Combination of Dermabrasion and Percutaneous Collagen Induction

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Do you have prune wrinkles in your lips? Does lipstick tend to run into these wrinkles? Have you smoked for several years? Do you have significant acne scars?

You have wrinkles because the collagen in the dermis has become inelastic and stiff. Wrinkles that normally occur with animation become fixed and are there even when the muscles are relaxed.

Dermabrasion is a surgical procedure where the outer skin layers are removed by abrading to where you start to see some disorganization the papillary to mid level dermis. It takes experience for the surgeon to know when he needs to stop. Any wound that is deep enough will result in at least temporary hypo-pigmentation. But if you do not go deep enough you will see very little improvement. Some wrinkles are so deep that you have to stop removing tissue even if there is some aspect of the wrinkle that will remain to keep from hypo-pigmenting the skin.

Dermabrasion is most often used to improve the look of facial skin left scarred by accidents or previous surgery, or to smooth out fine facial wrinkles, such as those around the mouth. It is also sometimes used to remove the pre-cancerous growths called keratoses.

Dermabrasion is a non-invasive skin care maintenance treatment. It is especially good for patients with thicker, oily skin prone to keratin accumulation.

Dermabrasion improves deep scars and wrinkles, and is the most effective treatment for acne scars. Essentially, the skin is "sanded" to soften sharp edges or surface irregularities. The result is a smoother skin appearance.

I believe you need to have a holistic approach when you are trying to improve the appearance of your skin because healthy skin is beautiful skin. In treating wrinkles and scars you need look beyond a particular modality of treatment and understand what has caused the problem. There are many reports in medical literature that point out the fact that as we age the levels of Vitamin A, C, and other antioxidants become deficient in our skin. These are needed for optimal healing after a surgical procedure. Ultra violet light destroys these essential vitamins. Vitamin A is a fat soluble vitamin and your liver will release only the amount needed for systemic health. Too much vitamin A systemically is toxic and will make you very ill. We are stuck having to apply it topically to care for our skin. Vitamin A has a role in skin that it does not have anywhere else in your body. In the 80's Retin A was supposed to be the answer. Retin A is vitamin A acid and vitamin A acid controls DNA in the skin´s nucleus. Topically vitamin A acid is very irritating and poorly absorbed. You do not have to apply vitamin A acid. Vitamin A comes as the acid, an acetate, an alcohol, and a palmitate form. If any of these other forms is able to cross the barrier and enter the skin, the skin will convert it to what other chemical form it needs including the acid form.

My approach is to have the patient use Environ skin products for at least 6 weeks before any skin surgical treatment. I have seen better patient outcomes after they have used these products than any other products I have used in my practice during the past 30 years. These products contain vitamin A, C, and other antioxidants in a non-irritating form that are readily absorbed.

All laser resurfacing, intense pulsed light treatments, fractional laser treatments etc., obtain their results by causing scarring in the dermis. Scar remodels to reduce the tension across it. This why the results of these treatments deteriorate with time. I frequently combine dermabrasion with a procedure that increases platelet derived growth factor, platelet factor 4, platelet binding proteins, chemokines and cytokins. These factors stimulate the formation of embryonic connective tissue, not scar tissue. This procedure consists of making multiple tiny perforation in the skin. There is no scarring with this procedure. It is called Percutaneous Collagen Induction. This procedure can also be used as a standalone procedure on any area of the body. The results are similar to that of an erbium laser resurfacing.

What is Percutaneous Collagen Induction?

Percutaneous Collagen Induction is the process during which we initiate the physiological collagen production of the dermis without causing any permanent damage to the epidermal layer of the skin. The best way to achieve this is by using a roller, with numerous needles of 0.5mm length. This process has been formerly described as skin needling. The process is actually quite simple but amazing at the same time.

By using the appropriate roller multiple times, back-and-forth in a star-like fashion over the whole area to be treated, thousands of miniscule wounds are caused on the dermis. At the same time, epidermal channels are opened. The physiological reaction of the dermis to this miniscule injury is collagen production. At the same time, we will supply the skin with specific serums with nutritional factors and vitamins, which are absorbed directly down to the dermis on extremely high rates due to the huge number of micro-channels caused by the roller. The combination of controlled trauma to the dermis and the supply of external agents, causes an optimal natural collagen production and deposition of collagen on the epidermal junction.

Dermabrasion is often performed in combination with Percutaneous Collagen Induction to achieve the best overall results. I would be pleased to sit down with you and discuss your concerns and give you my perspective on how to treat your problem.