This weekend my family and I got out of the Phoenix heat by distancing in a cabin in Big Bear Lake, CA. It was glorious being in the fresh air and cool temperatures! There was snow still on the top of the mountains. It was amazing! And then I fell and sprained my ankle. I wasn’t even doing anything exciting, just walking along and down I went so this year for Mother’s Day I got lots of scrapes, an air cast, a big colorful cankle and a tetanus shot! What does this have to do with skin? Nothing really, I just wanted to complain about my ankle. Actually, we can easily segue into skin because everything we as aestheticians and laser technicians do, is a controlled injury to the skin. Right about now, you may be asking “If we are trying to improve its health, why on earth would we purposefully injure our skin?!?!?” Here’s the scoop, your skin is amazing! It heals itself and, in the process, replaces older cells with new healthier cells. Healthy cells look better. It is an entire system of functions and one of those functions is to produce collagen in response to injury.
Now we know that harming the skin will prompt it to automatically produce new healthy cells that look younger and replace the old damaged cells that were there before. We’ve discovered the fountain of youth, right? Wrong. There are 35 billion skin cells in the human body…19 million for every square inch. In order to truly be the “fountain of youth”, we would have to beat the snot out of you and that’s just not feasible. We can, however, make small changes gradually over time to change the gene expression for younger healthier looking skin by making injuries of varying degrees and managing the healing process. What does that look like in terms of treatments? Well, it’ll look a little different for each individual because everyone’s skin has different challenges to target, but let’s look at some of the most common treatment protocols.
I highly recommend getting on a regular treatment schedule and getting established with a medical aesthetician. Why not a spa aesthetician? There is no difference in the basic education and licensure of a medical aesthetician and a spa aesthetician, but I’ve always said that all aesthetic school teaches you is how to pass your state board exams. The real education happens in the workplace and takes years of continued education to really cultivate strong knowledge of the skin’s anatomy, physiology, and histology. I spent the early years of my career in a spa atmosphere in Olde City, Philadelphia working under my first mentor. She was filled with skincare knowledge and I was a sponge soaking up her every word, but eventually, the spa scene felt stale to me. I craved a more medical viewpoint of the skin. Thus, began my journey into the world of medical aesthetics. This is not a separate title or license, but it is a separate discipline. It requires rigorous training and continuing education. Our facials are focused on results and usually aren’t as relaxing and enjoyable as spa facials. Conversely, you won’t see a whole lot of significant change from spa facials, but I often hear from patients that they can’t believe how different (for the better) their skin looks after a facial treatment with me. In my facial treatments I generally include a thorough cleanse, dermaplane, exfoliant, an alpha or beta hydroxy acid depending on skin type, extractions and milia removal, customized treatment mask, CO2 cryo treatment, and leave-on product to finish. I recommend these treatments every 4-6 weeks if possible. If this is not within your means, come when you can. Something is better than nothing.
If you ask any good aesthetic practitioner whether it be an aesthetician, cosmetic dermatologist, aesthetic nurse, or plastic surgeon they will tell you that the use of multiple modalities always produces better results than doing your favorite treatment repeatedly. Treating with different modalities creates different types of injury that produce differing degrees of collagen stimulation. Mixing it up also allows us to treat multiple layers of the epidermis and dermis. That means cellular turnover, pore refinement, texture and tone improvement, pigment reduction, fibroblast and collagen stimulation, and elastin contraction. We simply cannot accomplish all of these things with one tool, and certainly not in one treatment. Let your provider know that you want to develop a year long plan of action and discuss the best options for your skin’s unique needs.
Try exchanging your regular facial treatment for a BBL photofacial, Salt Facial or a microneedling (don't worry, we'll use numbing cream to keep you comfortable, we're not that cruel). They are easy to work into your routine as there isn’t much in the way of interruption to lifestyle. They have little to no downtime depending on the person’s skin and the degree of correction needed. At the most you might have 24 hours of no makeup and then 48 hours of what I call "social downtime" meaning you might look a little beat up, but you can wear makeup to cover and you will feel fine to go about normal activity. For more intensive correction you could choose something more aggressive like Scarlet SRF, or AGNES RF. These are radio frequency devices that lift and contract deep tissues in the skin and stimulate collagen production to tighten and redensify the skin. These treatments have a little more downtime, and require a bit more planning, but come with more visible results. Then there are the big guns! Laser resurfacing, AGNES RF for facial contouring and fat reduction, and NeoGen Plasma Skin Regeneration are the tools used in our office for non-surgical facial rejuvenation. All of these in-office procedures come with downtime and need to be planned out in advance. You may be given medications for comfort and infection control and you may be required to have a driver. Post care may include additional visits to our office and extreme care must be taken in the days after your procedure to follow post care instructions. I have done some of these game-changing procedures so that I can educate those interested from the patient as well as the provider perspective. They aren’t the most fun, but we will mitigate discomfort, and the payoff is worth it!
My healing progression after Erbium resurfacing (5 days total, but most will take closer to 7)
If you’ve never done anything, and you have corrective work to do, then ideally your first year should look something like this: 1 big corrective treatment, 2-3 mid-level treatments and 4-5 maintenance treatments. Subsequent years should consist of 2-3 mid-level treatments and 5-6 maintenance treatments. If you are young or don’t need much in the way of correction, you can skip that first scenario and go straight to “subsequent years”. Keep in mind that collagen takes 3-6 months (yes, I said MONTHS) to build in the skin, so that means you’ll have to be patient. You didn’t get all that damage overnight, and it won’t get better overnight. As they say, good things come to those who wait. The bottom line is having your practitioner treat you with varying modalities will help get you optimal outcomes in your skincare journey. Now I’m going to go ice my cankle!
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