Skin Rejuvenation - 101

Skin Maintenance and Chemical Peels

Some of us are simply interested in a refreshed look. This can be easily achieved by daily use of sunscreens and topical retinoids at night (if tolerated). Occasionally, we need to promote turnover of skin cells by targeting the top layer of skin using the time-tested method of peeling. Gentle chemical peels made of glycolic acid or more potent TCA peels can improve appearance by removing some superficial skin to erase dullness. Another method of exfoliation, microdermabrasion uses ultra-fine aluminum oxide crystals to selectively remove dead layers of skin. This process simultaneously stimulates production of elastin and collagen to effectively promote development of a firmer, more youthful looking skin.

As we progress through life, we might want ‘to turn back time’ and look 10 years younger. Fortunately, treatment options for this dramatic rejuvenation are manifold and can be tailored to one’s goals, age, lifestyle and even ability to tolerate downtime. A treatment plan may incorporate several different modalities: skin resurfacing techniques; laser removal of pigmented spots; laser skin tightening; strategic use of synthetic fillers, volumizers and Botox injections.

Skin Resurfacing for Dramatic Results

Skin resurfacing devices, like the paragon carbon dioxide (CO2) laser, effectively deliver dramatic results. They use controlled damage to trigger the skin’s healing response, a process that eventually leads to skin remodeling and improvement in various signs of aging. Laser resurfacing offers a precise, effective and long-lasting approach to skin rejuvenation. Since this technique directs short and concentrated pulsating beams of light at irregular skin, laser skin resurfacing removes skin very precisely. Specially designed pulsed CO2 lasers can vaporize skin layer-by-layer while causing minimal damage to untargeted skin tissue. While fractional resurfacing with Fraxel uses a very narrow column of light to heat layers of the skin to stimulate collagen production, the cool light of erbium laser treatments facilitate removal of uneven pigmentation and superficial roughness from aging and sun-damaged skin. Plasma resurfacing is a relatively new technology that delivers plasma, a high energy ionized gas, through the epidermis into the deeper layers of the skin where collagen production is stimulated. Indeed, CO2 lasers, erbium lasers and plasma devices can deliver dramatic results in a fractional, ablative or non-ablative manner with downtime inversely correlated to the number of treatments needed.

Skin Tightening

Skin tightening will further enhance the effects of skin resurfacing and are built in with CO2 laser treatments. When length of healing is a concern, radiofrequency can be used to tighten the skin, albeit the results may not be as reliable or long lasting.

Skin Luminosity - Brown, Sun, and Age Spots Treatment

Luminosity of the skin has been shown to directly correlate with a youthful appearance. Most rejuvenation plans therefore incorporate removal of brown/age/sun spots. If downtime with CO2 or erbium laser resurfacing are unacceptable, treatments including a range of laser or non-laser intense pulsed light sources (IPL) may be chosen. Many skin problems of adulthood, such as fine lines, blotchiness, age spots (liver spots, dark spots), surface roughness, wrinkles, and dull, lifeless skin, can be attributed to sun exposure. The unique ability of specific lasers and IPL to specifically target pigment in the skin results in safe, effective and rapid treatment of unsightly skin lesions that have brown pigmentation.

Wrinkle Treatment - Fillers - Botox , Restylane, Elevesse, Radiesse, and others

Stubborn wrinkles and fine lines often require more help than is available at the cosmetics counter. Modern technology has provided an array of fillers and volumizers that can be used over the entire face to strategically and effectively correct static lines and volume loss. In recent years, several new skin fillers have received approval by the U.S. Food and Drug Administration (FDA) for treating facial wrinkles and are safe and effective options for combating aging skin. Wrinkles are thought to result from the loss of three crucial skin components: collagen, elastin and hyaluronic acid through external and internal ageing. Cosmetic injectables offer a variety of safe, non-invasive ways to subtly optimize one’s appearance. Injection procedures with synthetic fillers have revolutionized aesthetic medicine and made cosmetic enhancements safe, easy and affordable. Of particular interest, the synthetic fillers (e.g. Restylane/Juvederm, Elevesse, Radiesse, Artefill and Sculptra) represent a new generation of alternatives to animal-based collagens. These newer products are more versatile in their weights and densities, biocompatible and longer lasting. Injectable fillers can be used to round out wrinkles, lines, and scars, or even to subtly give the face a more desirable shape.

In certain cases, treatment plans might also take advantage of removers of dynamic lines, like Botox, and fillers for volume restoration. Botox cosmetic acts as a safe, reliable medication, which blocks the actions of certain nerves. For wrinkles this means relaxing the muscles that crease the skin or pull the skin down.

Skin Rejuvenation - Summary

Clearly, skin rejuvenation can be effectively customized to individual treatment plans by combination of different modalities ranging from laser, light and other energy-based treatments to injectable fillers, volumizers, chemical peels and other non-ablative methods. The result is a smoother, clearer and healthier and more radiant skin.

A personalized treatment plan of pertinent modalities to skin rejuvenation is a veritable route to maintain youthful vitality throughout life.



Thanks to Dr. Franziska Ringpfeil MD. for contributing this article to our Anti-Aging blog:

Dr. Ringpfeil’s medical career began in Germany where she graduated from medical school and started training in dermatology. In 1990, she was invited to join Thomas Jefferson University. After completing residency and receiving board certification, she joined the faculty at Jefferson, specializing in cosmetic and pediatric dermatology.

She has authored numerous scientific papers in major professional journals, authored and co-authored several chapters in the leading textbooks for dermatology, and has lectured both nationally and internationally.

She received the Young Investigator Award by the American Academy of Dermatology, as well as an award by the AOA honor society for outstanding teaching faculty.

Dr. Ringpfeil founded Ringpfeil Advanced Dermatology in 2006. Her practice provides premium Dermatological care to Philadelphia, Main Line, and Delaware County.
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Philadelphia Skin Rejuvenation



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Prevent the Formation of Face Wrinkles

Wrinkles are permanent folds or creases in the skin that are generally caused by aging, stress, and dry skin. Certain parts of the face are especially sensitive and wrinkles are easily formed in those areas. They include the skin around yours eyes and your nose. For younger people, it is important to take proper care of the skin on your face in order to prevent the formation of wrinkles. For old people, however, whose skin has already become wrinkled in some areas, there are methods of removing or reducing those wrinkles.

Face wrinkles are caused by a variety of reasons. Aging is the primary cause of wrinkling in most people. As you age, the ability of your skin to regenerate itself begins to deteriorate, and skin no longer springs back into shape when stretched. Facial movements such as smiling or squinting stretch the skin, causing sags and folds to form, ultimately causing wrinkles. Smoking is one of the key culprits in causing such wrinkles. Tar and nicotine in cigarette smoke deprive skin cells of oxygen and nutrients, causing skin to wither and dry.

There are, however, several treatments available for treating wrinkles of the face. These treatments may vary in method and effectiveness, and you should be very careful about choosing some of the more invasive and harsher treatments.

One of the most popular treatments for wrinkles is Botox injections. Botox is a form of toxin that, when present in minute quantities, causes paralysis of the muscles that typically cause wrinkles on your face. Botox is extremely efficient at treating wrinkles, but it is a short-term, temporary solution. Botox treatments involve injecting the toxin into the facial muscles using hypodermic needles. This treatment needs to repeat every 3 to 4 months, otherwise the wrinkles will return and will be as severe as they were before treatment. Despite its popularity, Botox should only be used as a treatment of last resort, after you have exhausted other, less harsh, options.

There are also many creams that are supposed to help reduce or remove wrinkles. These creams are usually applied to the wrinkled area regularly and help moisturize and rejuvenate the skin so that wrinkles will be less visible or form less easily. Natural anti-wrinkle creams are particularly effective at preventing wrinkles from forming, and should be used by younger people who have yet to develop face wrinkles. Older people who have already developed face wrinkles may wish to consider using some of the synthetic or artificial creams that are better at reducing the evidence of wrinkles on the fact, especially around the eyes and nose where they are most visible.

You can also take some easy precautions to guard against the formation of wrinkles. First, always wear sun block when you are going to be out in the sun. Sunlight is very damaging to skin, and can cause you to develop wrinkles on your face prematurely. Washing your face too often can also lead to wrinkle formation, as soap tends to cause your skin to dry up, making it more prone to wrinkle formation.

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Thanks to Raj Kumar for contributing this article to our Anti-Aging blog:



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