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Improving Skin Surface & Texture

skin-surfaceApart from wrinkles and facial contours, the third ‘column’ of Aesthetic Dermatology aims to improve your skin surface and texture. Achieving an overall better ‘skin quality’ is equally as important as fixing lines and wrinkles to the overall appearance of your skin.

In one very interesting study, subjects were able to predict accurately a person’s age from photographs, which showed only a small area of their skin surface, but did not show the whole face. It has also been shown that irregular pigmentation not only makes others see you as older and less attractive, but surprisingly as less healthy, too. All this demonstrates the major difference that treating the skin surface and texture can make.

However, we have to understand that despite its importance, improving skin surface and texture with treatments, does not create the instant ‘wow’ effect that for example fillers and ‘botox’ offer. It is a gradual process with subtle effects, yet absolutely essential!

In our clinic we use a variety of bio-stimulatory procedures to improve fine lines and crêpy skin, improve skin elasticity, soften acne scars and shrink pores. All of the treatments below are ‘regenerative procedures’, meaning we ‘help the skin to help itself’, i.e. true bio-stimulation!

Please also have a look at the ‘Regenerative Dermatology’ section in the left hand menu to find out more about this exciting new area of Aesthetic Dermatology!

This regenerative treatment offers amazing benefits, not least of which is zero downtime! We use a Q-Switched Nd-YAG technology (Neodymium YAG) also known as the ‘Hollywood Facelift’ or ‘Clear Lift 4D’ in the media. This laser emits short, yet enormously powerful bursts of light that reach underneath the skin’s surface. Here, the light causes a photo-acoustic effect to create microscopic punctures in the dermis, which stimulates collagen and also helps fragment unwanted pigmentation in the skin.

Another distinctive characteristic of this laser is its fractional pattern, which means the laser beam creates microscopic ‘columns’ of skin regeneration, leaving untouched areas between the laser beams. This greatly lowers the risks of treatment, such as scarring.

This laser technology is non-ablative, meaning it leaves the skin surface entirely intact. The treatments leads to regeneration selectively in the deep backbone of our skin, the dermis, exactly where we need it for real anti-ageing benefits. Inducing controlled, microscopically small dermal wounds without injuring the overlying epidermis causes all stages of healing response and skin repair to happen beneath the unharmed skin’s surface – which means no downtime.

Our laser’s mechanism of action is somewhat similar to medical needling, but with the amazing difference that the thousands of micro-wounds and healing responses do not even touch, let alone puncture, the skin’s surface. This of course, makes this type of laser facial a true ‘lunchtime procedure’. And, as pigment isn’t its primary chromophore (molecular target) as it is for certain types of lasers, it’s safe for all skin types including dark skin. That’s because this laser gently shatters the unwanted pigment with shock waves, unlike conventional pigment lasers that are attracted by and heat up pigment specifically.
Best of all, it’s 100% painless, even without numbing cream. A course of six treatments at two week intervals will give the best results.

Carboxytherapy is another bio-stimulative treatment where we use your own skin’s ingenious ability to self-repair and renew to full advantage. As we get older, our capillaries (tiny blood vessels) and microcirculation in the skin greatly decline. It’s been reported that by the time we’re 30, oxygen levels in our skin have dropped by 25%, and further to a massive 50% by the age of 40. This is devastating for long-term skin health and wellbeing. Carboxy Facials boost our skin’s microcirculation, letting more oxygen and nutrients reach the skin to support skin regeneration with collagen and elastin remodelling and thus help offset a highly significant aspect of skin-ageing (and an often ignored one at that!).

Carboxytherapy works through the injection of tiny amounts of medical grade carbon dioxide (CO2) gas into the skin using a specialist device and a very fine needle. Eudelo’s Carboxy Facials are done after application of an effective numbing cream. The superficial injections essentially trick the skin into thinking it’s oxygen-starved, so it responds by dilating blood vessels and increasing blood flow to the area swiftly and powerfully. This increased circulation provides a surge of oxygen and other nutrients to the area treated for several hours.

In addition to the instant circulation boost, the temporary ‘oxygen starvation’ induced by carboxytherapy triggers the release of growth factors such as vascular endothelial growth factor (VEGF) which stimulates the production of new blood vessels (capillaries). These newly formed vessels, plus re-opened capillaries that had become dormant with ageing, assure improved microcirculation in the area long-term.

The Eudelo technique for Carboxy Facials is very different from standard forms of carboxytherapy, which we believe is one of the reasons for our superior results.

Cryostimulation uses the thermal shock of a cold temperature to bio-stimulate the skin. The thermal shock stimulates fibroblasts into producing more collagen and elastin, and also improves the oxygen supply to our skin, while leaving cells undamaged.

During the treatment, the skin is cooled down to about 5 degrees Celsius. Please note that a skin temperature of 5 degrees Celsius is very different from an air temperature of 5 degrees Celsius (people always ask, “would I not get the same effect in winter?”). In fact, to reach the target skin temperature of 5 degrees Celsius, we use a cold stream of –78 degrees Celsius (CO2) or –196 degrees Celsius (N2)! Once you have experienced cryostimulation, you know it’s very, very different from simple winter air… Pressurized CO2 gas devices add a further dimension to the procedure, pressure at 50 bar, which boosts lymphatic drainage and thermal shock effects, and makes the experience even more intense.

Cryostimulation helps slow the deterioration of the blood and oxygen supply to the skin, that comes with age, by improving the efficiency of our skin’s blood vessel network. During treatment, blood vessels contract and dilate which instantaneously boosts microcirculation to the skin for several hours after treatment and gives the network a strengthening ‘workout’, similar to training our muscles.

Regular sessions improve local blood flow in our skin more long-term. With time the resulting higher pressure on the thin capillary walls will cause microvascular networks to branch out in order to accommodate the increased volume of blood circulation. That means that our skin’s microcirculation, oxygen and nutrient supply will fundamentally improve. Additional benefits of the treatment are that it improves lymphatic drainage and triggers the release of endorphins, our natural ‘happiness hormone’.

Make sure your cryostimulation is done with a device that continuously measures your skin temperature (contact-less) during treatment. The skin needs it to be cold enough to trigger biological changes, but not so cold that it damages the tissue.

We are able to treat many forms facial redness (erythema) and broken vessels (teleangiectasias) using Laser and IPL technology. A laser is essentially a high-energy beam of light with unique properties. Laser light consists of photons (light particles) all of which have the same wavelength. IPL light differs in that it emits a broader spectrum of light with multiple wavelengths.

Different wavelengths are absorbed preferentially by certain target structures in the skin (also referred to as chromophores). So, lasers and IPL devices can be used to specifically target certain chromophores. When treating skin redness and broken vessels, we use a device that targets haemoglobin (the red colour in erythrocytes, or red blood cells).

One of the very common chronic skin conditions that often appears with facial redness and thread veins is rosacea. The vascular aspect of rosacea tends to respond very well to laser and IPL treatment. However, if you also suffer with rosacea related breakouts, these need to be cleared by a dermatologist first!

Mesotherapy is a classic bio-stimulatory treatment. It is a wonderful treatment to ‘feed’ your skin and help improve overall skin quality. After application of an effective numbing cream, a sterile cell-boosting cocktail is ‘infused’ into the skin with a series of painless tiny, superficial injections.

The high-grade skin-nourishing blend contains more than 50 key skin optimization ingredients, ranging from vitamins and minerals to amino acids, hyaluronic acid, coenzymes, nucleic acid bases and antioxidants, proven to protect and stimulate skin cells.

Mesotherapy is very popular in Continental Europe such as in France, Italy and Germany, but hasn’t yet caught up in the UK. The treatment is suitable for the face, neck, chest and hands (men AND women). Depending on the individual case and treatment area our Doctor will carry out the treatments either manually or with a special ‘mesotherapy gun’ we brought in specially from Germany (only the best for our patients!).

The great thing about Mesotherapy is that it can be used not only to nourish and correct mature skin, but also as a preventative measure in younger patients. The ultimate skin ‘refresh’ and one of Dr Valeria’s favorite anti-ageing ‘weapons’!

Mesotherapy is done as course of four to six sessions (2-4 week intervals), before going on to a less intense maintenance treatment.

Bio-revitalisation with hyaluronic acid (‘HA Skin Boosters’) is a great treatment for improving skin texture and hydration and putting a lovely bit of plumpness back into the skin. It is particularly suitable for finer lines, crisscross lines, crinkling of the skin and overall loss of elasticity, for example on the cheeks.

In our clinic, we use a high-dose, stabilised hyaluronic acid with a proven efficiency and safety record. Scientific studies have proved that this type of stabilised hyaluronic acid not only enhances the visible appearance of the skin, but can also improve its elasticity. The treatment also has the ability to induce your skin’s own collagen production and has antioxidant effects.

Revitalisation with HA Skin Boosters is done as a course of three to six sessions at three to four week intervals. We perform the injection treatment after application of an effective numbing cream for pain prevention.

For even better results, HA Skin Boosters can be combined with growth factors and medical needling (‘GF Gel Needling’), see below.

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Magnified view of the skin surface before (left)
and after (right) bio-revitalisation with HA Skin Boosters.

Medical needling is a wonderful, completely natural anti-ageing treatment that ‘helps the skin to help itself’. Instead of injecting any substances into the skin, this treatment only involves an advanced automatic needle pen (‘DermaPen’) or a needle roller (‘DermalRoller’), which is equipped with sterile, ultra-fine needles.

Medical needling mechanically mimics the effects of fractionated laser technologies by creating microscopically small punctures in the dermis, where our collagen lives. This intentional injury induces thousands of tiny, controlled wound-healing responses in this deep layer of the skin. Consequently, growth factors are released and fibroblasts are stimulated into synthesizing new skin matrix, including collagen. In time, this will lead to a firmer, more elastic skin with more refined skin surface. As we get older, our skin gets ‘lazy’ and collagen production slows down. With medical needling, we give the skin a gentle nudge to remind it to keep making fresh collagen – bio-stimulation in its true sense.

The great thing about medical needling is that we can induce effects in the deeper layer of the skin (the dermis) without having to fully strip the protective outer layer (the epidermis). Why is it so important to stimulate the dermis? Dr Stefanie calls the dermis the ‘backbone’ of the skin – the layer of collagen-containing connective tissue where the most prominent skin ageing processes take place. With needling we can reach the dermis without significantly damaging the epidermis. The superficial punctures introduced close again quickly, which is important since the epidermis protects our body from water loss and environmental damage.

Medical needling also helps with enlarged pores and acne scaring (or chicken pox scaring). However, any active acne has to be successfully treated before this can be started! And if a patient has been taking Isotretinoin tablets (e.g. Roaccutane®), we usually need to wait for six months before starting a procedure like this.

Medical needling is not a single treatment, but has to be done in a course of three to six sessions at six to eight week intervals. The procedure is performed after application of an effective numbing cream for pain relief.

For even better results, medical needling can be combined with an infusion of growth factors (‘GF needling’) or for anti-ageing purposes growth factors & HA Skin Boosters (‘GF Gel Needling’), see below.

You may have heard of needle-rollers for use at home. The highest quality, sterile micro-needles that we use in clinic are more than five times as long (1.5 to 3mm versus 0.2 to 0.3mm). Not surprisingly, they’re much more effective than home rollers in all respects. However, home rollers greatly enhance penetration of topically applied cosmetics and are thus a useful adjunct.

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Improvement of lines and skin elasticity after medical needling (before – left; after – right). The patient was looking for a ‘natural’ method of rejuvenation and did not want any ‘Botox’.

In order to further enhance the benefits of medical needling, we recommend combining the procedure with infusion of an advanced Growth Factor solution (´GF or PRP Needling´) or Mesotherapy solution (´Meso Needling´).

For our Meso Needling treatment, we use a high-grade skin-nourishing blend contains more than 50 key skin optimization ingredients, ranging from vitamins and minerals to amino acids, hyaluronic acid, coenzymes, nucleic acid bases and antioxidants, proven to protect and stimulate skin cells.

For the even more advanced GF / PRP Needling we use a highly effective, sterile solution containing a potent mix of various growth factors, to further encourage collagen and elastin production. The growth factors can be derived from your own blood (PRP, platelet rich plasma) or we use a commercially available growth factor solution, should you prefer this. In any case, the addition will super-boost your needling effects with even better results.

GF / PRP Needling is one of Dr Stefanie’s favorite bio-stimulatory procedures – she swears by it for her own skin also!

Here in our clinic, we pioneered the technique of combining bio-revitalisation using stabilised hyaluronic acid skin boosters with medical needling and infusion of growth factors (‘GF/PRP Gel needling’). What we have found is that due to their synergistic effects, these treatments work more powerfully in combination than when performed alone.

Our ‘GF / PRP Gel Needling Lift’ combines injections of HA Skin Boosters (see above) with GF / PRP needling performed immediately afterwards, where we infuse the skin with an advanced growth factor solution. The growth factors can be derived from your own blood (PRP, platelet rich plasma, see below for more information) or we use a commercially available growth factor solution, should you prefer this. In any case, the addition will super-boost your needling effects with even better results.

A ‘GF / PRP Gel Needling Lift’ works wonders to improve overall skin quality and help combat loss of facial skin elasticity. It puts some lovely plumpness back into your skin and also helps to refine the skin surface, gently add definition to the jaw line, shrink enlarged pores and improve depressed acne scaring.

If performed regularly it will help to slow down the skin’s ageing process over time. It’s the ‘Mercedes’ of our regenerative aesthetic procedures!

Platelet Rich Plasma (PRP) therapy of the skin, also known as the ‘Vampire facelift’ or ‘Dracula facelift’ is a revolutionary regenerative aesthetic treatment that encourages the skin to build more collagen and elastin and thus renew and rejuvenate itself – true bio-stimulation!

The treatment involves taking a blood sample from the patient, from which we then isolate a certain fraction of the blood, which is particularly rich in platelets. After application of a numbing cream for pain relief, this fraction of the patient’s own blood is injected back into the skin using a special technique.

Our Doctors use a special layered injection method, which places the PRP not only into the superficial skin itself to encourage collagen and elastin production, but also, if appropriate, into deeper tissue layers, with the aim of slowing down age-related tissue loss here also.

Platelets contain a high content of beneficial growth factors. Upon re-injection the platelets release these growth factors, which trigger surrounding skin cells to proliferate and stimulate collagen production, thus helping to repair and regenerate damaged tissue. Following a course of PRP treatment, your skin will gradually start to look more radiant and youthful.

PRP therapy is a great addition (or in some cases even alternative) to other non-surgical cosmetic treatments such as ‘botox’ and fillers. It’s considered a very natural treatment, as it uses the patient’s own cells and growth factors to stimulate tissue repair, rather than injecting synthetic substances. The initial course consists of three treatment sessions in monthly intervals.

In our clinic we perform TCA (Trichloroacetic acid) peels and different glycolic acid and salicylic acid (hydroxy acid) peels.

A TCA peel is a highly effective doctor’s peel, which is always performed by one of our Doctors. A TCA peel reduces the signs of sun damage with wrinkling and irregular pigmentation, and improves skin surface and texture.

There are different TCA strengths on the market. High strength TCA peels are performed as a one off treatment. They are very effective, but have considerable downtime and potential risks and side effects.

In our clinic we use a gentler type of TCA peel, which needs to be repeated four times, each at weekly intervals. After completing this course, you will achieve a similar end result to the higher strength TCAs, while having a lower risk of side effects. TCA peels work particularly well for slightly more mature skin with visible sun damage.

Our hydroxy acid peels are milder compared to our TCA peel, so may be more appropriate for younger patients or for patients who prefer not to have visible flaking after the treatment. All our hydroxy acid peels are bespoke and tailored to the individual patient and the needs of their skin.

Hydroxy acid peels are also great for patients with comedones (‘blackheads and whiteheads’) and a tendency for breakouts. We also perform a special type of glycolic peel for irregular pigmentation.

You will achieve a more refined skin surface with a fresher, more vibrant appearance and skin tone. The effects are much better than all home use peels on offer. Our hydroxy acid peels are usually performed six times, in 7 – 14 day intervals

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