How Lasers Work to Improve Skin

Laser technology for cosmetic usage has been around for the past 40 years, but has come into its own in the past five years, offering men and women a variety of treatments including hair removal, body sculpting and skin resurfacing. Occasionally, a patient will ask me how the laser actually works. Truth is, until recently, nobody has known the exact underlying processes that occur with lasers! Is it the laser light that motivates the collagen to rebuild or is it the heat that the laser delivers?

A researcher by the name of Susanne Dams, with Philips Research Eindhoven, conducted her own studies on lasers to find the answers.

Dams treated cell cultures and human skin with heat shocks of 45 and 60 degrees Centigrade, without using a laser light. (This is equivalent to 113 to 140 degrees Fahrenheit. Water boils at 212 degrees Fahrenheit, so 113-140 is hot but not boiling hot.) Her results show that the heat shocks increased the production of collagen. When laser light was added, the only measureable difference was the ability of the laser to pinpoint the exact location of heat delivery. This is an important part of the treatment, inasmuch as heating smaller areas of skin is safer than heating larger areas of skin. In fact, her study also showed that heating the skin to 113 degrees Fahrenheit for 8-10 seconds was the optimal amount of heat to increase collagen. Above that temperature there is no added benefit and, in fact, causes skin cell damage.

Collagen is a skin protein that gives skin elasticity and firmness, the “bounce back” that young skin enjoys. Beginning in the mid-20’s, our collagen production begins to decrease, leading to wrinkles and sagging skin.

Three ways to increase your collagen levels

Studies show that there are 3 primary collagen-builders for those of us in the over-30 crowd:

·      Laser Skin Treatments.

o   Although the CO2 laser is considered the Gold Standard for skin resurfacing, the after-effects force patients to hide from the world for 2-3 weeks as their faces crust over and peel. Not a pretty site and most people don’t have 2-3 weeks to spend for recovery. Fraxel treatments and even chemical peels can obtain similar results, with little to no downtime. Instead of one big treatment, chemical peels and fractionated laser treatments are divided into 4-6 treatments, giving essentially the same results without the recovery time.

·      Retinoids.

o   Retin-A is the only topical skin treatment that is proven to increase collagen. No matter what they tell you on TV, this is a fact. For those in need of this, I can prescribe Retin-A.

·      Hyaluronic Acid Fillers:

o   Fillers made with hyaluronic acid, such as Juvederm, Restylane and Perlane, have been shown to increase collagen. This explains why, over time, you may need less filler each time you come in for a filler treatment. It’s not because you retain the filler from the last treatment, but because your own collagen is rebuilding.

Some things that damage collagen, by the way, are sun exposure and tobacco usage. Avoid the sun and tobacco and you'll go a very long way toward keeping your looks as you age.

To your health & beauty,

Joe Danyo, MD

Could Beauty be Bone Deep instead of Skin Deep?

Like other plastic surgeons, I have focused on lifting the muscle and skin of my aging patients when performing a face lift in my Delaware plastic surgery office. Fat is often moved, as well—specifically the fat pad of the cheek—to a higher position to eliminate the flat look of the aging face. Sometimes, fat is injected to plump up that part of that face in need, such as around the temples, and between the mouth and nose, called the nasolabial folds.

However, researchers at the University of Rochester Medical Center, joined by colleagues from Harvard and Stanford, have discovered, through an evaluation of 120 individuals’ CT scans, that beauty may indeed be bone deep, and this research may change the way plastic surgeons perform face lifts.

The 120 participants were divided into three groups by age: 20-36, 41-64 and 65+. Measurements of the facial bones were taken to evaluate whether or not the facial bone structure becomes smaller with age. Scientists know that most of us will shrink as we age, and these researchers discovered that a similar phenomenon occurs in the face: the jaw bone, especially, will shrink in size, causing sagging in the lower face and a jawline that seems to disappear with the years. Their research suggests that future face lift procedures may include bone grafting or the use of plastic prosthetics to “beef up” the lower face and allow the face lift to be just that much better.