Aging vs. Hyaluron

ditulis 26 Jul 2015 09:53:57 PM

Supple Skin without Syringe and Scalpel Vista No.6/September 2009 Beauty and Medicine

Increasingly, looking young is very important in our society. Happily, surgery is no longer the only option for people who like to take a few years off their appearance. Lotions moisturize the skin so that it looks plump and supple again.

Miriam Rothlisberger

Interview with

WolfgangThurlimann, MD

FMH Dermatology and Venerology, Allergology and Clinical Immunology, Angiologyand Laser Medicine FMCH

Forchstrasse 55, 8032 Zu?rich (Switzerland) Telephone: 41 (0) 443833300 www.laserpraxis.ch

Beauty and a youthful appearance seem to matter more and more. Many people therefore opt for cosmetic treatments. How would you describe the people who come to you?

Most of my patients come to me because I am a specialist in dermatology and allergology. There is a connection between people’s exposure to the sun and many skin diseases as well as to skin aging. Sun exposure accelerates skin aging. Age and sun-related skin changes therefore share part of their causations. People don’t like these skin changes and want me to reverse them. They come from all walks of life because the treatments don’t exactly cost a fortune. Women notice the first signs of skin aging around age 35 when the first small wrinkles show up. Men usually see me around age 45. They mostly complain about pigmented macules (liver spots, brown spots).

The hyaluronic acid content in skin decreases as we age. This is considered one of the major reasons for the wrinkle formation. How does this work?

Skin aging is a complex process. Various functions are deregulated and as a result individual skin compounds become scarce. This affects mainly the collagen and elastin contents, which keep our skin supple and tight. Also reduced is the hyaluronic acid content and with it the moisture regulator in our skin. This moisture however is needed to keep skin firm and smooth. The outward signs of the hyaluronic acid deficit are wrinkles and duller looking skin.

Hyaluronic acid occurs naturally in skin. Skin filler formulations containing hyaluronic acid are therefore well tolerated and well suited for filler injection underneath wrinkles.

Hyaluronic acid treatments are available as injectable solutions and in the form of skin lotions. I have problems understanding how the hyaluronic acid penetrates into the deeper skin layers.

It is quite true, topically applied hyaluronic acid does not penetrate the skin far enough to reach the same deeper skin layers as injected hyaluronic acid. However, it is taken up by the upper skin cells, the epidermis. These cells respond by taking up and storing more water. Trial applications of hyaluronic acid lotions demonstrated that this leads to firmer and smoother skin where surface wrinkle were clearly visible before.

Are there also topical agents in the form of lotions, which can boost the hyaluronic acid synthesis by the skin cells themselves?

Saponins were shown to effectively stimulate the hyaluronic acid synthesis in human skin. They arenaturally occuring plant glycosides. Studies revealed that saponins can stimulate the synthesis of hyaluronic acid inside aging skin by 256 percent.

What are your criteria for recommending either skin injections or lotions?

As indicated above, lotions provide mostly the top layer of the skin, the epidermis, with additional hyaluronic acid. This increases the cell water content and therefore makes these top layer skin cells more supple and firmer and wrinkles are less prominent. Lotions are applied daily to aging skin when wrinkles first appear. Deeper wrinkles should be treated with injections of hyaloronic acid- containing formulations into the deeper layers of the skin.

However, the basic strategy against age-related skin deterioration is prevention. This means consistently avoiding the damaging effects of nicotine and UV radiation.

Today, many very effective sun screen lotions with pleasant properties are available. It is best to stay in the shade around noon when the UVA and UVB rays are too intense.

What other filling or generally rejuvenating methods are available today?

Many age-related skin changes can be reversed using gentle yet very efficient laser treatments. Dilated capillaries and age spots can be treated using IPL (intense pulse laser) techniques. Fractional lasers are used to treat coarsely structured skin. The newest generation of ablation lasers make it possible to even remove deep wrinkles, especially wrinkles above the upper lip. Radiofrequency radiation (RF) improves sagging skin by stimulating the generation of new collageneous tissue.