These are exciting times in dermatology.

The battle against the ageing process continues & indeed rages on. We have come along way. From the age of facelifts, to minilifts & other surgical methods to alleviate the signs of ageing, to the trend in more recent years of less invasive methods or non-surgical methods to rejuvenate the skin.

These too were fairly morbid, though often quite effective.

These techniques involved peeling the skin & chemically (phenol or fruit acids) or with Lasers, tightening & smoothening wrinkles or acne scars & open pores, giving a more youthful appearance.

However, they were morbid in that it would take about a week for the new skin to re-emerge, & then a further 2-4 months(for asian skins, 2-4 weeks for Caucasian skins) for the redness &  pigmentation to disappear. Not many of us can escape humanity for such long periods, known as the down time.

Finally the research & technologies to reduce this down time has born fruit.

The age of deep tissue tightening is upon us.

The TITAN (from Cutera tech ltd, USA) is the first to be launched late last year(2004).  This uses a broad band of light at 1100-1900nm & a long pulse duration or dwell time on the skin  to penetrate deep into the dermis or deeper layer of the skin to cause tightening of collagen. Collagen is the protein that weakens as a result of sun damage or genetic ageing(as our parents age).

Having  deeper penetrance results in a lifting effect. The results are more evident after 2-3 sessions 3-4 weeks apart.

The best part is there is no down time as it spares the top layer of the skin & thus is also safe in people of colour like us in Asia.

Laser technology has come up with the novel idea of causing multiple penetrations of heat known as micro thermal zones or MTZs, going down to the dermis & thus slow cooking the collagen & reshaping it back to its more youthful configuration.

These MTZs spare the dead cell layer of the skin(stratum corneum) & allow new epidermis to re-emerge in a matter of hours. The patient thus looks a little red for several hours with mild swelling that may last a day or two only.

 Repeated sessions(around 4), 4 weeks apart may result in wrinkle diminution of around 50% or more depending on extent & depth.

This particular technology is currently being researched for the treatment of dyschromia  & melasma or the blotchy pigmentation of ageing  with some encouraging results, though to date with only a relatively small patient population.This particular system is known as the Fraxel (Reliant technologies,USA)& was only launched mid 2004.

Many variations on these theme will no doubt appear within the next couple of years as more hope emerges for graceful ageing.