are mainly used SO2 and erbium

Laser skin resurfacing is laser removal of wrinkles and scarring after acne. The essence of the method of laser skin resurfacing boils down to the fact that a laser beam, penetrating into the surface layers of the skin, leads to the evaporation of its cells. Thus, the old layers of skin are eliminated, and after that a new one is restored. This evaporation effect is called ablation.

In addition to the evaporation effect of old skin cells, laser radiation contributes to the appearance of other effects near the area of ​ ​ influence. This leads to the disappearance of fine wrinkles and smoothing of deeper wrinkles. In addition, the laser acts on the scars after the eels, which after such treatment become almost invisible.

Since the skin is 77% water, those lasers are selected for grinding, the radiation of which is well absorbed by water and, therefore, skin. The energy and duration of the laser pulses are selected so that the radiation is completely absorbed in the upper layer of the skin.

In the absorption area, there is a rapid rise in temperature to a few hundred degrees, causing the tissue to evaporate almost instantly. The rate of evaporation (vaporization) is so high that the heated layer turns into steam, not having time to give heat to the deeper layers of the skin. The erbium laser emits at a wavelength of 2.94 microns. This radiation is absorbed by water with an absorption coefficient of 12,000 cm-1, that is, 10 times more efficient than the radiation of a CO2 laser. In this regard, the radiation of the erbium laser penetrates to a smaller depth (about 1 μm), without thermal damage to the surrounding tissues. Therefore, an erbium laser is sometimes called a "cold" laser.

Among those skilled in the art of laser skin resurfacing, there is no consensus as to which of the above two lasers is preferable. It is believed that thermal damage to collagen fibers when polished with a CO2 laser gives a greater rejuvenating effect than "cold" polishing with an erbium laser. On the other hand, there is a growing number of doctors who prefer the erbium laser as safer. It is recognized that after erbium grinding there is a lower percentage of complications than after grinding with a CO2 laser.

Laser hair removal

For laser hair removal, mainly 2 types of lasers are used

It is based on the use of powerful light pulses of a certain spectral range to suppress hair growth. The red light of the alexandrite or ruby laser is well absorbed by the melanin present in the hair roots and hair bulbs, but at the same time it freely penetrates the superficial layers of the skin. The energy of the light pulse is absorbed by the hair follicles and converted into thermal energy, which leads to their heating and destruction. As a result, further hair growth is stopped.

The duration and energy of the laser pulse are selected so that the follicles have time to collapse without damaging the surrounding areas of the skin. But unfortunately, the laser is not able to cope with colorless thin cannon hair, since it does not see anything colorless and besides, it stimulates their growth with its energy, and they turn into thick solid terminal ones.

Since the laser uses exclusively light to remove hair, this procedure does not cause skin irritation, which other epilation methods can cause.

A spot with a diameter of up to 15 mm is illuminated in one pulse (depending on the laser power and the replaceable fiber-optic tool used). In this case, the entire illuminated area of ​ ​ skin is processed at once, and there is no need to aim at each individual hair. This makes it possible to treat a large area relatively quickly in a few minutes, observing the accuracy of manipulations.

Removal of vessels by laser

KTR laser (vascular laser)

Removal of vascular defects on the skin is effectively carried out using a cosmetic KTP laser - this is a well-known neodymium grenade laser (Nd: YAG) paired with a nonlinear crystal of potassium phosphate titanyl (KTP), which doubles the frequency of the emitted light to a wavelength of 532 nm located in the green region of the spectrum. The vascular laser is well established in the coagulation of facial telangiectasias, the treatment of rosacea and wine stains. The high sensitivity of melanin to this wavelength makes this laser effective in correcting pigment pathologies. But for the same reason, the laser cannot be used for patients with dark skin types.

Laser treatment of vascular disorders is based on thermal action of laser radiation on vessels without changing the structure of adjacent tissues. The green radiation of the KTR laser penetrates the surface layers of the skin and is well absorbed by hemoglobin of the blood. As a result, a large amount of heat is released in the damaged blood vessel, the blood is coagulated, and the inner wall is destroyed. In the future, the pathological vessel becomes overgrown with connective tissue, and the skin takes on a natural color.

In practice, it is important to take into account the time of thermal relaxation of the vessel, which corresponds to the period required for the transfer of heat outside the vessel. This time depends primarily on the diameter of the vessel and can vary from 1 ms (for a vessel with a diameter of 50 μm) to 80 ms (for a vessel with a diameter of 400 μm). When irradiated with too short pulses with a very intense laser, the blood vessel absorbs a sufficiently large amount of energy that does not have time to dissipate. Because of this, the temperature and pressure inside the vessel increase significantly, which leads to the rupture of its wall and to microenvironment. Clinically, this manifests itself as purpura or microhemorrhagia.

With an increase in the duration of the laser pulse, a selective coagulation mode can be obtained when, with a gradual increase in the temperature of the vessel wall, it solders and disappears. The pulse duration should be longer than the relaxation time of the vessel, but limited, otherwise a large amount of heat is vainly dissipated to the outside, and significant changes can occur in the vast area of ​ ​ the surrounding dermis. At the site of laser exposure, the natural color of the skin is restored. The tissues around the vessel practically do not absorb laser radiation and remain intact, so scarring does not occur after surgery formations.

PDL Dye Laser

The wavelength can range from 585 to 595 nm, the yellow spectrum of radiation. The popular vascular laser, like the KTP laser, fights well against telangiectasias on the face, rosacea and wine spots. Disadvantages are the high risk of burns and the difficulty of generating a long pulse for coagulation of large vessels. To this end, individual manufacturers produce quasi-long pulse lasers (a series of consecutive short pulses). Another drawback of lasers operating at this wavelength is the high scattering ratio, which prevents deep-lying targets from being coagulated. The technology is more of historical value as it can easily be replaced by modern 590 nm broadband light systems. Clinical studies have shown that broadband light systems are not inferior in efficiency to dye lasers.

Alexandrite laser

The wavelength of 755 nm has a greater penetration depth and can reach deeper and larger targets in comparison with the first two lasers. Also, the great advantage of alexandrite lasers is the ability to coagulate blue vessels on the legs, which is impossible for the first two. Alexandrite laser is successfully used for epilation and removal of vessels. The disadvantage is the risk of burns on dark skin types and short pulse length, which makes you work at tougher capacities with large targets. This problem has been solved by individual manufacturers. To date, there are alexandrite lasers with a pulse length of up to 200 ms.

Diode lasers

Wavelength 800-810 nm, the price/quality ratio is an undeniable advantage. The appearance of long-pulse (up to 100 ms) and ultra-long-pulse diode lasers (10-1000 ms) expanded the range of use of these devices from laser epilation procedures to laser coagulation of vessels. The diode laser confidently occupies an intermediate position between lasers coagulating "red" vessels and lasers coagulating "blue" vessels. By increasing the pulse duration, these lasers can work on dark skin types. The MedArt VAriMed laser belongs to ultra-long-pulse lasers, which allows it to remove vessels of various diameters on the face and legs.

Neodymium lasers

Wavelength 1064 nm, undeniable leaders in safety and the ability to work on dark skin types, up to VI phototype. Another advantage of neodymium lasers is the depth of penetration of the laser beam. Nodymal lasers show good results when removing vessels with a diameter of 0.5 mm or more. Smaller diameter vessels require a high energy density, which increases the risk of burns. It should also be remembered that long-pulse neodymium lasers used to remove vessels cause grade 3 burns, i.e. necrosis of all layers of the skin with the formation of hypotrophic scars.

IPL (Broadband Pulsed Light)

The low cost of broadband pulsed light procedures is not synonymous with the low efficiency of vascular photocoagulation procedures. IPL systems use different wavelengths to remove vessels: 530 nm, 550 nm, 560 nm, 570 nm, 590 nm, etc. Broadband pulsed light devices are not equal when it comes to multiple small and common vascular facial pathologies - rosacea, cuperosis, erythematosis, wine spots. Thanks to the large crystal area, these devices quickly and efficiently coagulate the vessels. Often, one to three procedures are enough for photographic rejuvenation of the face. With multiple telangiectasias of the face and rosacea, it is not possible to qualitatively treat a large area with a laser beam.

IPL drawbacks

Abundance of low-quality systems in the market with non-standardized energy density. This, as a rule, distinguishes systems in price.

• Risk of burns higher than neodymium, diode and alexandrite lasers
• High dissipation prevents removal of vessels on the legs

Laser tattoo removal

To destroy the dyes that form the basis of the tattoo, the laser must emit light that is absorbed by the dye. Granules of tattoo dyes selectively absorb laser radiation, break into small fragments and are gradually removed through the lymphatic system.

To output radiation in such lasers, a hinged mirror light guide is used, which allows you to deliver laser radiation to the doctor's work instrument.

Compared to other methods, laser removal of tattoos is a safer method, since laser radiation affects only the dye, and not the surrounding skin. The laser allows tattoos to be displayed without scarring or scars. Complete excretion of most tattoos and dermal pigmentation requires 2-5 sessions. More than 10 sessions may be required to produce large tattoos.

Laser scar treatment

The use of erbium ER: YAG and SO2 lasers in cosmetology and aesthetic surgery allows painless and minimally traumatized skin to remove the upper skin along with areas of pigmentation, scar tissue, fine wrinkles, stretch marks. In addition, erbium ER: YAG, carbon dioxide SO2 and neodymium ND: YAG lasers contribute to the reduction of collagen fibers located in the deep layers of the skin, which leads to a visual tightening effect. The use of modern laser equipment allows you to follow an individual approach to the treatment of each patient, programming the dose, spectrum and duration of exposure to the surface of the scar or (and) skin.

Erbium laser

To date, erbium ER: YAG is the most optimal laser for the treatment of scarring and stretch marks.

Erbium laser refers to ablative lasers, when exposed to the skin or surface of the scar - it evaporates. The procedure for such treatment of scars is called laser resurfacing. (Ablation is a complex physical effect in which layer-by-layer evaporation of the surface to which the laser beam is directed occurs).

Repair processes in treated areas form a new, more elastic dermis (new collagen) and a new epidermis without discoloration. Not exposed to healthy tissue, accelerates the processes of re-epithelialization, usually reducing the rehabilitation period to 2-4 days. While maintaining all the positive qualities, the erbium laser allows you to work with the skin very thinly. The mechanism of action of the erbium laser can also be based on selective photothermolysis. The depth of its effect on the skin can be limited to 5 microns. Another positive quality of erbium is its gentle effect on the skin. It results in minimal tissue burn and vascular coagulation. Therefore, erbium resurfacing even on large surfaces can be carried out without anesthesia. For this property, erbium grinding is also called "cold." The period of rehabilitation after resurfacing with an erbium laser is shorter by half compared to a CO2 laser. Another advantage when working with an erbium laser is that there are no demarcation (separation) lines between the treated and unprocessed surfaces. Erbium laser is very effective in removing postoperative scars, treating skin stretch marks and many other problems. But it has no skin compression effect, so the use of an erbium laser is preferable at normal or slightly higher than the average skin fat content. And this is the only laser that allows you to work on thin, dry skin.

The action of erbium laser light is not a purely thermal process, it is due to thermomechanical effects. The wavelength of the erbium laser is 2940 nanometers, this coincides with the maximum of the water absorption spectrum. The sparing effect of the erbium laser is due to the short duration of its pulses, during the absorption of which part of the water contained in the tissue undergoes a jump-like transition from a liquid state to a vapor state. In this case, due to the rapid expansion of water, a sufficiently high pressure arises for a short time, and fragments of biofilm are ejected from the laser impact zone due to the pressure drop. This mechanism is at the heart of working with both soft fabrics (instead of cutting tools) and hard fabrics (instead of a drill machine).

Effects on erbium and carbon dioxide laser tissues. It can be seen that the thermal impact from the erbium laser is less, which leads to less tissue injury and rapid recovery after the procedure.

Carbon dioxide (SO2) laser

SO2 laser is also ablative, i.e. when it is exposed to the skin or surface of the scar, it evaporates.

In the early 1990s, this laser was the first to be used to treat scarring. Since then, such lasers have undergone certain changes and modifications, but the carbon dioxide (SO2) laser has retained a number of very serious shortcomings in its work and is indicated mainly for the treatment of scars in patients with oily skin and deep onion scars. SO2 laser is the toughest laser system currently in existence, i.e. it damages surrounding tissues more than the rest of the lasers. The depth of its effect on tissues is 20 microns. For laser devices of the first generation, with all the advantages, a serious problem remained - the "demarcation" line (similar to mechanical grinding), but now, on carbon dioxide (SO2) lasers, the so-called super-pulse mode is used, which allows you to reduce the depth and grass of tissues. The main advantage of the CO2 laser is the effect of traction (compression) of the skin. This leads to narrowing of pores and a significant decrease in skin oiliness. This effect is very important for porous and oily skin. It works at a length of 10600 nm and primarily acts on tissues containing water.

Neodymium Laser Nd: YAG

Neodymium Nd: YAG laser is a non-ablative laser, that is, when it is applied to the skin or surface of the scar, the tissue covers are not damaged, and the laser beam penetrates into the skin or scar, having a selective effect on the internal structures of the dermis or scar tissue.

The effect of a neodymium laser with a wavelength of 1064 nm is based on homogeneous photothermolysis. Due to the use of an ultra-long pulse with a pronounced thermal component, a controlled burn occurs in tissues, manifested in the form of partial coagulation of the microvascular channel, destruction of fibroblasts and partial direct denaturation of the collagen structure. Aseptic inflammation develops in the area of ​ ​ exposure, which leads to the development of young collagen with an optimized spatial location, filling and elongation of fibers, early revascularization of tissues, activation of the appearance of young fibroblasts. That is, the neodymium laser in the treatment of scars destroys the vessels, and this leads to a violation of blood flow in them, which prevents the supply of nutrients to the scar and the deposition of collagen, reduces its growth, accordingly reduces the scar itself, and also achieves a dermoplastic effect.

The use of a neodymium (Nd: Yag) laser with a wavelength of 1064 nm for the treatment of scars, the treatment of vascular pathologies, epilation, non-ablative laser rejuvenation of the skin, removal of tattoos, acne therapy in active form, is now, according to general recognition, the most modern, effective, safe and popular method, gaining increasing recognition among leading specialists in the field of laser medicine.

The wavelength of a neodymium (Nd: YAG) laser is most optimal in terms of efficacy and the absence of any side effects inherent in some other types of lasers also used to date in laser aesthetic medicine.

As can be seen from the above illustration, the neodymium (Nd: YAG) laser, due to its low absorption in the skin, compared to other types of laser systems and intense light systems, has the ability to penetrate directly to the hair follicle, pathological vessel, for example, in the scar, or tattoo pigment, depending on which use of neodymium (Nd: YAG) laser in aesthetic medicine we consider. Accordingly, it is possible to completely and without any scattering in the skin, and its potentially dangerous heating, to convey all the energy of the pulse of the neodymium laser to the object that we chose as a target, in the case of the illustration, this is a hair follicle. At the same time, skin color has practically no significant effect - this makes a neodymium (Nd: YAG) laser with a wavelength of 1064 nm unique in terms of the possibility of performing procedures on all skin phototypes from I to VI, which was confirmed by the FDA, which allowed the use of neodymium lasers for permanent laser hair removal on all skin phototypes.

Pulsed Dye Laser

(BRILLIANT and BRIO) (wavelength 585 nm) refers to so-called vascular lasers, causes a photothermolysis process leading to microvascular thrombosis. In early 1980, it was noted that with the use of a pulsed laser on dyes, scars become less red, softer and less hypertrophic. The laser destroys the vessels, and this leads to impaired blood flow, prevents nutrients from entering the scar and collagen deposition. After treatment, there is a decrease in the size of the scar, an improvement in its elasticity and relief of itching.

After laser treatment

Within two to three days after laser treatment, mild redness, minor swelling may occur. The place, processing may look refreshed or sunbathed. This effect can be observed for 7-10 days. Peeling, which can be observed during the week, is eliminated with the help of light scrubs. Makeup can be applied the day after the procedure.

After the procedure, direct exposure to sunlight should be avoided and high UV protection sunscreens (at least 30) should be used for 3 months after treatment. As the skin feels dry, a light moisturizer should be applied. Heavy fat-based ointments are not recommended as they can close the pores of the skin. Coarse scrubs should not be used for at least a week after the procedure. You should refrain from smoking and taking alcohol. Be sure to consult your doctor before starting new medications.

Contraindications

Contraindications to laser treatment:

• Epilepsy
• Pregnancy
• Inflammatory processes in the proposed treatment area
• Malignant formations in the treatment area
• Performed less than 2 weeks prior to treatment with chemical peels and similar procedures
• Psoriasis
• Atopic dermatitis in the stage of exacerbation.

Market Valuation

2022: Laser hair removal market growth by 14.6% to 24 million procedures

In 2022, 24 million laser hair removal procedures were carried out in Russia, which is 14.6% more than a year earlier. In comparison with 2018, the market volume doubled. Such data in July 2023 were cited by analysts at the GuideMarket marketing research agency.

According to experts, since 2018 there has been a difference between the growth rate of market volume in comparable prices and the growth rate of the market in physical terms. This is due to the annual increase in the average check in the market. In 2022, the average check on the market remained at the level of 2021.

There are two types of players on the market of studios and salons providing laser hair removal services: studios with a registered medical license and studios without a license, using devices that are not registered as medical devices. According to GuideMarket experts, the share of studios without medical licenses in Russia ranged from 50 to 69% from 2017 to 2022, averaging 63%.^[3]

Among the major trends and market prospects of laser hair removal studios, analysts note the following:

• The market size is increasing annually, which in the context of economic problems in the state indicates a significant potential of the industry and prospects for continued demand growth in the coming years.
• Laser hair removal is the most promising method for removing unwanted hair;
• Some modern studios eventually become multidisciplinary institutions that offer a variety of not only laser hair removal services, but also a significant number of cosmetic services, services using hardware technologies, etc.
• Franchise business development. The start of franchise establishments in the future will be very popular with many business owners. So familiar and proven brand and guaranteed quality of services always attract a stable clientele.
• Technology development. Online video lessons, mobile applications, social media activity are all integral to the promotion of any successful studio.

Notes