Beautiflu Skin Through The Ages

Can New Laser Treatments Reverse the Aging Process?”

By Kimberly Moskowitz, MD

Let’s face it; whether we are 25, 35 or 55, we are all aging.   Rather than “aging gracefully”, most of us have more of a “kicking and screaming” attitude, evidenced by the fact that we spend over 9 billion dollars a year on anti-aging creams, potions and other treatments to keep us from looking our age.  Rather than faint when we look in the mirror with each new decade, let’s look at the process of aging skin and see what we can do about it.

As the years pass, distinct changes occur in the four layers of our skin.  The skin’s outermost layer is the epidermis.  Pigment producing cells in our skin called melanocytes live in the bottom layer of the epidermis where they determine our skin color.  Cumulative effects of the sun, age, smoking, and hormones cause melanocytes to become more active but less predictable.  This results in overproduction of melanin causing blotchy skin discoloration, “age spots”, and melasma. 

Below the epidermis, the dermis is a busy workplace where tiny capillaries nourish the skin, hair follicles grow, and nerve endings and sweat glands function.   The dermis is home to collagen and elastin, the abundant fibrous proteins that provide structural support for our skin.  Without collagen and elastin, the skin would literally collapse into wrinkles and crepey fine lines.  Cells in our dermis called fibroblasts produce collagen and elastin. As we age, fibroblasts secrete less collagen, causing our skin to sag and wrinkle.   Sunlight also takes its toll as UV rays penetrate deep into the dermis where they damaging cellular DNA, collagen, and elastin.  The visible manifestations of sun damage include sun spots, fine lines, wrinkles, thickened skin and tiny spider veins on the face and chest.

Below the dermis is a layer of fat called subcutaneous tissue.  As we age, volume in this fatty layer diminishes leaving the face, neck, and hands thinner and more fragile. The innermost layer is comprised of muscles that cause deep lines in the face as we repetitively smile, frown, and purse our lips while smoking or drinking through a straw.

In the 21st century, Laser technology has continued to keep up with a society that demands instant gratification.  Lasers work their magic on the two outer layers, the dermis and epidermis.  In the dermis, they generate thermal wounds that stimulate fibroblasts to become more active and secrete abundant new collagen.  Old collagen noticeably contracts and becomes plump and organized like young collagen.  This causes overlying skin to become tighter, supple, and more youthful.

The newest addition to the cosmetic physician’s repertoire of skin resurfacing miracles is the Fraxelä laser.  Fraxelä treats  sun spots, wrinkles, acne & surgical scarring, and early skin cancers.   Traditional resurfacing lasers (ablative lasers) vaporize the entire epidermis resulting in long and difficult post-operative periods of weeks to months.  These older laser treatments carry risk of permanent pigment abnormalities and scarring.  Non-ablative “lasers” such as IPL have little to no down-time and show excellent results in treating sun damage, blotchy pigmentation, and facial vessels, but yield only mild improvement in wrinkles and fine lines.

Fraxel™ Restore combines the efficacy of ablative lasers and the favorable side effect profile of non-ablative devices.  It takes its name from the fact that it works on only a fraction of the skin’s surface at a time.  It emits precise clusters of microscopic light beams, creating micro-thermal zones, each surrounded by tiny areas of untreated skin.  Because the epidermis surrounding these micro-thermal zones is left intact, untreated cells move in and rapidly heal the laser-treated areas.  Each Fraxel treatment takes 30 minutes to an hour.  Treatment sessions are generally scheduled every four weeks for a total of four to six sessions.  Patients leave with a sunburn-like redness and mild swelling that resolves in one to five days rather than 4-8 weeks as with traditional laser resurfacing.  Fraxel treatments not only repair decades of sun damage, but also dramatically improve wrinkles around the eyes and mouth.  In many patients, it can replace the need for surgical correction of the aging face.

Achieving beautiful skin is a life-long journey of science, art and wisdom.  On this journey it is important to remember that your skin did not age over night and so, it will not become a flawless work of art by tomorrow.  Although we cannot turn back time, Fraxel and other light treatments can erase the effects of time, leaving skin younger, healthier, and supple.  With age and a little help from today’s technology, comes the wisdom to know that aging gracefully really means being able to ask for a little help.


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