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LESS IS MORE

LESS IS MORE

An approach to associated treatments that combat skin ageing,  without surgery

LESS IS MORE 

By Geanina MARIN – pharmacist, dermo-pharmaceutical cosmetology specialist 

founder of SanaSKIN-Couture Clinic – Authorized depigmentation centre by mesoestetic Pharma Laboratoires 

The trend in beauty and the fight against the signs of ageing is now firmly towards minimal or even non-invasive treatments. This is perfectly in line with a vision of beauty that is less radical, gentler and, above all, ultra-personalised, compatible with everyday life and, of course, without heavy sequelae and social isolation. Patients are therefore looking for scalpel-free alternatives to help them enjoy their advancing years, and a facelift without surgery is one of them. 

But aesthetic medicine has not had its last word: treating ageing of the face and neck as a whole – laxity, changes in volume, quality and glow of the skin – is now possible without the slightest incision. This “full face” approach is possible thanks to the choice of the best treatments that specialists in the field will associate with it. Top of the list? Injectable procedures. But not in just any way; by using hyaluronic acid fillers, more or less different or fluid, adapted to each area. Injected at different depths to blend in perfectly with the face, they will restore harmony. No freezing effect, no swelling, no changes. Because less is more. 

The combination of hyaluronic acid with resorbable tensor thread will reposition the tissues and redefine the contours of the face, like a “mini-lift”. Chemical peels meanwhile, will improve skin quality, brown spots, texture, post-acne scars etc. 

Ageing, whether intrinsic or extrinsic, starts at the cellular level. It is a change in biological, biochemical and molecular mechanisms which, over time, involves a loss of functionality; the cell ceases to work efficiently, leading to certain changes that result in a change in skin, fat, muscle and bone. 

The main clinical manifestations observed are: reduced synthesis of the main structural elements such as hyaluronic acid, collagen and elastin, and a decreased ability to repair and renew cell tissue. Both processes lead to loss of skin turgor and the appearance of expression lines and wrinkles. A change in fat distribution leading to ptosis and the loss of the famous “youth triangle”. 

Anti-aging medical solutions composed of cocktails rich in hyaluronic acid of different molecular weights, amino acids, vitamins, enzymes, coenzymes or minerals, successfully combat the visible signs of ageing by acting on the main cellular biological processes as well as the skin’s natural processes. Skin blemishes are a common problem, triggered by many factors and whose characteristics and treatment depend on the type of blemish, phototype, age and skin type. 

Photoaging is a term used to describe clinical and dermatopathological changes in middle-aged and older adults chronically exposed to sunlight. It is characterized clinically by skin tightening, wrinkling, roughness, sagging skin, pallor, telangiectasia, color changes, lentigines and spots. Hyperpigmentation disorders are characterised by a darker skin tone, which may be caused by increased melanin synthesis or increased numbers of melanocytes in the epidermis.  Skin peels aim to improve appearance and therefore boost confidence. 

Chemical peeling  

Chemical peeling, also called chemical exfoliation, is a procedure in which a chemical substance applied to the skin causes controlled destruction of the epidermis with or without part of the dermis, leading to skin regeneration and remodeling. Chemical peels can be used to treat various skin conditions such as acne, sun damage, pigmentation disorders, stretch marks and scars. It involves the application of one or more chemicals, capable of inducing the destruction of epidermal areas and/or dermal layers and the subsequent tissue regeneration process, to treat certain skin conditions and/or to resolve or improve aesthetic issues. The components can act synergistically, acting on different layers of the skin. For example, salicylic acid may work by effectively removing keratin from the superficial layers of the skin, allowing pyruvic acid to penetrate deeper. This will allow acids, e.g. pyruvic acid, retinoic acid, to act deeper down. These components will help to stimulate cell renewal, thereby removing and exfoliating dead cells from the stratum corneum. Cell regeneration is therefore taking place, which would already occur physiologically, albeit more slowly. It then helps remove damaged or otherwise degenerated cells, which in turn are frequently replaced by normal epidermal cells. Finally, these key ingredients create a variable inflammatory response: this, by stimulating fibroblasts, is able to activate the production of autologous elastin and collagen, substances fundamental to achieving a revitalising and skin rejuvenating effect. Brightening agents can also be used in pharmacological formulations. 

Among the factors that influence the depth of the peel, and therefore the degree of its therapeutic effects, are the properties of the chemical agent used (e.g. concentration and pH), the application technique, and the condition and sensitivity of the patient’s skin. When a chemical peel is performed, proper patient assessment and thorough treatment can produce safe, reliable and satisfactory results. 

When are chemical peels indicated? 

 Peels are mainly used in the clinical-aesthetic field. The peeling procedure is a valuable method for aging skin, photoaging, acne scars and melasma, as well as for improving skin vitality, tone and texture.  

In aesthetic medicine, chemical peeling is considered a true skin rejuvenation treatment. This is made possible by the use of substances, more or less natural derivatives, which, once spread on the skin to be treated, act as exfoliants, favouring the removal of older and superficial layers of the skin. 

What is microneedling? 

It is a minimally invasive technique that involves the generation of microchannels in the skin, followed by the topical application of pharmacologically active ingredients. In other words, tiny needles create microchannels in the skin that help improve product absorption. The combined use of micro needling and ultra-customised,  “custom-made” solutions formulated in the clinic produce biostimulation that significantly increases efficacy and maximises treatment results. 

What areas and aesthetic problems can be treated? 

Microneedling is a technique that can be applied to different areas of the face and body. When used on the scalp, it slows down and combats hair loss. Applying it to the face, décolleté or hands treats hyperpigmentation, improves skin vitality and radiance or combats laxity and wrinkles. On the body, it can be used to treat localized fat and provides a firming treatment for arms, abdomen and legs, treats double chin. Any product applied during or after the treatment is absorbed more quickly and easily into the integument, making it more effective than if it were simply applied to the skin. The combination/combination of these procedures (chemical peeling and microneedling) aims to achieve in a relatively short time remarkable results in improving the quality and health of the skin, that “glowing-skin” so desired and appreciated by all of us. A sequence of 4-5 associated treatments every two weeks is recommended. 

Focus on melasma 

How is melasma characterized? 

Melasma presents as pigmented patches that grow slowly and most often symmetrically on the face, with a shade ranging from light to dark brown. 

These facial hyperpigmentations are proving to be an increasingly common problem in women from the age of 30 onwards. Oral contraception or pregnancy may be triggers. Melasma is also commonly referred to as ‘pregnancy mask’, although it can also occur outside of pregnancy. Thus, the role of hormones is regularly highlighted, even though melasma can develop without any hormonal impregnation in women. There are two main types: 

▪ centrofacial type : 63% of cases (affecting the cheeks, forehead, chin, upper lip ) 

▪ Malar type : 21% of cases (symmetrically affecting the cheeks and nose ). 

Melasma, whatever the type, generally appears at the first exposure to the sun and worsens in summer. The ideal time to start depigmentation treatment is in winter. 

STRENGTHS OF PEELS COMBINED WITH HOME CARE 

The different peels used penetrate the middle layer of the skin to reach the pigment deep down. The desired goals are to reduce hyperpigmentation and even out the complexion. Improvement is gradual and takes place over time. This type of effective and skin-friendly programme greatly limits the risk of pigmentation recurrence. 

Pluses: skin becomes smooth and radiant with a more even texture. The famous glow-up gives a fresh complexion, like coming back from holiday. 

Magistral serums at home 

Tailor-made for your skin’s thickness, colour and type, they provide the skin with the nutrients it lacks. Your skin will benefit from powerful active ingredients based on vitamins, antioxidants, hyaluronic acid and natural anti-inflammatories. These concentrated active ingredients reduce melanin production, gently exfoliate the skin and activate intracellular mechanisms to reverse the oxidative process in the skin. They strengthen and firm the results.  

Stages of a treatment  

Consultation/ Diagnosis 

Procedure 

Post treatment 

The difficulty of treating melasma depends on the correct diagnosis. It is important to distinguish between melasma and benign brown spots (benign lentigines) on the face, which can be easily treated in one laser session. 

For correct diagnosis and treatment, it is preferable to make use of technology, equipment that can analyse the skin in different light spectra, thus being able to accurately determine the depth of pigmentation spots. 

Melasma can also occur during pregnancy, a particular form called chloasma. This requires special attention as some active ingredients are not recommended during pregnancy. A consultation with a specialist dermatologist allows you to receive a reliable diagnosis. 

 Procedure 

The peeling treatment consists of applying one or more exfoliating agents in liquid or mask form after a specific preparation of the skin. It is followed by the application of topical regenerating preparations. The session lasts between 30 and 60 minutes. 

This procedure removes damaged portions of the epidermis and dermis and then replaces them with rejuvenated, blemish-free skin of better quality. 

One to four consecutive exfoliation sessions may be required. The spacing of these is not standardised as it depends on the type of melasma. 

RESULTS TO EXPECT FOLLOWING A MELASMA TREATMENT 

Removal of hyperpigmentation spots is achieved within 3 to 12 months, depending on the difficulty and extent of the melasma. The first results are visible after 4 to 6 weeks. Depigmentation is also faster for patients with a light phototype. Once pigment control has been achieved, the longevity of the result depends mainly on the behaviour adopted by the patient, in particular the assiduous application of high factor sun protection and the careful choice of dermato-cosmetic products used at home. In addition, the peeling gives an extra deep glow: the skin is brighter and the complexion more even. It also improves superficial fine lines and the appearance of scars. It’s a complete beauty treatment. 

For years, the quest to maintain a youthful appearance has persisted, and recent advances in aesthetic dermatology have catalysed the emergence of non-invasive techniques such as the use of lasers, medical radiofrequency, chemical peels and mesotherapy. These remain attractive alternatives for successful facial skin rejuvenation. 

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