Press Release from the American Academy of Dermatology

ANAHEIM, CALIF. (July 31, 2001) – Each year, more and more people are turning to cosmetic procedures to erase the telltale signs of aging. In fact, a recent survey found that 60 percent of women polled in both the United States and Europe would consider having a procedure done if it could be performed safely and with subtle results. Thanks in part to new minimally invasive treatments pioneered primarily by dermatologists, women – and men – have a variety of options to choose from that meets their criteria.

Speaking today at Academy 2001, the American Academy of Dermatology’s summer scientific meeting in Anaheim, Calif., dermatologist Nicholas Lowe, MD, Clinical Professor, Department of Dermatology, UCLA School of Medicine, Los Angeles, discussed combining different minimally invasive treatments for rejuvenating the aging face.

"Facial aging is often the key to perceived chronological age," explained Dr. Lowe. "By combining more than one cosmetic procedure to treat a specific area of the face, patients get better results because the overall treatment is more customized."

Non-Ablative Laser Combinations

One of the newer methods used to treat aging and sun-damaged skin is non-ablative resurfacing. Non-ablative resurfacing delivers pulses of light to the skin, tightening the lower levels of the skin to improve its overall tone and texture.

Unlike traditional lasers, non-ablative resurfacing does not wound the top layers of the skin allowing for a short recuperation period.

Used in combination with botulinum toxin – which works by blocking nerve signals transmitted from the brain to the muscle, causing temporary paralysis of the injected muscle – non-ablative laser resurfacing can successfully treat fine lines around the mouth and eyes by stimulating the dermal cells that produce new connective tissue. When carefully injected in low doses by dermatologists and dermatologic surgeons, botulinum toxin has been shown to enhance the results of laser skin resurfacing. By using botulinum toxin to reduce facial muscle skin creases, the new non-folded dermal tissue will lead to the best possible skin smoothing.

When combined with fillers such as hyaluronic acid or bovine collagen (an animal form of a protein that acts as the support structure of the skin) non-ablative laser resurfacing improves wrinkles on the forehead, and around the mouth and nose. Non-ablative laser resurfacing can also be used following laser resurfacing, chemical peeling, microdermabrasion, or facelift procedures to enhance results.

Laser Resurfacing Combinations

Recent advances in laser skin resurfacing allow healing to occur much more rapidly than in the past and with minimal patient discomfort. Pulsed carbon dioxide laser resurfacing, which uses heat energy to selectively destroy the outer and middle layers of the skin, has become the standard for moderate to advanced aging skin. While these short pulse lasers successfully erase deeper facial wrinkles, this type of laser resurfacing is a procedure requiring sedation or local anesthesia and recuperation. Although with superficial carbon dioxide resurfacing, initial healing may only take one week. The Erbium Yag laser selectively removes the outer layer of the skin with less heat exchange. It can be used as a superficial or medium depth resurfacing procedure. The Erbium Yag laser improves superficial and moderately deep wrinkles on the upper lip and the "crows feet" around the eyes.

Most recently, the Erbium Yag laser has been used in combination with the pulsed carbon dioxide laser to accelerate the healing time from a pulsed carbon dioxide laser procedure by removing the heat damaged tissue.

"Patients undergoing laser skin resurfacing for crows feet lines at the corner of the eyes and forehead lines may benefit from treatment with botulinum toxin," explained Dr. Lowe. "We have found that botulinum toxin enables ‘undisturbed’ collagen repair to occur following laser skin resurfacing, which enhances results."

Combination Therapy with Soft-Tissue Fillers

Soft-tissue fillers involve injecting a filling substance under the skin to "plump up" or contour and correct wrinkles or scars on the face. New technology has created better materials and new methods are proving successful in treating a variety of cosmetic conditions.

While botulinum toxin remains one of the most popular treatments for wrinkles and fine lines, injectable bovine collagen therapy is another tissue filler that is effective for softening lines around the mouth, augmenting lips and correcting early muscle loss around the mouth. In young skin, the collagen framework is intact and the skin remains moisturized and elastic. Over time, the support structure weakens and the skin loses elasticity.