This article is part of a special issue investigating key questions about skincare. Find the full series here.
Our skin inevitably loses some of its elasticity as we age. In the past, the main weapon against the wrinkles and sags 鈥� for those who could afford it 鈥� was to go under the surgeon鈥檚 knife. Today, there are a wealth of less invasive alternatives that promise to firm up and rejuvenate our skin 鈥� everything from Botox injections to devices that blast light or ultrasound into the skin, and even 鈥渧ampire鈥� facials, where blood extracts are injected into the face.
Given that healthy skin brings wider health benefits, do these 鈥渢weakments鈥� rejuvenate from the outside in? 鈥淭he question is, is this just vanity or are you doing anything that鈥檚 going to help your future self?鈥� says dermatologist at Guy鈥檚 and St Thomas鈥� Hospital, London. 鈥淚t depends on the type of treatment.鈥�
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Lost elasticity
Ageing comes with many transformations, but the primary cause of our wrinkles is a reduction in collagen and elastin, proteins that provide firmness and elasticity. Treatments such as Botox 鈥� injection of botulinum toxin to prevent muscles contracting 鈥� will do nothing to stop these changes, though they can be an effective way to prevent frown lines when injected into certain facial muscles. Likewise, injections of gel-like substances called dermal fillers beneath the skin can smooth wrinkles and add volume to sagging tissue, but don鈥檛 address the underlying structural changes, and come with risks.
Help could be at hand by other means, however. In recent decades, a , radiofrequency, ultrasound and intense pulsed light devices have been introduced that can ostensibly restore that youthful glow. Developed from treatments to promote wound healing and reduce scarring, these technologies all involve penetrating the outer layers of the skin to heat it from within.
鈥淚f you heat the skin up enough, you basically stimulate a kind of a wounding response,鈥� says Kiely, which then spurs the body to produce collagen and elastin to heal the damage. 鈥淪o you鈥檙e playing with the body鈥檚 ability to repair itself.鈥�
Tiny injuries
Another therapy, microneedling, in which tiny needles puncture the skin to create micro-injuries, is also based on these wound-healing principles.
High-quality, large-scale studies in this field are sorely lacking, but evidence suggests these treatments can , with noticeable effects on skin appearance. However, they need to be regularly repeated and the long-term benefits are unclear. 鈥淭he heat energy basically causes a tightening of the skin, but whether in the long run they鈥檙e beneficial, we don鈥檛 know,鈥� says Kiely, who is also founder of the skincare company .
An ideal treatment would also rejuvenate individual skin cells so that they resemble younger versions of themselves, through other changes in their biochemical processes. The most promising results so far come from led by at Stanford University, California, on the effects of intense pulsed light treatment on the skin of five women aged over 50. The treatment resulted in demonstrably less wrinkled skin, despite no increase in collagen or elastin levels, with the researchers reporting that 鈥溾�榬ejuvenation鈥� at a molecular level has also occurred, with a number of genes linked to the aging process being altered in expression after treatment to more closely resemble young skin鈥�.
Despite the hoopla, there is little evidence that vampire facials do or do not work
Search online and it is easy to find more outlandish ideas. A case in point is vampire facials, the colloquial term for platelet-rich plasma injections, which have garnered much recent media attention. In these, blood is taken from the arm and treated to extract components called platelets, which are then injected into your face to supposedly reduce wrinkles. 鈥淒espite the hoopla, there鈥檚 little evidence to show that it works 鈥� or doesn鈥檛 work,鈥� is the of the American Academy of Dermatology Association.
For now, the effectiveness of all these tweakments is rather vague. It is possible that some light or laser treatments can improve the strength of our skin, at least temporarily. But whether this can turn back our cells鈥� molecular clocks remains to be proven.
