Combination of Dermabrasion and Percutaneous Collagen Induction

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 remain even when the muscles are relaxed.

Dermabrasion is a surgical procedure where the outer skin layers are removed by abrading to where some disorganization of the papillary to midlevel dermis is seen. 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 hyperpigmentation. But if the surgeon does not go deep enough you will see very little improvement. Some wrinkles are so deep that the surgeon must stop removing tissue even if there is some aspect of the wrinkle that will remain, to prevent hypo-pigmentation of 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 minimally-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.

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 highlight 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.

Ultraviolet 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, and esters, 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.

I recommend the use of 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 compared to 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 is 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 cytokines.

These factors stimulate the formation of embryonic connective tissue, not scar tissue. This procedure consists of making multiple tiny perforations in the skin. There is no scarring with this procedure. It is called needling with a pen. This procedure can also be used as a stand-alone 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 the mechanical device, with numerous needles whose depth of punctuation for different skin thicknesses can be controlled. The process is actually quite simple but amazing at the same time.

Thousands of miniscule penetrating wounds are caused in 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 at extremely high rates due to the huge number of micro-channels caused by this process.

The combination of controlled trauma to the dermis and the supply of external agents cause optimal natural collagen and elastin production and deposition of collagen on the epidermal junction.

The results obtained by these types of procedures are relatively of short duration, 3-6 years. Scar is continuously being remodeled to reduce tension. This is going on with every scar as long as you are alive.