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Skin Rejuvenation - All you need to know

Many stories of our lives leave their marks on our skin: stress lines, scars and even lines of laughter. So, the decision of skin rejuvenation treatment must be extremely personal and tailored to achieve your goals. Skin rejuvenation offers several avenues to restore freshness and vitality of youth.

Skin Maintenance and Chemical Peels
Some of us are simply interested in a refreshed look. This can be easily achieved by daily use of sunscreens and topical retinoids at night (if tolerated). Occasionally, we need to promote turnover of skin cells by targeting the top layer of skin using the time-tested method of peeling. Gentle chemical peels made of glycolic acid or more potent TCA peels can improve appearance by removing some superficial skin to erase dullness. Another method of exfoliation, microdermabrasion uses ultra-fine aluminum oxide crystals to selectively remove dead layers of skin. This process simultaneously stimulates production of elastin and collagen to effectively promote development of a firmer, more youthful looking skin.
As we progress through life, we might want ‘to turn back time’ and look 10 years younger. Fortunately, treatment options for this dramatic rejuvenation are manifold and can be tailored to one’s goals, age, lifestyle and even ability to tolerate downtime. A treatment plan may incorporate several different modalities: skin resurfacing techniques; laser removal of pigmented spots; laser skin tightening; strategic use of synthetic fillers, volumizers and Botox injections.

Skin Resurfacing for Dramatic Results
Skin resurfacing devices, like the paragon carbon dioxide - CO2 laser, effectively deliver dramatic results. They use controlled damage to trigger the skin’s healing response, a process that eventually leads to skin remodeling and improvement in various signs of aging. Laser resurfacing offers a precise, effective and long-lasting approach to skin rejuvenation. Since this technique directs short and concentrated pulsating beams of light at irregular skin, laser skin resurfacing removes skin very precisely. Specially designed pulsed CO2 lasers can vaporize skin layer-by-layer while causing minimal damage to untargeted skin tissue. While fractional resurfacing with Fraxel uses a very narrow column of light to heat layers of the skin to stimulate collagen production, the cool light of erbium laser treatments facilitate removal of uneven pigmentation and superficial roughness from aging and sun-damaged skin. Plasma resurfacing is a relatively new technology that delivers plasma, a high energy ionized gas, through the epidermis into the deeper layers of the skin where collagen production is stimulated. Indeed, CO2 lasers, erbium lasers and plasma devices can deliver dramatic results in a fractional, ablative or non-ablative manner with downtime inversely correlated to the number of treatments needed.

Skin Tightening
Skin tightening will further enhance the effects of skin resurfacing and are built in with CO2 laser treatments. When length of healing is a concern, radiofrequency can be used to tighten the skin, albeit the results may not be as reliable or long lasting.

Skin Luminosity - Brown, Sun, and Age Spots Treatment
Luminosity of the skin has been shown to directly correlate with a youthful appearance. Most rejuvenation plans therefore incorporate removal of brown/age/sun spots. If downtime with CO2 or erbium laser resurfacing are unacceptable, treatments including a range of laser or non-laser intense pulsed light sources (IPL) may be chosen. Many skin problems of adulthood, such as fine lines, blotchiness, age spots (liver spots, dark spots), surface roughness, wrinkles, and dull, lifeless skin, can be attributed to sun exposure. The unique ability of specific lasers and IPL to specifically target pigment in the skin results in safe, effective and rapid treatment of unsightly skin lesions that have brown pigmentation.

Wrinkle Treatment - Fillers - Botox , Restylane, Elevesse, Radiesse, and others
Stubborn wrinkles and fine lines often require more help than is available at the cosmetics counter. Modern technology has provided an array of fillers and volumizers that can be used over the entire face to strategically and effectively correct static lines and volume loss. In recent years, several new skin fillers have received approval by the U.S. Food and Drug Administration (FDA) for treating facial wrinkles and are safe and effective options for combating aging skin. Wrinkles are thought to result from the loss of three crucial skin components: collagen, elastin and hyaluronic acid through external and internal ageing. Cosmetic injectables offer a variety of safe, non-invasive ways to subtly optimize one's appearance. Injection procedures with synthetic fillers have revolutionized aesthetic medicine and made cosmetic enhancements safe, easy and affordable. Of particular interest, the synthetic fillers (e.g. Restylane/Juvederm, Elevesse, Radiesse, Artefill and Sculptra) represent a new generation of alternatives to animal-based collagens. These newer products are more versatile in their weights and densities, biocompatible and longer lasting. Injectable fillers can be used to round out wrinkles, lines, and scars, or even to subtly give the face a more desirable shape.
In certain cases, treatment plans might also take advantage of removers of dynamic lines, like Botox, and fillers for volume restoration. Botox cosmetic acts as a safe, reliable medication, which blocks the actions of certain nerves. For wrinkles this means relaxing the muscles that crease the skin or pull the skin down.

Skin Rejuvenation - Summary
Clearly, skin rejuvenation can be effectively customized to individual treatment plans by combination of different modalities ranging from laser, light and other energy-based treatments to injectable fillers, volumizers, chemical peels and other non-ablative methods. The result is a smootherArticle Submission, clearer and healthier and more radiant skin.
A personalized treatment plan of pertinent modalities to skin rejuvenation is a veritable route to maintain youthful vitality throughout life.

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Dr. Ringpfeil's medical career began in Germany where she graduated from medical school and started training in dermatology. In 1990, she was invited by the chairman of dermatology at Thomas Jefferson University to join his department. After completing residency and receiving board certification, she joined the faculty at Jefferson, specializing in cosmetic and pediatric dermatology.

She has authored numerous scientific papers in major professional journals, authored and co-authored several chapters in the leading textbooks for dermatology, and has lectured both nationally and internationally.

She received the Young Investigator Award by the American Academy of Dermatology, as well as an award by the AOA honor society for outstanding teaching faculty.

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