Both dermatologists and cosmetic surgeons have a variety of advanced and direct techniques they regularly employ to combat the effects of photoaging. Taking a look behind the doors of one such practice, dermatologic surgeon Rebecca A. Kazin, M.D., F.A.A.D., Washington Institute of Dermatologic Laser Surgery, Washington, D.C., offers her practice pearls for the techniques she uses on her patients’ faces to turn back these undesirable effects of time.
From the perspective of photoaging prevention, Dr. Kazin emphasizes that the strategies for maintaining skin health align with society’s desire for a youthful appearance. “They, fortunately, go hand-in-hand. The treatments we recommend for photoaging prevention are great for maintaining skin health. Sunscreen, topical antioxidants, and retinoids are all great to prevent photoaging while promoting healthy skin.”
When treating the effects of photoaging, Dr. Kazin opts for a direct, yet minimally invasive strategy. “Regarding my peers, I think we all have our favorite techniques and tend to go to them first,” she says. “I tend to do a lot with injectables, then add laser. I have many colleagues who go to laser first.”
For Dr. Kazin, the type of treatment depends on the age of the patient as well. In younger adults Dr. Kazin will use lasers to treat the effects of photoaging. “For those aged 20 to 30, I am generally recommending lasers to treat any redness or discoloration on face or chest from prior sun exposure,” she says.
In those patients who are approaching their middle-age years, Dr. Kazin works on brightening the skin tone and addressing the formation of lines and wrinkles.
“Typically I start neuromodulators in the 30 to 40 year old to give a more refreshed appearance and prevent deepening of the lines between the brow and on the forehead.”
Patients who are older can experience volume loss, which can contribute to the aging effect. “Volume loss and the need for fillers increases in those 40 and older,” Dr. Kazin said. “I focus primarily on the midface to restore youthful facial proportions.”
Although elderly skin tends to be thinner and frail, Dr. Kazin still employs a direct approach to the aging face. “In patients 60 and older, I focus on ‘cleaning the canvas’ and typically recommend non-ablative resurfacing treatments to globally soften dyspigmentation, fine lines, and wrinkles.”
In terms of the future from a clinical perspective, Dr. Kazin believes the next generation of treatments will build on current technology with further improvements. For example, she believes laser hair removal will be done successfully on white or blond hair, and we will see the development of laser treatments to attempt to cure acne.
In the end, Dr. Kazin reminds us that beauty is dependent upon something more than aging. “Studies reveal that humans regard facial symmetry as beautiful,” she said. “Sometimes, subtle enhancements that simply restore facial symmetry can have a maximum impact.”