What kind of treatment works to treat skin aging?

1. Treatment Modalities
for Skin Aging
Department of Dermatovenereology
Faculty of Medicine
Maranatha Christian University
Bandung
Peter Nugraha Soekmadji

2. Conflict of Interest Statement
• NO support or commercial funding for this
presentation or for any products mentioned
here

5. Cause of Skin Aging:
Understanding the Exposome

6. Skin Aging Exposome
The skin aging exposome. Krutmann J, Bouloc A, Sore G, Bernard BA, Passeron T. J Dermatol Sci. 2017 Mar;85(3):152-161. doi:
10.1016/j.jdermsci.2016.09.015. Epub 2016 Sep 28. Review.

7. UVR-Induced
Skin Inflammation
Atmospheric skin aging-Contributors and inhibitors. McDaniel D, Farris P, Valacchi G. J Cosmet Dermatol. 2018 Apr;17(2):124-
137. doi: 10.1111/jocd.12518. Review.

9. The skin aging exposome. Krutmann J, Bouloc A, Sore G, Bernard BA, Passeron T. J Dermatol Sci. 2017 Mar;85(3):152-161. doi:
10.1016/j.jdermsci.2016.09.015. Epub 2016 Sep 28. Review.

10. IR-Induced
MMP Expression
Low to moderate doses of infrared A irradiation impair extracellular matrixhomeostasis of
the skin and contribute to skin photodamage. Robert C, Bonnet M, Marques S, Numa M, Doucet O. Skin Pharmacol Physiol.
2015;28(4):196-204. doi: 10.1159/000369829. Epub 2015 Feb 10.

11. Infrared plus visible light and heat from natural sunlight participate in
the expressionof MMPs and type I procollagen as well as infiltration of inflammatory cell in human skin in vivo. Cho S, Lee MJ, Kim MS, Lee S,

12. Atmospheric skin aging-Contributors and inhibitors. McDaniel D, Farris P, Valacchi G. J Cosmet Dermatol. 2018 Apr;17(2):124-
137. doi: 10.1111/jocd.12518. Review.

13. Atmospheric skin aging-Contributors and inhibitors. McDaniel D, Farris P, Valacchi G. J Cosmet Dermatol. 2018 Apr;17(2):124-
137. doi: 10.1111/jocd.12518. Review.

14. Antioxidants Protect From
IR-Induced MMP Expression
Infrared radiation-induced matrix metalloproteinase in human skin: implications forprotection. Schroeder P, Lademann J, Darvin
ME, Stege H, Marks C, Bruhnke S, Krutmann J. J Invest Dermatol. 2008 Oct;128(10):2491-7. doi: 10.1038/jid.2008.116. Epub 2008
May 1.

15. Skin Aging & Air Pollution
Airborne particle exposure and extrinsic skin aging. Vierkötter A, Schikowski T, Ranft U, Sugiri D, Matsui M, Krämer U, Krutmann
J. J Invest Dermatol. 2010 Dec;130(12):2719-26. doi: 10.1038/jid.2010.204. Epub 2010 Jul 22.

16. Skin Aging & Smoking
Skin aging induced by ultraviolet exposure and tobacco smoking: evidence fromepidemiological and molecular studies. Yin L,
Morita A, Tsuji T. Photodermatol Photoimmunol Photomed. 2001 Aug;17(4):178-83.

17. Skin Aging & Smoking

18. Skin Aging & Nutrition
Dietary nutrient intakes and skin-aging appearance among middle-aged Americanwomen. Cosgrove MC, Franco OH, Granger SP,
Murray PG, Mayes AE. Am J Clin Nutr. 2007 Oct;86(4):1225-31.

19. Skin Aging & Stress
Psychological stress perturbs epidermal permeability barrier homeostasis:implications for the pathogenesis of stress-
associated skin disorders. Garg A, Chren MM, Sands LP, Matsui MS, Marenus KD, Feingold KR, Elias PM. Arch Dermatol. 2001
Jan;137(1):53-9.

20. Skin Aging:
Treatment Modalities

21. Spectrum of Options

22. Laser & IPL

23. Laser & IPL

24. Radiofrequency

25. HIFU

26. Multimodal Treatment:
The Future of Rejuvenation

27. Combination with Toxins
Are combined same-day treatments the future for photorejuvenation? Review of the literature on combined treatments with lasers, intense
pulsed light, radiofrequency, botulinum toxin, and fillers for rejuvenation. Cuerda-Galindo E, Palomar-Gallego MA, Linares-Garcíavaldecasas R. J
Cosmet Laser Ther. 2015 Feb;17(1):49-54. doi: 10.3109/14764172.2014.968578. Epub 2014 Oct 16. Review.

28. Combination with Fillers
Are combined same-day treatments the future for photorejuvenation? Review of the literature on combined treatments with lasers, intense
pulsed light, radiofrequency, botulinum toxin, and fillers for rejuvenation. Cuerda-Galindo E, Palomar-Gallego MA, Linares-Garcíavaldecasas R. J
Cosmet Laser Ther. 2015 Feb;17(1):49-54. doi: 10.3109/14764172.2014.968578. Epub 2014 Oct 16. Review.

29. Skin Aging:
Regional Multimodal Treatment

30. Upper Face
Consensus Recommendations for Combined Aesthetic Interventions in the Face UsingBotulinum Toxin, Fillers, and Energy-Based Devices.
Carruthers J, Burgess C, Day D, Fabi SG, Goldie K, Kerscher M, Nikolis A, Pavicic T, Rho NK, Rzany B, Sattler G, Sattler S, Seo K, Werschler WP,
Carruthers A. Dermatol Surg. 2016 May;42(5):586-97. doi: 10.1097/DSS.0000000000000754.

31. Mid-Face
Consensus Recommendations for Combined Aesthetic Interventions in the Face UsingBotulinum Toxin, Fillers, and Energy-Based Devices.
Carruthers J, Burgess C, Day D, Fabi SG, Goldie K, Kerscher M, Nikolis A, Pavicic T, Rho NK, Rzany B, Sattler G, Sattler S, Seo K, Werschler WP,
Carruthers A. Dermatol Surg. 2016 May;42(5):586-97. doi: 10.1097/DSS.0000000000000754.

32. Lower Face
Consensus Recommendations for Combined Aesthetic Interventions in the Face UsingBotulinum Toxin, Fillers, and Energy-Based Devices.
Carruthers J, Burgess C, Day D, Fabi SG, Goldie K, Kerscher M, Nikolis A, Pavicic T, Rho NK, Rzany B, Sattler G, Sattler S, Seo K, Werschler WP,
Carruthers A. Dermatol Surg. 2016 May;42(5):586-97. doi: 10.1097/DSS.0000000000000754.

33. Neck
Neck Rejuvenation Using a Combination Approach: Our Experience and a Review of the Literature. Vanaman M, Fabi SG, Cox SE.
Dermatol Surg. 2016 May;42 Suppl 2:S94-S100. doi: 10.1097/DSS.0000000000000699. Review.

34. Neck
Neck Rejuvenation Using a Combination Approach: Our Experience and a Review of the Literature. Vanaman M, Fabi SG, Cox SE.
Dermatol Surg. 2016 May;42 Suppl 2:S94-S100. doi: 10.1097/DSS.0000000000000699. Review.

35. Neck
Neck Rejuvenation Using a Combination Approach: Our Experience and a Review of the Literature. Vanaman M, Fabi SG, Cox SE.
Dermatol Surg. 2016 May;42 Suppl 2:S94-S100. doi: 10.1097/DSS.0000000000000699. Review.

36. Decollettage
Three-Dimensional Rejuvenation of the Décolletage. Peterson JD, Kilmer SL. Dermatol Surg. 2016 May;42 Suppl 2:S101-7. doi:
10.1097/DSS.0000000000000758. Review.

37. Arm
Rejuvenation of the Aging Arm: Multimodal Combination Therapy for Optimal Results. Wu DC, Green JB. Dermatol Surg. 2016
May;42 Suppl 2:S119-23. doi: 10.1097/DSS.0000000000000732. Review.

38. Hand
Hand Rejuvenation Using a Combination Approach. Butterwick K, Sadick N. Dermatol Surg. 2016 May;42 Suppl 2:S108-18. doi:
10.1097/DSS.0000000000000687. Review.

39. Leg
Leg Rejuvenation: A Combination Approach: A Review and Our Experience. Weiss M, Mahoney AM, Gold M, Lawrence N.
Dermatol Surg. 2016 May;42 Suppl 2:S131-8. doi: 10.1097/DSS.0000000000000753. Review.

40. Buttock & Thigh
Combination Therapy for Rejuvenation of the Outer Thigh and Buttock: A Review and Our Experience. Coleman KM, Pozner J.
Dermatol Surg. 2016 May;42 Suppl 2:S124-30. doi: 10.1097/DSS.0000000000000752. Review.

41. Pearls & Pitfalls
• Acute stress responses & chronic damage
responses drive the skin aging process
• Photoaging mainly results from daily exposure
to non-extreme, low doses radiation
• Various multimodal regimens offer more
effective results for suitable patients