Anti-Wrinkle Treatments

Anti-Wrinkle Treatments

The high UV index in Brisbane contributes to premature wrinkling of the skin. Laser resurfacing and collagen treatments are aimed at stimulation of collagen and replacing loss collagen respectively.  Anti wrinkle relaxants are aimed at reduction of muscle movements which contributes to wrinkling.

  • Wrinkles maybe broadly classed into two groups.  Dynamic winkles which are exaggerated with muscle movements and static wrinkles which occur at rest.
  • Dynamic wrinkles can be treated with anti-wrinkle injections however static wrinkles which occur at rest can be treated with dermal fillers, chemical peels and laser.
  • Static wrinkles around the forehead and smile lines can be prevented by anti-wrinkle injections.
  • Fine lines can be prevented with sunscreen and Vitamin A prescriptions.

Wrinkles can be a combination of both intrinsic and extrinsic factors.

Intrinsic ageing:  This term refers to the universal age related change that occurs with everyone. With age; gravity takes effect therefore deepening lines and increasing skin laxity. There is a steady decrease in dermal collagen and elastin; the building blocks of the skin. Fine lines are early signs of intrinsic aging.

Extrinsic ageing: UV damage is the major cause of wrinkling especially in Queensland. Years of accumulated solar exposure will predispose to uneven texture, pigmentation, and fine wrinkling of exposed areas. With time, wrinkles will deepen and intensify.  UV radiation decreases the thickness of the upper layers of the skin and also fragment collagen and elastin. Both these structures form the scaffolding of the skin, and help prevent wrinkles. The is a gradual loss of skin tone over time, correlating to a reduction in collagen and elastin.

Smoking may also contribute to wrinkling, especially on the upper lip area creating what is known as smoker’s lines.

The initial step in wrinkle management is careful clinical examination by a Dermatologist to ascertain which type of wrinkling the skin exhibits. By observing muscle movements and assessing skin tone and texture, we would be able to accurately assess the contribution of both dynamic and static wrinkles.

The aims of wrinkle treatments are threefold-

  1. Treat dynamic wrinkling
  2. Address static wrinkles and replace loss of dermal volume.
  3. Prevent further UV damage, reduce future extrinsic aging and slow down intrinsic aging.

Dymanic wrinkles are due to muscle movement which in turn gives rise to wrinkles. In many cases wrinkles maybe exaggerated by dynamic muscle movements. Examples of this include frown lines, forehead lines (appear when look up) and crows feet (smile to reveal lines radiating from the eye area). The aim of treatment is to reduce muscle tone in the groups of muscles exaggerating the expression. Anti-wrinkle treatments such as anti-wrinkle injections can dramatically reduce dynamic wrinkling.

Anti-wrinkle injections can dramatically reduce dynamic wrinkles around the frown lines (wrinkles between the eyebrows), crow’s feet (wrinkles around the eyes) and smokers lines (wrinkles around the mouth). This treatment is effective with a safety record spanning 20 years.

What are anti-wrinkle injections?

Anti-wrinkle injections are a natural, purified protein that relaxes wrinkle-causing muscles creating an improved cosmetic appearance. The active ingredient is a muscle relaxant obtained from the bacteria and is manufactured in sterile laboratory conditions. Due to the effects of this product anti-wrinkle injections are a prescribed only medication.

How do anti-wrinkle injections work?

The active ingredient in the anti-wrinkle injection binds to nerve endings and prevents the release of chemical transmitters that activate muscles. This way, the natural, purified protein relaxes the muscles that cause wrinkles.

This process may take upto 2 weeks for the maximal effect to be seen. After a few months the nerve endings usually grow new connections to the muscles and the effect wears off. The injections are typically repeated about two to three times a year, as directed by your Dermatologist.

What does treatment with anti-wrinkle injections involve?

The first step is to have a consultation with a consultant dermatologist. They will evaluate whether anti-wrinkle injection therapy is appropriate for you, discuss the expected outcome, and answer any questions you may have.

Anti-wrinkle injections are a non-surgical treatment for wrinkles. A small amount of substance is injected into the selected facial muscles with a very fine needle. Discomfort from injections is minimal and brief and comparable to an ant bite.  Ice application or anaesthetic cream can be applied ½ hour prior to the procedure to minimize discomfort.

Slight redness at the injection site is frequently seen, but this usually fades within a few hours. Makeup, if desired can be worn after the anti-wrinkle injection procedure. Results are usually seen after a week, however may take upto 2 weeks for the full effect to become apparent.

How long do anti-wrinkle injections last?

Anti-wrinkle injections last, on average, three months to four months in most patients. With repeat anti-wrinkle injection treatments the effect tends to last longer as muscles weaken over time.

Are anti-wrinkle injections safe?

Anti-wrinkle injections are safe, with a track record of over 20 years. In fact the same proteins used in anti-wrinkle injections are commonly used in much higher doses to treat children with cerebral palsy to reduce muscle spasms and lazy eye syndrome.

Are there any precautions that I need to take after being treated with anti-wrinkle injections?

Normal activities can be resumed soon after treatment, however, there are some basic precautions that should be taken to reduce risks of side effects and obtain the best results from your treatment.

  • Ice may be applied to the treated area to help reduce discomfort, swelling and bruising
  • Try to exercise your treated muscles for the first hour after treatment. If you forget, it will not impact on your treatment negatively
  • Do not lie down or do strenuous exercise for 4 hours after treatment
  • Do not have a facial, nor rub or massage the treated areas for 24 hours after treatment

As this is a cosmetic procedure there is no claimable Medicare rebate for this treatment.

Dermal fillers can be helpful for wrinkles and creases in the lower half of the face, particularly the crease running down from each side of the nose to the corners of the mouth. They are a safe, non-surgical and effective method of lifting, rejuvenating and shaping the face.

What are dermal fillers?

Dermal fillers are used to fill or replace loss volume due to the reduction in skin collagen and elastin. Fillers provide an immediate dose of collagen and ground substance, instantly filling hollows, furrows, wrinkles and lines. Westside Dermatology use fillers consisting of a natural substance called hyaluronans and is allergy free.

What areas can be treated?

  • Lips
  • Smile creases
  • Cheeks
  • Frown lines, creases and wrinkles
  • Acne and chickpox scars

What does the procedure involve?

After a consultation with one of our cosmetic injectors, we will discuss and advise on how dermal fillers may be suitable for you, including what filler to use, what area to treat, and most importantly discuss the expected outcome, duration of results and costs.

The procedure itself involves multiple fine injections to the treatment area. We often use a combination of ice and a numbing cream prior to the injections, reducing the discomfort to a manageable level. The procedure takes between 20 to 40 minutes depending on the treated area.

What will I look like after the treatment and how long will the results last?

Immediately after the filler procedure, you can expect slight redness and swelling which is absolutely normal. This inconvenience is temporary and settles within a day or two. Light make up maybe applied the following day if desired. The majority of patients feel comfortable enough to resume their work and normal activities after treatment. Bruising may develop a day or two after fillers, but will settle over 3-5 days.

The longevity of fillers will depend on the areas treated, and the type of fillers used. On average, it can last 6-8 months, however much like one’s metabolic rate, there is also an individual variation in the longevity of fillers in different people.

What is the best dermal filler for me?

Westside Dermatology offers a variety of temporary fillers, each suited to different applications. Our Cosmetic Injectors will advise you on which dermal filler is best, depending on the location, longevity and results you desire.

**Westside Dermatology do not perform Permanent Fillers due to the increased risks of serious side effects and complications.

Can dermal fillers be combined with other treatments?

Absolutely! Fillers are only one arm of the rejuvenation process. Fillers are frequently combined with anti-wrinkle injections, which relax the underlying muscles. Balance is the key to natural facial rejuvenation. Apart from treating loss volume, the use of fractionated laser and TCA peels can improve skin texture, tone and clarity.

More on dermal fillers

The technical advances in laser and refinements in technique have made laser treatment a standout treatment of fine lines through to deep wrinkling. With laser treatment other visible signs of aging are also treated including; uneven texture and pigmentation and loss of skin tone.

What types of lasers can be used for wrinkles?

Laser maybe performed as full resurfacing – a combination of Erbium and CO2, or as fractionated laser resurfacing (Fraxel). Fractionated laser resurfacing has the added advantage of reducing recovery times, however several treatments may be required.

Treatment parameters and technique will depend on the degree of photodamage, the extent of wrinkling and the recovery time allowed. A detailed examination and discussion of treatment options is essential for optimal results.

Fractionated laser has provided a revolution in the treatment of facial rejuvenation. Fractional lasering induces thousands of micro-punctures whilst leaving surrounding tissues intact. This allows the skin to heal much faster than if the entire skin was treat at once (old school laser resurfacing). Fractionation stimulates collagen production in addition vaporizing both superficial and deep pigmentation. It promotes the skin’s healing process to create new, tighter tissue with improved skin texture.

What are the main advantages of  Fraxel or Fractionated Laser Therapy?

ProFractional has the unique ability to penetrate very deep into the skin, but with very little heat damage to surrounding tissue.  This combination allows for efficacious collagen remodeling (due to the deep treatments) and a high safety margin (due to low thermal damage) on all skin types.  This combination makes ProFractional one of the safest, yet most effective resurfacing lasers available today.

What areas of the body can be treated?

Most skin areas can be treated.  Popular treatment areas are the face and neck, although many people also treat the décolletage and hands.  Your laser practitioner can adjust the laser settings appropriately for the specific area being treated.

How long will it take to recover?

Complete healing typically occurs within a few days and most patients usually feel comfortable enough toget back to normal activities and apply makeup a day or two after the treatment.  There may be some swelling that which will subside within several days following the treatment.

When should I expect results?

As your skin heals in the days following your treatment, you may notice a general tightening effect. However, the true benefit of most fractionated devices is the collagen remodeling will take up to 4 to 6 months to fully heal following your treatment.  It may therefore take several months to see maximum benefit from your treatment.

More on Fractionated laser treatments

TCA peeling is an effective method of treating sundamage, pigmentation, freckling and wrinkles. Chemical peels such as TCA remove the upper layers of the skin, but also induce collagen remodelling which works to improve both skin texture and skin tone.

What is a TCA peel?

TCA (Trichloroacetic acid) peels are a time tested method of treating sundamage, uneven skin texture, and decreased skin tone. Peeling with TCA gives a predictable response and result.  The procedure takes approximately 10-15 minutes to perform and is conducted in one of our operating theatres.  Generally one to three peels are conducted over six to ten weeks.

What is the recovery of TCA peels?

Recovery from TCA peels depends on two important factors; the concentration of TCA used and also the site of treatment.  The most common concentration used is between 20-25% for the face, with a typical recovery time of 6-8 days.  TCA peels of the chest area generally take longer to heal; 10-12 days in total.

What conditions can be treated with TCA peels?

TCA peels can be an excellent method of treating skin pigmentation and uneven skin texture.  Conditions such as freckles, sun-damage and melasma can be successfully treated by TCA peels. In addition higher strength TCA peels can improve wrinkles and increase skin tone. In higher concentrations of TCA; dermal collagen is stimulated – which accounts for the improvement in tone and wrinkle reduction.

This treatment is ideal for heavy sun-damaged skin and stubborn pigmentation

More on TCA peels

More on Chemical peels

Glycolic and lactic acid peels can reduce fine wrinkling.  Peels conducted on site at Westside Dermatology and typically start from 20% through to 70%. Preparations can be purchased which provide a maintenance plan to use at home.  This is usually teamed with Tretinoin for superior results.   Alpha Hydroxy Acids increase dermal collagen by stimulation of fibroblasts (cells which produce collagen).

What are Alpha Hydroxy Acid (AHA) peels?

This peeling agent is the most commonly used chemical peel and is frequently referred to as the ‘lunch time peel’. Side effects are uncommon, recovery is quick (within an hour or two), and the procedure is affordable.  Our peel concentration starts at 20% and typically ends at 70%.  We recommend a series of peels spaced between 2-3 weeks apart.

How do AHA peels differ from TCA peels?

Alpha hydroxy acid peels are gentle peels with little or no downtime and is ideal for superfical pigmentation and correction of very fine wrinkles. TCA (Trichloroacetic acid) peels are aimed at reaching the deeper layers of the skin. Depending on the concentration, a downtime of upto 6-8 days can be expected for TCA peels on the face. This peel is ideal for deeper and more severe pigmentation and more severe wrinkling.

How are chemical peels performed?

All forms of chemical peeling are conducted on site at Westside Dermatology. Patients are assessed by a specialist practitioner prior to any peel to determine the skin type and the best agent/concentration. Glycolic acid peels are conducted by experienced Registered Nurses and TCA peels are conduced by consultant Dermatologist.

How will I know what chemical peel is right for my condition?

Several important factors come into consideration as to what treatment is best for you.  Trained Registered Nurses consider factors such as the patient’s skin condition, the degree and depth of pigmentation, acne, sun-damage, skin type, and the recovery or downtime allowable.  Additionally we may provide other options apart from chemical peels to best treat your condition.

What is the difference between chemical peels conducted at other centers and peels prescribed at Westside Dermatology?

Chemical peels at Westside Dermatology are performed by experienced Registered Nurses or specialist Dermatologists. All patients are carefully assessed prior to prescription of a peel. Our selection of 5 types of chemical peels with varying concentrations enables us to prescribe an accurate regime for your condition.

Chemical peels conducted at Westside Dermatology can be far stronger than that conducted at beauty therapist or day spas. Our accessibility and experience treatments such as Fractional lasers, BBL and PDT will also provide patients with the best treatment options for their condition.

More on chemical peels

Prevention of wrinkles can be achieved by reducing extrinsic factors such as UV exposure and smoking.  Sunscreen forms the basis of UV protection, additionally anti-oxidants such as Vitamin C.

Dermatologist often prescribe topical retinoids such as Tretinoin. Retinoids can stimulate collagen production as well as increase the thickness of the epidermal layers, in turn diminishing fine visible wrinkles.  Unless there are contraindications, we suggest the nightly use of retinoids in your skin care regime. Prescription retinoids are approximately 100-1000 times higher in concentration then over the counter products.  This prescription typically cost less than $30 to fill, and lasts upto 4 months!

The treatment of wrinkles is only one aspect of aging; preventing wrinkling and photodamage is the foundation for the future.  A Dermatologist can guide you in regards to sensible product use and provide an unbiased assessment of your daily regime.  Wrinkles rarely occur in isolation – professional assessment of your skin tone and texture with appropriate treatments will give a natural, balanced and harmonious outcome for our patients.

Treatments Dynamic wrinkle reduction Static wrinkle reduction Effects on skin texture
Anti-wrinkle injections +++++ ++ Nil
Laser treatment + +++ +++++
Fillers ++ ++++ Nil
TCA peels +++ ++++
Glycolic peels + ++

Dr Davin Lim
Consultant Dermatologist

Dermatologists have an array of treatment options to treat wrinkles at Westside Dermatology.  The progress of fractionated lasers over the past few years has given patients a new modality to treat wrinkles and address rejuvenation, providing consistently excellent results with minimal down time.

Addressing wrinkling is only one part in treating the ageing skin. The treatment of photodamage, skin texture, and pigmentation will give clients a better outcome.