Perfecting the Art of Graceful Aging

Dr Kim Prescott discusses treatments that enhance collagen production in the skin

Multiple factors that contribute to accelerated aging in the skin are difficult to avoid, from nutrient deficiencies or changes in hormone levels, to extrinsic factors like sun exposure and environmental pollution. Over time, the active cells in the skin, the fibroblasts, become less efficient at producing collagen, elastin and hyaluronic acid, and as the structure of the skin alters it become thinner. This leads to skin laxity, with the appearance of fine lines and wrinkles, as well as uneven pigmentation.

There are so many different treatments available for improving skin quality, and one of the most commonly asked questions in my practice is which one is the best. There is no easy answer to that question, as science backs up the reality that many of these skin technologies come with clinical studies demonstrating results. It is important to remember, however, that in every study, there is a group of people who do not respond, or who do not respond as well as some of the others. In addition, some technologies are associated with higher risks of side-effects in certain people. For this reason, it is important that your skin practitioner assesses your skin carefully and selects a personalised treatment plan for you. Increasingly, treatment plans will involve combinations of treatments conducted over a period of time – often 4 to 6 months – in order to work on different anti-aging pathways, and to increase the chances of ongoing effects after the treatments are completed.

I’ll cover a few different treatments over the next few months, but recently I’ve had a few questions about 2 popular treatment modalities – microneedling and radiofrequency, so I’ll start with these two. Both modalities are well established in terms of their efficacy and safety profiles, and sophisticated new technology platforms now combine them into a single treatment for enhanced results.

Collagen Induction Therapy

Also known as collagen induction therapy, microneedling involves creating tiny channels in the epidermis and dermis of the skin. The treatment improves penetration of targeted ingredients into the dermis, activates fibroblasts, to produce collagen and elastin and stimulates the release of the body’s own rejuvenation messengers known as growth factors. Overall improvements in skin texture and tone following a microneedling treatment are clinically proven in a number of clinical studies, including a series of skin biopsies published by Dr Des Fernandes, a renowned skin research scientist, that clearly showed an increase in collagen of more than 400%.

Microneedling can be done at home or in the salon for noticeable improvements in skin, but medical microneedling is indicated to manage more specific skin concerns, including scarring and pigmentation. This procedure should be carried out in a clinical setting by a highly trained health professional for optimal results. It is very important that the correct products are used in some of these more advanced treatments, and that the practitioner adjusts for accurate depth of penetration in the different areas of the skin and for different skin concerns.

As it doesn’t use any kind of energy, microneedling remains one of the best treatments to treat skin in certain areas, including skin over the thyroid or breast area and the delicate skin under the eyes. (Figure 1)

Figure 1: Improvements in skin quality after a course of microneedling (images courtesy of Dermapen)

Volumising The Skin

Radiofrequency (RF) is a skin rejuvenation technology that has been widely used in skin tightening treatments, and for improvement of cellulite, scarring and stretchmarks. Radiowaves penetrate the skin, meeting resistance, and this generates heat. Thermal energy contracts collagen fibres leading to immediate skin tightening, as well as stimulating production of new collagen and elastin for longer term skin rejuvenation.  A few years ago, skin experts started presenting case studies combining the effects of RF and microneedling, with faster healing time, and noticeable improvement in the volume of the skin; very good news for those who prefer to avoid using injectable hyaluronic acid fillers in the face.

New technologies were subsequently developed and a number of highly sophisticated technology platforms are currently available, including Fractora and VoluDerm. The new VoluDerm Hybrid Energy treatment combines dual energy, RF first for effective penetration and controlled heating of the skin, followed by galvanic current for enhanced clinical results. The HE energy is delivered via an array of sophisticated micro-pins, with minimal disruption to the outer layer of the skin. This means that there is minimal downtime, with the majority of people going home with nothing more than a mild flush.

A number of clinical studies have demonstrated significant improvement in the volume of the skin due to increased levels of collagen, elastin and hyaluronic acid. (Figures 2 and 3)

Figure 2 Improvements in skin quality after a course of microneedling (images courtesy of Dermapen)

Figure 3 Collagen density has increased 10 days after VoluDerm HE (Eur J Dermatol 2014; 24(1): 46-52 with permission from Pollogen Ltd)

Microneedling is widely used in the following indications:

  • Skin tightening
  • Natural collagen induction
  • Lifting and rejuvenating
  • Reduces wrinkles and fine lines
  • Hyper- and hyperpigmentation
  • Improves stretch marks
  • Hair regeneration and hair thinning, alopecia
  • Acne scars, surgical scars and wound healing
  • Minimises pore size
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