COMPLEXION, PART III: Treatments for Mature Skin


Photofacial Treatments: Intense Pulsed light (IPL), BroadBand Light (BBL)
Photofacial treatment is effective in removing age spots, freckles, fine wrinkles, broken capillaries, telangiectasias (red, purple, or blue small veins on the face), hemangiomas, sun damage, and some flat birthmarks. IPL/BBL might also be useful in reducing the facial flushing and redness associated with rosacea

Photodynamic therapy (PDT) with Levulan is a two-step, FDA-approved procedure for the treatment of pre-cancerous actinic keratoses (rough, red, scaly patches on the skin) and superficial basal cell skin cancer. Off-label uses of PDT include treatment of acne, rosacea, sebaceous hyperplasia, and skin rejuvenation.

Laser resurfacing effectively removes the epidermis and a portion of the dermis, thereby removing unwanted epidermal changes and initiating regeneration of new epidermis, collagen, and elastic tissue. In addition, heat deposition offers the additional benefit of tissue tightening and collagen shrinkage. This translates clinically into the smoothing out of superficial irregularities, including wrinkles, acne scars, and age spots, and seborrheic and actinic keratoses as well as tightening the skin and improving overall appearance.

Dr. Reszko’s Tip: Familiarize yourself with the following terms:
Non-ablative resurfacing—the laser beam coagulates (destroys), but does not remove, the treated skin. Laser treatment stimulates the growth of new collagen within the dermis, increasing skin thickness and improving the overall appearance.

Ablative resurfacing—the laser beam vaporizes and completely removes treated skin. As the wound heals, new skin is visibly tighter and smoother.

The individual treatment outcome depends on the laser energy, density of treatment zones, and the type of the equipment used. In general, non-ablative laser resurfacing is less invasive and requires less recovery time but may be less effective than ablative laser resurfacing. Ablative laser treatments may be have to have to be performed under general anesthesia and/or sedation.

Skin Tightening Technologies

Non-surgical, non-invasive skin-tightening technologies are quickly becoming viable alternatives to traditional surgical approaches for loose skin. They increase collagen production, clinically leading to smoother, tighter skin with improved texture, decreased creepiness, redefining contours along the jawline and chin and softening of wrinkles and fine lines. These technologies are associated with minimal to no downtime, since the procedure bypasses the surface of the skin and delivers targeted energy specifically into the deep, structural elements where collagen is synthesized. The procedure, however, might be associated with some discomfort.

Ultherapy® is an ultrasound-based procedure that uses focused ultrasound waves to lift and tighten loose skin of the face, including brows, periorbital skin, neck, the area under the chin, and the décolletage (upper chest area). Benefits continue to build gradually over 2 to 3 months, and can continue to improve for up to 6 months after the procedure.

Thermage and Thermage CPT is a radiofrequency (RF) treatment used to tighten and shape the face and body. Radiofrequency waves safely heat the deeper layers of the skin, stimulating existing collagen and promoting new collagen production. Similarly to Ulthera, Thermage creates natural and gradual improvement that can last up to 3 years.

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