Fanny J. Berg, M.D.
If you are bothered by visible signs of aging, including wrinkles and age spots, there are a variety of treatment options that can provide a more youthful appearance.
Facial rejuvenation describes the various approaches that may be combined to provide a rejuvenated and healthy look.
Facial rejuvenation can be safely performed in the doctor’s office with minimal if any downtime and can achieve the following cosmetic results:
Some medications, such as topical retinoids (Renova®, Refissa®, tretinoin), can be applied to the skin and reduce the appearance of fine lines and superficial wrinkles. They also provide a more balanced skin tone by reducing the appearance of pigmented areas. The benefits of other cosmetic procedures may last longer in those who take topical retinoids.
Topical retinoids of sufficient "strength" to provide visible benefits are available by prescription only.
Cosmeceuticals are skin care products that are available without a prescription. These have other active ingredients, such as glycolic acids, antioxidants and peptides. These too help to improve the texture and appearance of the skin.
Dermal fillers "plump" up the lines and furrow in the face, which smoothens the skin and reduces the appearance of wrinkles.
Botulinum toxin injections diminish lines and wrinkles associated with facial expression. Botulinum toxin (Botox®, Dysport®) is used to treat vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and wrinkles around the eyes (“crow's feet”). It may also be used to diminish the appearance of bands on the neck.
Dermabrasion uses an abrasive instrument to mechanically rub away the topmost layer of skin (epidermis) to provide a rejuvenated appearance. Dermabrasion can be used to treat substantial scarring, discoloration, and sun damage. The results are generally very good and long-lasting.
Microdermabrasion uses small particles to gently “sand away” the topmost skin layer (to stimulate new skin growth. This non-invasive treatment requires no anesthetic, and involves no downtime. Multiple treatments every 2-3 weeks are usually recommended
Chemical peels use a chemical solution to remove the outer layers of skin and stimulate new skin growth. There are different strengths of chemical peels defined by the depth of skin penetration; superficial, medium or deep. Superficial peels, as the name suggests, are the mildest and are often referred to as “lunchtime peels”. The new skin that grows in response to a peel is smoother and less wrinkled, and has a more consistent texture and tone.
Chemical peels may produce reddening and peeling similar to a sunburn, which typically lasts a few days to several weeks, depending on the strength of the peel.
Intense pulsed light (IPL) is a non-invasive treatment that uses high intensity pulses of visible light to treat a variety of skin conditions, including facial lines and wrinkles. IPL may be referred to as a “photofacial” or “photorejuvenation”.
Radiofrequency waves can be targeted to the deepest layers of the skin, resulting in skin contraction and tightening. This non-invasive approach can lead to gentle lifting of the face, brow, and cheeks without downtime. Thermage is the most commonly known tissue tightening device, but there are several others now available.
Photodynamic therapy involves the application of a medicine to the skin that is left in place for a specified time. This helps to sensitize the skin to light. The area is then treated with blue light, IPL, or a laser. The procedure can provide a rejuvenated appearance and effectively treat early changes in the skin that may lead to skin cancer.
Some skin lesions, such as moles, scars, and benign skin growths, may be surgically removed (excised)
Your doctor will recommend a treatment best suited to your personal needs, desires, medical history and skin type.
In most cases, multiple procedures will be combined for the best possible outcome and long-lasting results.
In general, more mild treatments are recommended for those with minimal signs of aging or sun damage, and more aggressive treatments may be recommended for those with more advanced signs of aging or sun-damaged skin.
For instance, those with minimal signs of aging may achieve wonderful results with the use of only topical retinoids, microdermabrasion, superficial chemical peels, and/or Botox.
Those with moderate signs of aging may benefit from the addition of dermal fillers, medium-depth peels and/or IPL (photofacial).
Those with more significant signs of aging may benefit from the addition of ablative laser resurfacing and/or deep chemical peels.