Main trend

Superficial peels are the most common, as they have no down time and allow efficient results in few sessions on wrinkles, skin radiance and brown spots

What is it?

A chemical exfoliating technique

• Used for the treatment of certain cutaneous disease conditions or for aesthetic improvement.
• Application of one chemical exfoliating agent to the skin resulting in destruction of the epidermis and/or dermis.
• Stimulates the regeneration of new epidermal and dermal tissues.

The main peels

3 main types of PEELS depending on the depth of penetration of the active ingredients in the skin :

1- SUPERFICIAL PEELS
Destruction of part /or all epidermal layer : glycolic acid AHAs, Jessner's solution, Salicylic Acid BHA, Lipo-Hydroxy-Acid LHA

2- MEDIUM DEPTH PEELS
Destruction down to papillary dermal layer TCA 15 to 30%

3- DEEP PEELS
Destruction of layers into the reticular dermis : Carbolic acid (Phenol) & high TCA > 30%

Main trend

About less invasive techniques

Phototherapy technique derived from Laser expansion

• Fractional Laser
• IPL : Intense Pulsed Light
• LED : Light Emitting Diodes

What is it?

Light Amplification by the Stimulated Emission of Radiation
Monochromatic source of light with high intensity

Any type of laser (CO2, Erbium, Resurfacing, …) is defined by several characteristics :

• Wavelenght (λ)
• Transmission type : continuous, plused or ultra-pulsed
• Power : from a few mW (LED) to thousand of Watts.

Advantages: selectivity of the target in order to be the more efficient with the less side effects
Ablative and Non-ablative Lasers -less invasive- are distinguished.

The main lasers:

Fractional methods (example : FRAXEL)
Technique
Fractional photothermolysis: Low Power Infrared Laser generating micro-areas of cutaneous thermic damages and acting directly on the core of derma, preserving general aspect of epiderma at the same time. These little healing areas are renovated by better quality structures.
3 to 5 necessary sessions for a treatment
Indications
Cutaneous aging
Acne scars
Melasma?

IPL
Technique
A large wavelength spectra is delivered (vs Laser that delivers only one wavelength) with different targets according to the filters used : follicle, vessels, pigmentations, …
5 to 7 necessary sessions for a treatment
Indications
Epilation
Rejuvenation, Lentigo, vascular lesions, …
Acne, Scars
Photodynamic therapy : actinic keratosis treatment simultaneaously associated with 5-ALA/Levulan.
Light source usually used could be replaced by IPL essentially for aesthetic indications.

LED
Technique
Low power Laser (1 to 10 mW), non-ablative and non-thermic, which induces a biological response to light = photomodulation.
Would activate synthesis of cellular energy (ATP) and other substances, would stimulate collagen development (pro-collagen I) and would reduce its degradation (decrease of MMP1).
A lot of sessions are necessary for a treatment.
Indications
- Chrono and photo-induced cutaneous aging signs (yellow and red):
Improvement with time and iteration of treatments.
- Acne (blue => antibacterial effect by stimulation of natural production of levulonic acid)
Would activate healing

Main trend

The trend is towards resorbable products injected through less traumatic small needles. Hyaluronic acid and botulinium toxin are the most commonly used products

What is it?

Sub-cutaneous injection of a absorbable -or not- product, to minimize wrinkles or redensify derma (filling)

The main injections

botulic toxin injections
to clear expression wrinkles, improve oval of face, have a serene and fresh look. 2 to 3 sessions per year are recommended. This treatment could be efficient in the neck, for crow's feet and lip lines.
The efficient results are visible from 2 to 5 days after the injection.

injections of fillers :
to clear aging wrinkles, minimize nasolabial lines and increase lip volume. Effects are and immediate and permanent.

• Hyaluronic acid is now est the most used, for all known indications: vertical lip and nasolabial lines, lips, volume and face contour. It is currently prefered to collagen because it is not allergen (no pre-required test).
• Calcium hydroxylapatite and poly-l-lactic acid
  are also used.

non-absorbable product injections :
these products contain different polymers (derived from acrylic, polyacrylamid obtained by polymerisation of acrylamid or of polymethylmethacrylate microspheres -PMMA) associated with water or collagen. They are mostly indicated in reconstructive surgery cases.