New Year, New Skin

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January is the time for fresh starts and renewal. Our skin health is important, and just as we recommit to going to the gym to shed pounds, we can commit to a “skin gym” of sorts, where we commit to restoring and refreshing our skin. We all know that injectables like Botox® and Juvederm® are a go-to for reducing lines and rejuvenating the skin, however, they alone are not enough to maintain a youthful, healthy glow. Skin integrity changes over time, making it thinner and more translucent. The tone of our skin changes, as well as its elasticity. Brown spots and broken blood vessels begin to appear. Luckily, we can build collagen, smooth the surface, reduce redness and brown spots, and firm the skin. We will discuss some of the procedures that can improve the health and glow of our skin so that we can start this year afresh!

We now know how to harness the power of our own growth factors to stimulate collagen and renew the skin. PRP, or platelet rich plasma, is procedure that employs our own platelet-derived growth factors to stimulate collagen production in the dermis. PRF—platelet rich fibrin is the newest concept in skin rejuvenation, where growth factors are delivered over a longer period of time and result in more robust, longer-lasting results. PRF can be used in a similar way that we use fillers. These procedures may be combined with peels, Fraxel, microneedling, and Bella FX radiofrequency microneedling. A new option for rejuvenation includes treatment of genital areas of both men and women for enhancement of sexual function and pleasure. Yes—PRP/PRF can enhance sensation and therefore the sexual experience.

Texture changes and increased visibility of pores are things patients complain about daily. A popular and effective treatment that smooths the skin and reduces pore size is Bella Microgold. Tiny doses of neuromodulator (like Botox) and injection-grade hyaluronic acid are injected into the skin superficially to provide a perfect glow and beauty filter in real life! It is an instant-gratification procedure with consistent results. Patients who come in regularly every three or four months enjoy smoother and smoother skin. Another option is the laser series Fraxel Resore®. The laser energy from this device goes deep, and yet the fractionated technology allows for the skin to heal quickly, within two days. A series of four to six Fraxel® treatments stimulates collagen regeneration for thicker, smoother, more youthful-appearing skin. Another way to resurface is deep microneedling. In fact, the concept is the same except microneedling does not use thermal energy. Microneedling is an older technique that has become new again. Its benefits are stimulation of collagen and smoothing of fine lines. Radiofrequency microneedling is another option, which takes microneedling to the next level, with energy arcing through the collagen layer to tighten skin and remodel collagen.

Peels are lovely for the skin—allowing that glow to shine through. I, myself, do a Jessner’s peel monthly, and it keeps brown spots and fine lines at bay. This peel is very mild, with minimal to no visible flaking, but with excellent results. Deeper peels, such as TCA (trichloroacetic acid), can provide even more results, particularly in the under-eye area, but with about seven days of downtime.

Brown spots, growths, and broken blood vessels mar the complexion. The VBeam laser is the gold standard for reducing redness and broken blood vessels. It also stimulates collagen and can be performed in conjunction with a Jessner’s peel. In addition, the Perfecta device can be used to remove specific individual brown spots. IPL (intense pulsed light) is a device that rejuvenates the skin by removing unwanted freckling from sun damage and is used to rejuvenate the face, neck, chest, hands, and legs with minimal downtime. Small growths that appear, such as benign keratoses and enlarged oil glands, can be very simply removed with liquid nitrogen treatment or electrocautery, depending on the type of growth. Many people don’t realize how simple and quick it is to remove unwanted moles and growths. On the face in particular, these procedures heal beautifully, leaving minimal to no trace.

The skin has five layers on the surface that regenerate naturally about every 48 days. The dermis is the “hide” of the skin, where collagen lives. There is one injectable that more specifically targets collagen stimulation in this area. Sculptra® is a suspension of particles that induces a healing response and collagen genesis in the dermis. This results in volume restoration to the face and a thicker, more robust dermis.

Skin tightening is great for restoring a rested, youthful appearance. Sagging in the lower face as well as crepiness of neck skin appear shortly after changes in the eyelid skin. For the eyelids, Thermage® is a great firming option that has no downtime and lasts up to two years. For the neck and lower face, Ultherapy® is the strongest skin-tightening device known to us at this time. Bella FX, or radiofrequency microneedling, tightens skin, reduces pore size, stimulates collagen and reduces the appearance of broken blood vessels. Skin tightening with these devices is a great option for those who want a nonsurgical pick-me-up.

The New Year is here, and there is no doubt that getting in shape is on all of our minds. Why not get our skin in shape as well? I saw a quote once that said: “If I could firm my face with exercise, I would.” The procedures discussed above address the most common skin texture, tone, and color concerns. We are fortunate to live in a time when technology can help us be our best selves. When it comes to your face, choose a board-certified dermatologist and only trust your skin to the best. Happy New Year!

anna 2021

The statements in this article are for general informational purposes only and do not substitute for individual medical advice. Dr. Anna Guanche is a board-certified dermatologist specializing in cosmetic injectables and energy devices for non-invasive rejuvenation. Follow her @annaguanchemd.