Wrinkles

Why wrinkles form

Over the years, the dermis produces less collagen, and UV light damages the collagen and elastic fibres that remain. The skin becomes thinner, and lines that at first appeared only with facial expression stay visible at rest. At the same time, the skin loses firmness and folds form along the jawline. Dynamic wrinkles such as frown lines are usually treated with botulinum toxin and are not covered here.

Wrinkles in the skin itself: fractional lasers

A fractional laser creates a grid of narrow columns in the skin. The intact skin in between lets the treated areas heal quickly and lay down new collagen. A non-ablative laser heats the columns without opening the skin; an ablative laser vaporises the tissue within them.

The Mosaic 3D (Er:glass, 1550 nm) and the LaseMD Ultra thulium laser (1927 nm) are non-ablative. The Mosaic 3D reaches into the dermis; the LaseMD Ultra works more superficially and also improves dull skin tone and pigmentation. In a comparative study, wrinkles improved more with non-ablative 1550 nm Er:glass, the Mosaic 3D's wavelength, than with an ablative fractional Er:YAG laser. This approach takes more sessions, each with a short recovery.

On the ablative erbium fibre laser UltraClear, coagulation is adjustable alongside ablation, so treatment ranges from light to deep resurfacing. After a deeper treatment, recovery usually takes around five days. The CO₂ laser eCO2 3D leaves the most heat around each column, so the surrounding collagen contracts as well. The trade-off is the longest recovery: according to Cynosure Lutronic, redness after deeper resurfacing can last a week or longer. In darker skin, post-inflammatory hyperpigmentation (PIH) is the main risk of ablative treatment.

Folds from skin laxity: tightening with radiofrequency

A fold caused by laxity needs heat in a larger volume of tissue, without opening the skin. That is what monopolar RF provides: the current flows from a single electrode on the skin through the dermis and the connective tissue beneath it, heating that volume. The collagen contracts immediately and is remodelled over the following months, so tightening continues to improve. Because RF does not act on melanin, skin colour plays a much smaller role.

The XERF uses two frequencies and three depth modes, continuously measures the impedance of the skin and cools the surface during treatment. In one study, the eyebrow and upper eyelid were measurably higher one and three months after treatment. Redness and swelling usually resolve within a day. The XERF suits mild to moderate laxity of the jawline, the cheeks and the skin around the eyes, in patients who want to be back to normal quickly.

In RF microneedling with the Genius, insulated needles deliver the current into the dermis at a chosen depth. Because the needles also create tiny wounds, the treatment addresses texture and fine lines as well as laxity. Redness and swelling settle within a few days.

Wrinkle treatment in your practice

If you mainly see patients with fine lines and photodamage who want little downtime, a non-ablative laser such as the Mosaic 3D is a logical first step. If you also want to treat deeper wrinkles, the UltraClear or the eCO2 3D adds ablative treatment. If you see many patients with a lax jawline or cheeks, the XERF complements this without needles. Some practices also combine the XERF with the LaseMD Ultra, in a separate session, for texture and pigmentation.

We will go through your patients and your existing equipment with you. After installation, we provide clinical training, treatment protocols and technical support. You can buy a device outright or lease it.