As we age, our skin becomes thinner and less elastic. This is due to collagen and elastin, the tissues that keep the skin firm, becoming weaker. You may begin to notice fine lines and sagging skin on your face and neck. You also may notice uneven skin tone, sun damage, and visible blood vessels.

Dermatologists can perform variety of surgical and non-surgical facial rejuvenation treatments to help your skin look healthy and youthful.

WHAT COMMON AGING CONCERNS CAN DERMATOLOGISTS TREAT?

Treatments provided by dermatologists can:

• reduce wrinkles
• treat sun damage
• restore fullness to the skin
• improve skin tone and the appearance of blotchiness
• eliminate visible blood vessels

HOW DOES A DERMATOLOGIST TREAT AGING SKIN?

Many factors influence the treatment that your dermatologist recommends to rejuvenate your face, including your age, health, skin type, and the amount of sun damage you have had. Your dermatologist can also recommend rejuvenation procedures for the skin on your neck, chest, shoulders, or hands. In some cases, more than one treatment may be used to produce more effective and longer-lasting results.

Your dermatologist can perform many of these facial rejuvenation treatments and procedures in their office. This offers you a convenient and cost-effective approach with little or no downtime.

WHY SHOULD I SEE A DERMATOLOGIST FOR FACIAL REJUVENATION?

The American Academy of Dermatology urges anyone considering cosmetic surgery to choose a board-certified physician. Dermatologists are doctors who have expertise in the medical, surgical, and cosmetic treatment of skin, hair, and nails.

There are many cosmetic procedures available in spas, shopping malls, and walk-in clinics. While these may offer convenience, you should be aware that many of these procedures are performed by non-physicians. There also may be limited equipment, training, and supervision available to handle complications or medical emergencies. This can jeopardize your health and appearance.

The AAD recommends that you do your homework and consider a doctor’s training and credentials before deciding if a particular physician is the right choice for your facial rejuvenation.

WHAT TYPES OF TREATMENTS ARE AVAILABLE IN A DERMATOLOGIST’S OFFICE?

Facial rejuvenation procedures fall into the following categories:

Topical Products

Topical products can begin to treat early signs of aging, reducing the need for rejuvenation procedures or increasing the

time between them.

Topical products are best for treating:

• early and mild signs of aging, such as fine lines or wrinkles

The most important product your dermatologist will recommend to you is sunscreen. Studies have shown that daily use of sunscreen can significantly slow the process of skin aging among middle-aged men and women. Even those individuals with significant sun damage showed some skin improvements after using sunscreen daily.

Look for a broad-spectrum (protects against the sun’s UVA and UVB rays), water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or higher. Apply it every day to exposed skin, especially your face, neck, chest, and hands.

In addition to sunscreen, talk with your dermatologist about over-the-counter products that include the following anti- aging ingredients:

• Retinoids (stimulate collagen production)
  • There is also a prescription retinoid, tretinoin, which has been approved by the U.S. Food and Drug Administration for aging
• Antioxidants (prevent free radical damage)
  • Vitamin C, Vitamin E, idebenone, ferulic acid, phloretin, Coenzyme Q10
• Hydroxy Acids (exfoliate dead or damaged skin cells)
  • AHAs (Alpha Hydroxy Acids)
  • BHAs (Beta Hydroxy Acids)
• Peptides, Growth Factors, and Stem Cell Extracts (promote turnover of aging skin cells)

Fillers

Fillers are injected into your skin. The type of filler used depends on your age, health, and rejuvenation needs. Fillers can:

• Replenish lost fullness in your face
  • Best for under the eyes, and around or in the lips
• Lift your brow or a downturned mouth
• Reduce the appearance of scars

There is little or no downtime with this treatment. Some fillers provide temporary results while others can last longer.

Botulinum Toxin Rejuvenation

For this treatment, tiny amounts of botulinum toxin are injected into specific muscles in order to relax the muscles and reduce the appearance of the fine lines and wrinkles associated with facial expression.

Botulinum toxin can:

• treat vertical lines between the eyebrows and on the bridge of the nose
• eliminate forehead lines and furrows
• soften the appearance of crow’s feet
• diminish visible bands on the neck

There is no downtime with this treatment. Results are visible within one week and last between three to 6 months.

Chemical Peels

A chemical peel is a treatment used to improve your skin’s appearance. A chemical solution is applied to the skin that causes the top layers of skin to flake or peel away.

A chemical peel can:

• reduce the appearance of fine lines, especially under the eyes and around the mouth
• reduce the appearance of sun damage, age spots, freckles, or blotchiness
• brighten a dull complexion
• smooth rough-feeling skin

There are different types of chemical peels and different strength levels. Your dermatologist will choose the proper chemical solution and depth of your peel, based on the type of skin damage you have and your desired results. The depth of your peel will determine the amount of downtime following this treatment.

Microdermabrasion

Microdermabrasion is a non-invasive procedure that gently exfoliates the skin to diminish signs of aging. Microdermabrasion can:

• brighten skin’s appearance
• diminish the appearance of fine lines

This is treatment requires little or no recovery or downtime. Your dermatologist may recommend multiple treatments spaced two to three weeks apart to achieve your desired results.

Microneedling

Microneedling is the use of a rolling device with multiple tiny, disposable, sterile needles that rolls over the skin quickly and painlessly to stimulate new collagen formation.

Microneedling can:

• reduce the severity of wrinkles (particularly around the mouth)
• tighten pores
• improve the appearance of scars (from acne, surgery, burns, and other trauma)

This treatment can be combined with other skin rejuvenation techniques, such as fractionated lasers to enhance results. Little recovery time is needed. Your skin may be pink or red for a few hours or a day following treatment.

Non-ablative Lasers

This treatment uses a laser to damage the collagen beneath your skin. This stimulates the growth of new collagen. Non-ablative lasers can:

• tighten skin
• diminish the appearance of discoloration
• reduce the appearance of some scars

Because this treatment only heats the layers underneath the skin and does not damage the outer layer of skin, recovery from this procedure takes only a few days. However, results tend to appear gradually and may require additional treatment to achieve your desired appearance.

Ablative Lasers

Ablative lasers use an intense wavelength of light to remove the outer layers of skin. The laser also stimulates the underlying skin, resulting in new collagen being formed. As the skin heals, new skin forms that is smoother and tighter. If you have skin of color, talk with your dermatologist about whether this treatment is right for you.

Ablative lasers can:

• reduce the appearance of sun damaged skin and wrinkles
• tighten underlying skin
• repair rough-feeling skin
• diminish the appearance of scars, especially acne scars

This treatment requires general anesthesia and your skin will be raw and weeping for several weeks. Your dermatologist will provide you with topical treatments to apply to your skin as it heals. After several months, your skin should be fully healed and your results noticeable.

Fractional Rejuvenation

Fractional resurfacing treats small areas of skin by focusing the laser on columns of your skin. These columns of treated

skin create new collagen.

Fractional rejuvenation can:

• minimize the appearance of sun damage, acne scars, and fine lines
• improve rough-feeling skin
• tighten skin
• treat actinic keratoses, precancerous skin growths

This procedure does not require any downtime.

Intense Pulsed Light (ipl)

This treatment uses light waves that target redness or melanin (the pigment that gives color to your skin) in the skin to

reduce its appearance.

IPL can treat:

• sun damage and discoloration, including freckles and brown spots
• redness from rosacea or broken blood vessels
• flushing due to rosacea

IPL requires several treatments to achieve visible improvements. This treatment does not require any downtime.

Light Emitting Devices (LED)

Also called Color Light Therapy, this treatment is available in four wavelengths of ultraviolet (UV)-free LED lights. The color of the light used depends on your skin concern. This is a treatment available in the dermatologist’s office and there are also at-home devices you can purchase. Talk with your dermatologist if you are considering an at-home device. Your dermatologist can discuss whether an at-home device will be best for your skin.

LED can:

• boost collagen production
• treat fine wrinkles
• improve the appearance of skin discoloration
• clear acne by destroying bacteria on the skin This treatment does not require any

Plasma Technology

This treatment uses plasma energy to remove sun damaged skin on the surface as well as boost collagen growth. Plasma technology can:

• improve the appearance of fine lines
• even out skin discoloration
• promote skin tightening, especially along the jowls This treatment does not require any

Radiofrequency

This treatment uses radio waves to penetrate deep into the skin promoting collagen growth.

Radiofrequency can:

• tighten skin to produce a “lifting” effect on the face, brows, and cheeks
• improve the appearance of sagging skin, especially on the neck This treatment does not require any

Photodynamic Therapy (PDT)

This treatment involves applying a topical medication, 5-aminolevulinic acid (ALA), to the skin. The skin is then treated with a light or laser, depending on your skin concerns.

PDT can:

• reduce the appearance of sun damage
• treat fine lines
• improve rough-feeling skin
• treat actinic keratoses, precancerous skin growths
• minimize the appearance of pores and reduce oiliness This treatment does not require any

Neck & Jowl Treatments

A growing number of rejuvenation procedures are available to improve the appearance of the neck and jowl areas. Depending on your desired result, treatment options may include a combination of different techniques, such as fat- freezing, injections, laser resurfacing, or tumescent liposuction.

WHAT ARE THE RISKS OF FACIAL REJUVENATION?

All medical procedures have associated risks. In general, the more invasive the procedure, the greater the

associated risk.

Following some of these procedures, you may experience some temporary side effects, such as mild redness, swelling, bruising, and minor discomfort. Scarring, persistent redness, or permanent pigment changes are possible with more invasive procedures.

Talk with your dermatologist to determine which facial rejuvenation treatment is right for you and to learn tips to minimize the risks.

A dermatologist is a physician who specializes in treating the medical, surgical and cosmetic conditions of the skin, hair and nails. To learn more about facial skin rejuvenation, log onto aad.org or call toll free (888) 462-DERM (3376) to find a dermatologist in your area.

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Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

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