PEER-REVIEW | HAND REJUVENATION | Technology has evolved from painful procedures that
required significant downtime to non-painful, non-invasive
procedures with no downtime and effective results.
stimulate fibroblasts, which leads to collagenesis. This
combination increases blood perfusion to the treatment area, supporting fibroblast activity and the rejuvenation process as a whole69
. The Isōlaz system (Solta Medical,
Inc., Hayward, CA, USA) allows for manipulation of the optical characteristics of the skin by incorporating a vacuum to pull the dermis closer to the surface of the skin then exposing it to light, which improves the efficiency of energy transmission70–72
.
Key points . This allows the
physician to treat the target area with lower wavelength light and lower fluences, increasing efficacy and decreasing patient discomfort73
The Polaris WRA™ (Syneron Medical Inc.) device
uses both bipolar RF energy and diode laser at 900 nm to simultaneously treat rhytides and skin laxity. The RF energy penetrates the skin, heating deeper tissues and inducing neocollagenesis, while the diode laser targets pigmentation and vascular issues that are more superficial74
. Yu et al compared the Polaris device to
ReFirme ST™ (Syneron Medical, Inc.), which uses bipolar RF energy to supplement infrared laser at 700–2000 nm and induce non-painful skin tightening by remodelling dermal tissue without damaging the epidermis75, 76
. Although there were no statistically
significant differences between the two devices for general skin improvements, histopathological changes showed a higher collagen fibre density after treatment with the Polaris WRA. Furthermore, there were statistically significant improvements in the cheek, jowl and nasolabial folds with Polaris WRA and in the nasolabial folds treated with ReFirme ST75
32 ❚ . October 2013 |
prime-journal.com
■ Rejuvenation of the hands is an important consideration since the appearance of the hands tends to show more significant photoageing than a person’s face
■ Technology has evolved from painful procedures that required significant downtime to non-painful, non-invasive procedures with no downtime and effective results
■ Intense pulsed light (IPL) devices target both dyspigmentation and vascularity, resulting in an overall improvement of photodamage
■ Light emitting diodes (LED) have been shown to have anti- inflammatory properties and accelerate wound healing with no reported side effects
■ Radiofrequency techniques cause collagen shrinkage with skin tightening due to increased penetration depth
Conclusions The face and hands receive the most exposure to sunlight throughout a person’s lifetime, and therefore show the most photodamage in the form of dyspigmentation, texture changes, wrinkles and loss of volume. Although the majority of aesthetic dermatologic treatments target the face, rejuvenation of the hands to treat photoageing is also an important consideration. Technology has evolved from painful procedures that required significant downtime to non-painful, non- invasive procedures with no downtime and effective results. Specifically, light and RF-based technologies continue to be implemented and improved on to achieve the optimum degree of photorejuvenation for the aesthetic patient. These procedure can be combined with volume replacement using fillers or fat to yield optimal hand rejuvenation outcomes.
Declaration of interest Dr Nestor serves on the advisory
board as well as being a speaker, consultant, and investigator for Medicis Pharmaceutical Corporation, and he is a consultant and investigator for Ulthera and Erchonia Corporation. Additionally, Dr Nestor has been a consultant, investigator and has served on the advisory board for Galderma. Dr Newberger has no conflict of interest to declare.
Figures 1 © Solta Medical, Inc., 2 and 3 © Dr Mark S. Nestor Article references on page 34
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