Noninvasive Facial Rejuvenation. Part 1: Patient-Directed

Abstract

A proper knowledge of noninvasive facial rejuvenation is integral to the practice of a cosmetic surgeon. Noninvasive facial rejuvenation can be divided into patient- versus physician-directed modalities. Patient-directed facial rejuvenation combines the use of facial products such as sunscreen, moisturizers, retinoids, α-hydroxy acids, and various antioxidants to both maintain youthful skin and rejuvenate damaged skin. Physicians may recommend and often prescribe certain products, but the patients are in control of this type of facial rejuvenation. On the other hand, physician-directed facial rejuvenation entails modalities that require direct physician involvement, such as neuromodulators, filler injections, laser resurfacing, microdermabrasion, and chemical peels. With the successful integration of each of these modalities, a complete facial regimen can be established and patient satisfaction can be maximized. This article is the first in a three-part series describing noninvasive facial rejuvenation. The authors focus on patient-directed facial rejuvenation. It is important, however, to emphasize that even in a patient-directed modality, a physician's involvement through education and guidance is integral to its success.

Keywords

photoaging - noninvasive facial rejuvenation - skin care - patient-directed facial rejuvenation

• References

• 1 Guyuron B, Rowe DJ, Weinfeld AB, Eshraghi Y, Fathi A, Iamphongsai S. Factors contributing to the facial aging of identical twins. Plast Reconstr Surg 2009; 123 (4) 1321-1331
• 2 Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol 2001; 54 (3) 176-186
• 3 Hubbard BA, Unger JG, Rohrich RJ. Reversal of skin aging with topical retinoids. Plast Reconstr Surg 2014; 133 (4) 481e-490e
• 4 Palm MD, O'Donoghue MN. Update on photoprotection. Dermatol Ther 2007; 20 (5) 360-376
• 5 El-Domyati M, Attia S, Saleh F , et al. Intrinsic aging vs. photoaging: a comparative histopathological, immunohistochemical, and ultrastructural study of skin. Exp Dermatol 2002; 11 (5) 398-405
• 6 Reenstra WR, Yaar M, Gilchrest BA. Aging affects epidermal growth factor receptor phosphorylation and traffic kinetics. Exp Cell Res 1996; 227 (2) 252-255
• 7 Lewis KG, Bercovitch L, Dill SW, Robinson-Bostom L. Acquired disorders of elastic tissue: part I. Increased elastic tissue and solar elastotic syndromes. J Am Acad Dermatol 2004; 51 (1) 1-21 , quiz 22–24
• 8 Sunscreen FAQs . (n.d.). Available at: https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs . Accessed May 6, 2016
• 9 Reinau D, Osterwalder U, Stockfleth E, Surber C. The meaning and implication of sun protection factor. Br J Dermatol 2015; 173 (5) 1345
• 10 Neale R, Williams G, Green A. Application patterns among participants randomized to daily sunscreen use in a skin cancer prevention trial. Arch Dermatol 2002; 138 (10) 1319-1325
• 11 Moyal DD, Fourtanier AM. Broad-spectrum sunscreens provide better protection from solar ultraviolet-simulated radiation and natural sunlight-induced immunosuppression in human beings. J Am Acad Dermatol 2008; 58 (5) (Suppl. 02) S149-S154
• 12 Draelos ZD. Active agents in common skin care products. Plast Reconstr Surg 2010; 125 (2) 719-724
• 13 Spencer TS. Dry skin and skin moisturizers. Clin Dermatol 1988; 6 (3) 24-28
• 14 Friberg SE, Ma Z. Stratum corneum lipids, petrolatum and white oils. Cosmet Toilet 1993; 107: 55-59
• 15 Grubauer G, Feingold KR, Elias PM. Relationship of epidermal lipogenesis to cutaneous barrier function. J Lipid Res 1987; 28 (6) 746-752
• 16 Duell EA, Aström A, Griffiths CE, Chambon P, Voorhees JJ. Human skin levels of retinoic acid and cytochrome P-450-derived 4-hydroxyretinoic acid after topical application of retinoic acid in vivo compared to concentrations required to stimulate retinoic acid receptor-mediated transcription in vitro. J Clin Invest 1992; 90 (4) 1269-1274
• 17 Griffiths CE, Russman AN, Majmudar G, Singer RS, Hamilton TA, Voorhees JJ. Restoration of collagen formation in photodamaged human skin by tretinoin (retinoic acid). N Engl J Med 1993; 329 (8) 530-535
• 18 Fisher GJ, Kang S, Varani J , et al. Mechanisms of photoaging and chronological skin aging. Arch Dermatol 2002; 138 (11) 1462-1470
• 19 Samuel M, Brooke RC, Hollis S, Griffiths CE. Interventions for photodamaged skin. Cochrane Database Syst Rev 2005; (1) CD001782
• 20 Kang S, Bergfeld W, Gottlieb AB , et al. Long-term efficacy and safety of tretinoin emollient cream 0.05% in the treatment of photodamaged facial skin: a two-year, randomized, placebo-controlled trial. Am J Clin Dermatol 2005; 6 (4) 245-253
• 21 Clark III CP. Office-based skin care and superficial peels: the scientific rationale. Plast Reconstr Surg 1999; 104 (3) 854-864 , discussion 865–866
• 22 Tran D, Townley JP, Barnes TM, Greive KA. An antiaging skin care system containing alpha hydroxy acids and vitamins improves the biomechanical parameters of facial skin. Clin Cosmet Investig Dermatol 2015; 8: 9-17
• 23 Ramos-e-Silva M, Celem LR, Ramos-e-Silva S, Fucci-da-Costa AP. Anti-aging cosmetics: facts and controversies. Clin Dermatol 2013; 31 (6) 750-758
• 24 Fabi S, Massaki N, Goldman MP. Efficacy and tolerability of two commercial hyperpigmentation kits in the treatment of facial hyperpigmentation and photo-aging. J Drugs Dermatol 2012; 11 (8) 964-968
• 25 Herndon Jr JH, Stephens TJ, Sigler ML. Efficacy of a tretinoin/hydroquinone-based skin health system in the treatment of facial photodamage. Cosmet Dermatol 2006; 19 (4) 255-262
• 26 Babilas P, Knie U, Abels C. Cosmetic and dermatologic use of alpha hydroxy acids. J Dtsch Dermatol Ges 2012; 10 (7) 488-491
• 27 Gensler HL, Magdaleno M. Topical vitamin E inhibition of immunosuppression and tumorigenesis induced by ultraviolet irradiation. Nutr Cancer 1991; 15 (2) 97-106
• 28 Lin JY, Selim MA, Shea CR , et al. UV photoprotection by combination topical antioxidants vitamin C and vitamin E. J Am Acad Dermatol 2003; 48 (6) 866-874
• 29 Murad S, Grove D, Lindberg KA, Reynolds G, Sivarajah A, Pinnell SR. Regulation of collagen synthesis by ascorbic acid. Proc Natl Acad Sci U S A 1981; 78 (5) 2879-2882
• 30 Colven RM, Pinnell SR. Topical vitamin C in aging. Clin Dermatol 1996; 14 (2) 227-234
• 31 Pinnell SR, Madey DL. Topical vitamin C in skin care. Aesthet Surg J 1998; 18 (6) 468-470
• 32 Traikovich SS. Use of topical ascorbic acid and its effects on photodamaged skin topography. Arch Otolaryngol Head Neck Surg 1999; 125 (10) 1091-1098
• 33 Humbert PG, Haftek M, Creidi P , et al. Topical ascorbic acid on photoaged skin. Clinical, topographical and ultrastructural evaluation: double-blind study vs. placebo. Exp Dermatol 2003; 12 (3) 237-244
• 34 Junkins-Hopkins JM. Antioxidants and their chemopreventive properties in dermatology. J Am Acad Dermatol 2010; 62 (4) 663-665
• 35 Beitner H. Randomized, placebo-controlled, double blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoageing of facial skin. Br J Dermatol 2003; 149 (4) 841-849
• 36 Cerutti PA, Trump BF. Inflammation and oxidative stress in carcinogenesis. Cancer Cells 1991; 3 (1) 1-7
• 37 Sun Y, Oberley LW. Redox regulation of transcriptional activators. Free Radic Biol Med 1996; 21 (3) 335-348
• 38 Suzuki YJ, Forman HJ, Sevanian A. Oxidants as stimulators of signal transduction. Free Radic Biol Med 1997; 22 (1–2) 269-285
• 39 Cadet J, Douki T. Oxidatively generated damage to DNA by UVA radiation in cells and human skin. J Invest Dermatol 2011; 131 (5) 1005-1007
• 40 Kielbassa C, Roza L, Epe B. Wavelength dependence of oxidative DNA damage induced by UV and visible light. Carcinogenesis 1997; 18 (4) 811-816
• 41 Sander CS, Chang H, Salzmann S , et al. Photoaging is associated with protein oxidation in human skin in vivo. J Invest Dermatol 2002; 118 (4) 618-625
• 42 Graf J. Antioxidants and skin care: the essentials. Plast Reconstr Surg 2010; 125 (1) 378-383
• 43 Stojiljkovic D, Pavlovic D, Arsic I. Oxidative stress, skin aging and antioxidant therapy. Acta Fac Med Naissensis 2014; 31 (4) 207-217
• 44 Chen L, Hu JY, Wang SQ. The role of antioxidants in photoprotection: a critical review. J Am Acad Dermatol 2012; 67 (5) 1013-1024
• 45 Hoppe U, Bergemann J, Diembeck W , et al. Coenzyme Q10, a cutaneous antioxidant and energizer. Biofactors 1999; 9 (2–4) 371-378
• 46 Prahl S, Kueper T, Biernoth T , et al. Aging skin is functionally anaerobic: importance of coenzyme Q10 for anti aging skin care. Biofactors 2008; 32 (1–4) 245-255
• 47 Giovannini C, Filesi C, D'Archivio M, Scazzocchio B, Santangelo C, Masella R. [Polyphenols and endogenous antioxidant defences: effects on glutathione and glutathione related enzymes]. Ann Ist Super Sanita 2006; 42 (3) 336-347
• 48 Wang ZY, Huang MT, Lou YR , et al. Inhibitory effects of black tea, green tea, decaffeinated black tea, and decaffeinated green tea on ultraviolet B light-induced skin carcinogenesis in 7,12-dimethylbenz[a]anthracene-initiated SKH-1 mice. Cancer Res 1994; 54 (13) 3428-3435
• 49 Katiyar SK, Perez A, Mukhtar H. Green tea polyphenol treatment to human skin prevents formation of ultraviolet light B-induced pyrimidine dimers in DNA. Clin Cancer Res 2000; 6 (10) 3864-3869
• 50 Pacheco-Palencia LA, Noratto G, Hingorani L, Talcott ST, Mertens-Talcott SU. Protective effects of standardized pomegranate (Punica granatum L.) polyphenolic extract in ultraviolet-irradiated human skin fibroblasts. J Agric Food Chem 2008; 56 (18) 8434-8441
• 51 Bagchi D, Bagchi M, Stohs SJ , et al. Free radicals and grape seed proanthocyanidin extract: importance in human health and disease prevention. Toxicology 2000; 148 (2–3) 187-197
• 52 Saija A, Tomaino A, Trombetta D , et al. In vitro and in vivo evaluation of caffeic and ferulic acids as topical photoprotective agents. Int J Pharm 2000; 199 (1) 39-47
• 53 Palmer DM, Kitchin JS. A double-blind, randomized, controlled clinical trial evaluating the efficacy and tolerance of a novel phenolic antioxidant skin care system containing Coffea arabica and concentrated fruit and vegetable extracts. J Drugs Dermatol 2010; 9 (12) 1480-1487
• 54 Krinsky NI. Antioxidant functions of carotenoids. Free Radic Biol Med 1989; 7 (6) 617-635
• 55 Palombo P, Fabrizi G, Ruocco V , et al. Beneficial long-term effects of combined oral/topical antioxidant treatment with the carotenoids lutein and zeaxanthin on human skin: a double-blind, placebo-controlled study. Skin Pharmacol Physiol 2007; 20 (4) 199-210
• 56 D'Souza G, Evans GRD ; Plastic Surgery Educational Foundation Technology Assessment Committee. Mexoryl: a review of an ultraviolet a filter. Plast Reconstr Surg 2007; 120 (4) 1071-1075
• 57 Gold M, Rendon M, Dibernardo B, Bruce S, Lucas-Anthony C, Watson J. Open-label treatment of moderate or marked melasma with a 4% hydroquinone skin care system plus 0.05% tretinoin cream. J Clin Aesthet Dermatol 2013; 6 (11) 32-38