Photo Aging and 3-Dimensional Rejuvenation

In the August 2011 Cosmetic Dermatology journal there was an excellent article entitled “Photo aging and 3-Dimensional Rejuvenation” by Nels Kruger, PhD and Neil S. Sadick M.D. I really liked how it was presented noting that aging and sun damage isn’t just one dimensional so we need to approach the “slowing down” of those changes by treating each affected skin layer. I want to share this approach with you via the treatments available at CDLC.

Type 1 Rejuvenation. Think of the very top layer of skin (epidermis) as your “tablecloth”. With use it becomes spotted, discolored, finely wrinkled, dull looking, even “thread bare” in some areas. This is where microdermabrasion, superficial skin peels, dermaplaning and a good home care program comes into play. Non ablative lasers help with the discoloration (both red & brown) such as age and sun freckles and broken blood vessels. Just as some table cloths require multiple spot treatments and/or long soaks, you will see continued improvement and maintained improvement if multiple superficial treatments are preformed regularly. We love the combo peels: Mini Melanage, Gloss and the VI Peel, dermaplaning and the SilkPeel microdermabrasion.

Type 2 Rejuvenation. This is the “table pad” layer where our dermis, with its fibrous network of collagen, elastin, glycoaminoglycams, veins, arteries and nerves all support the overlying epidermis. This layer is vulnerable to unprotected long term UV radiation particularly UVA. Care requires regular use of topical UV protection by sun block and/or clothing, the tretinoin creams, antioxidant and DNA repair creams. Repeated non ablative laser treatments such as CDLC’s Gemini laser and medium depth chemical peels.

Type 3 Rejuvenation. This reminds me of treating an old sun exposed wicker table. In the skin, the focus is not only on the broken-down collagen fibers in the deep dermis but actual volume loss which occurs from UV triggered lipoatrophy, the downward migration of the cheek fat pads and the receding of the facial bones (the eye sockets sink, the jaw & chin recede). This rejuvenation requires the ablative lasers such as the fractionated CO2 lasers. At CDLC, this is called the Pixel which is the name of the hand piece that fractionates the CO2 laser beam into pinpoint wounds. The wounding is necessary to stimulate the growth of new collagen more deeply. We have learned to address the volume loss with fillers of various density depending on the amount of loss and the area involved. Generally this primarily involves the upper cheek area and around the mouth (although it has been fun to smooth nose irregularities, plump up earlobes and soften jowl lines.)