Minimally-invasive treatments like dermal fillers, botulinum toxins and lasers are often sought after today by both men and women. With these treatments, we can combat visible signs of ageing such as volume loss, wrinkles, fine lines and pigmentation, enabling us to put our best face forward.
While each treatment targets specific indications, many of them work synergistically with each other. Because of this, aesthetic physicians often combine two or more treatment modalities to yield optimal results for their patients.
Fillers and toxins
Hyaluronic acid (HA) dermal fillers are an integral part of anti-ageing aesthetic medicine. Because of its ability to absorb water (up to 200x its size), HA fillers can restore lost volume, increase plumpness and provide deep hydration when injected into the skin. This results in more visible, effective and longer-lasting results than even the most expensive topical creams. HA dermal filler brands include Restylane, Juvederm, Belotero and Teosyal.
Another injectable, botulinum toxin type A, is also a popular go-to treatment for reducing the appearance of wrinkles such as glabellar or furrow lines between the eyebrows. When injected, botulinum toxin type A releases a neurotransmitter called acetycholine, which reduces or prohibits the muscle’s ability to contract, smoothening out the skin above it as a result.
According to Dr Lam Bee Lan, medical director of Ageless Medical in Singapore, “When administered in the right dosage by an experienced medical practitioner, botulinum toxin type A has the ability to reduce the appearance of wrinkles, without compromising the patient’s facial expressions.” Botulinum toxin type A is marketed under brands such as Botox, Dysport and Xeomin.
For the past nearly two decades, aesthetic physicians have been using a combination of botulinum toxin A and HA fillers to accentuate patients’ facial features and rejuvenate their skin in a way that appears natural.
Skin healers based on PN and PDRN
One revolutionary injectable in the aesthetic physician’s toolbox is a skin healer based on polynucleotides (PN) and polydeoxyribonucleotides (PDRN), known as Rejuran.
When injected into the skin, it encourages the skin to regenerate key components that deteriorate with age, such as collagen, while stimulating cell growth and wound-healing. This improves the skin’s elasticity, tone and texture while balancing its oil and moisture levels.
According to Dato’ Dr Liow Tiong Sin from Signature Clinic in Kuala Lumpur, Malaysia, “One of the unique attributes of PN/PDRN healers is its synergistic effects when used in combination with other treatments such as HA fillers or lasers for skin rejuvenation. Some studies also show that PN has the ability to reverse signs of ageing in greying hair and wrinkles around the eyes.”
Rejuran’s anti-inflammatory and advanced wound-healing properties make it especially suitable for those who suffer from chronic inflammation of the skin such as acne scars or even eczema. In addition to reducing wrinkles, it can also reduce pigmentation and prevent the formation of scars.
Energy-based treatments such as lasers are the go-to option for those who do not want to go under the needle (or knife) to look good.
Lasers work by creating miniscule injuries on the skin, stimulating the skin to replace damaged tissue from these injuries with new cells, and produce new collagen. However some lasers can cause side effects such as hyperpigmentation, which can be minimised and even eliminated with next-generation devices such as PicoLO and QuadroStar ProYellow.
Using wavelengths of 1064nm and 532nm, PicoLO utilises picosecond laser technology that delivers ultra-short bursts of energy to the skin in trillionths of a second (picoseconds), impacting the targeted layer of skin like a shockwave. This makes it safer to use and capable of more precise applications than earlier-generation nanosecond lasers that use photothermal (heat) energy. Because PicoLO delivers energy at very consistent or stable levels and speeds, energy enters and leaves the skin more quickly than other picosecond lasers, minimising side effects, pain and damage to the skin.
PicoLO can be used in the treatment of pigmentation disorders such as lentigo, melasma and freckles, reducing acne scars, fine lines and wrinkles, correcting scars, tightening pores, removing tattoos, and rejuvenating the skin.
Meanwhile, QuadroStar ProYellow uses yellow light of 577nm wavelength, which has been found to be efficient and safe in treating facial melasma in Asian women with Fitzpatrick skin types 3 to 4. Because the 577nm wavelength has a lower melanin absorption level compared to the 532nm wavelength (previous generation green-light lasers), the treatment has been found to be safe for darker-skinned patients without the risk of developing post-treatment hyperpigmentation.
ProYellow is effective in treating a variety of skin conditions ranging from haemangiomas (strawberry marks), stubborn dilated capillaries which often present as telangiectasia (spider veins), warts, pigmented lesions, lentigines, acne scars and blemishes, and even hormonally-induced skin conditions such as melasma which is known to be difficult to treat.
In many cases, doctors prescribe a combination of laser and injectable therapies to address various indications, to provide the best possible treatment outcomes.