Press Room

The market is booming with surgery-free skin-tightening treatments, but are they really the answer to smoother, firmer skin while improving the quality of it? Although the verdict is still out– some experts tout them as the next best thing while others feel they offer very little improvement ¬– with the different technologies out there and what concerns they may really be able to fix are questions many face.

What are skin-tighteners?
A noninvasive doctor administered procedure, skin tighteners are machines that employ one of two types of energy (radiofrequency or infrared light) to tighten the skin below the surface by eating the dermis, causing inflammation and a small injury, which makes existing collagen contract and new collagen to be produced. While there is a variety of different brand names, all skin tighteners utilize at least one of the technologies mentioned above; some even combine the two together.

How skin tighteners work?
Historically, plastic surgeons and dermatologists observed that ablative lasers tightened the skin – from there, a whole crop of nonablative skin-tightening machines came to the market. “CO2 lasers were used primarily for wrinkle reduction on the face, and they tightened the skin to some degree. How long the results lasted were debatable,” says Dr. Goldberg. But CO2 lasers (which use carbon dioxide) couldn’t be used on the body because of potential scarring. “Some of the first lasers used for skin tightening (CO2) achieved significant tightening, but do so at the expense of increased thermal damage, prolonged healing and redness,” says Montclair, NJ, plastic surgeon Barry DiBernardo, MD. Modern-day devices are targeted strictly at tightening without damage to the outer layer of skin and with no downtime. Other current devices make small wounds in the skin, leaving the surrounding skin intact, for longer healing.

Skin tighterners can prompt new collagen to form, and all follow this basic premise: Thermal (heat) energy is delivered beneath the skin to safely injure the dermis. An inflammatory response is initiated, which stimulates the activity of fibroblasts (the cells that create collagen).

How does the machine work?
First the skin is cooled with either a cooling tip or a built in plate to prevent burning. “You’re inundating the skin with heat, so the cooling mechanism makes the treatment more comfortable and helps prevent blistering,” says Dr. Goldberg.

Second, energy/heat is quickly emitted and passed deep down to the cells that are responsible for creating collagen. The skin is then cooled again to prevent burning.

Third, the bottom layers of the skin react to the heat, causing a slight injury and inflammation that signals the existing collagen to contract and for new collagen to be made.

Fourth, new collagen is signaled to be made over the next 90 days, which is about how long it takes to see results. Some patients don’t see results for up to six months, while other see little, if any, change.

Radiofrequency Technology (Uses heat and energy): These treatments use nonablative radiofrequency energy (electric and magnetic energy coupled with radio waves) in short yet intense pulses to oscillate through the skin and deliver heat to the dermis (the deepest layer of skin) at low temperatures without damaging the epidermis (the uppermost layer of skin). The level of heat can also be adjusted with these treatments to further target the deeper layers of the dermis.

Infrared Technology (Uses light): Light-based lasers are attracted to chromophores, naturally occurring substances in the skin. Since water is a chromophore – and a dominant one that lasers are drawn to – the laser heats the water in the skin to cause inflammation. “Just the right wavelength need to be used so that the water in the skin is heated and not other chromphores like hemoglobin or melanin, which will result in adverse side effects,” says Dr. Pozner. Infrared-based machines don’t damage the epidermis, which is why some doctors choose to use them on areas that are known to scar.

Infrared+Radiofrequency (Combining forces): Some skin tighteners combine radiofrequency energy with other modalities, like infrared light. But in order to really gauge which treatment you’ll best benefit from, seek out a qualified center which has access to several different technologies. “This is not a one-size-fits-all type of treatment, and, in my opinion, there is not one single system available that’s going to target all of your concerns.” Dr. Alster says. “It’s really a matter of mixing and matching the different technologies to get the best results.”

New Beauty – Spring/Summer 2010